DIABETES RESEARCH (© JCM Ltd)
CHINESE HERBS CAN HELP PREVENT DIABETES
A Cochrane database systematic review carried out by Australian authors has assessed the effects and safety of Chinese herbal medicines for the treatment of people with impaired glucose tolerance (‘pre-diabetes’). The researchers considered data from 16 clinical trials including 1391 people who received 15 different herbal formulations. Meta-analysis of eight trials showed that those receiving Chinese herbal medicines combined with lifestyle modification were more than twice as likely to have their fasting plasma glucose levels return to normal levels compared to lifestyle modification alone. Those receiving Chinese herbs were less likely to progress to diabetes during the study period (one month to two years). No adverse effects were reported in any of the trials. (Chinese herbal medicines for people with impaired glucose tolerance or impaired fasting blood glucose. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006690).
ACUPUNCTURE USEFUL FOR OF DIABETIC BLADDER DYSFUNCTION
A Chinese pilot study suggests that acupuncture may be clinically useful in the treatment of diabetic bladder dysfunction (DBD). Thirty cases in an acupuncture group were compared with 15 cases in a sham acupuncture group. In the acupuncture group, five of six urodynamic measures demonstrated significant improvement over the 15-day treatment period. Only one measure significantly improved in the sham acupuncture group. There were significant differences after therapy in four measures (bladder compliance, maximal bladder capacity, bladder volume at desire to void, and urge to void) between the groups. In 25 subjects of the acupuncture group incontinence improved from 2.4 to 1.4, while in the sham acupuncture group incontinence deteriorated from 2.2 to 2.3. (Acupuncture in the treatment of diabetic bladder dysfunction. J Altern Complement Med. 2009 Aug;15(8):905-9).
ELECTROACUPUNCTURE FOR GASTROPARESIS IN DIABETIC PATIENTS
A randomised, single-blinded pilot study has demonstrated that electroacupuncture (EA) effectively reduces the dyspeptic symptoms of diabetic gastroparesis (delayed gastric emptying) and accelerates gastric emptying. Nineteen patients with type two diabetes who had had symptoms of gastroparesis for more than three months were randomised into two groups. Each group received four sessions of EA or sham EA at Zusanli ST-36 and Hegu L.I.-4 over two weeks. Gastric half-emptying was significantly shortened by EA treatment (143.8 minutes versus 98.8 minutes), but did not change (98.9 minutes versus 90.9 minutes) in the sham EA group. Symptom severity improved significantly both at the end of treatment and two weeks after the end of the trial when compared with baseline in the EA group, but did not change from baseline with sham EA. There were no significant changes in fasting and postprandial blood glucose, serum gastrin, motilin, and PP in either group. (Electroacupuncture in Diabetic Patients with Symptoms Suggestive of Gastroparesis. J Altern Complement Med. 2008 Aug 23. [Epub ahead of print]).
TAI CHI FOR METABOLIC SYNDROME
An Australian pilot study (11 people) suggests that a twelve week tai chi and qigong training programme results in significant improvements in four of the seven indicators of metabolic syndrome, including BMI and systolic and diastolic blood pressure, as well as in glycosylated haemoglobin levels, insulin resistance, stress, depressive symptoms, general health, mental health and vitality. (A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health related quality of life, and psychological health in adults with elevated blood glucose. Br J Sports Med. 2008 Oct 16).
TAI CHI FOR TYPE 2 DIABETES
A Chinese study has investigated the effects of 14 weeks of tai chi practice on metabolic control and lipid metabolism in women with type 2 diabetes. Twenty women, mean age 57, were randomly assigned to either tai chi or a control group. In the tai chi group, exercise duration was one hour per day, five days a week, for 14 weeks. It was found that after 14 weeks, the tai chi group had significantly lower fasting plasma glucose, glycated serum proteins, triglycerides and higher fasting plasma insulin concentrations than controls. The authors conclude that tai chi could be used as an intervention tool to improve glycaemic control and serum triglyceride level in elderly people. (Effects of 14-week Tai Ji Quan exercise on metabolic control in women with type 2 diabetes. Am J Chin Med. 2008;36(4):647-54).
EAR ACUPRESSURE IMPROVES ANTIOXIDANT STATUS IN DIABETICS
A Taiwanese group has evaluated the impact of auricular pellet acupressure on antioxidant status in patients with diabetes mellitus (DM). They studied 69 people with DM, who were allocated either to an experimental group who underwent acupressure or to a control group. The experimental group received auricular pellet acupressure three times daily for five consecutive days. After a two-day rest period, the procedure was performed on the contralateral ear. Acupressure was performed twice on each ear, over a total treatment period of 20 days. The control group did not undergo auricular pellet acupressure. At the end of the treatment period, blood was collected from all study participants and assayed for the antioxidant enzymes superoxide dismutase (SOD) and catalase. Serum concentrations of SOD and catalase were found to be significantly higher in the experimental group than in the control group. The results suggest that auricular pellet acupressure can increase the concentration of antioxidative enzymes in patients with DM and may thus be able to prevent diabetic complications caused by lipoperoxidation and free-radical formation. (Effect of auricular pellet acupressure on antioxidative systems in high-risk diabetes mellitus. J Altern Complement Med. 2008 Apr;14(3):303-7).
TAI CHI FOR DIABETES
Tai chi can improve blood markers of type 2 diabetes. A British case-control study examined the effect of a 12-week programme of tai chi on the T helper cell activity of 30 patients with type 2 diabetes and 30 healthy people of the same age. After 12-weeks, glycated haemoglobin (produced when excess blood sugar combines with the oxygen transported in red blood cells) levels fell significantly in the diabetic patients. Levels of anti-inflammatory cytokine interleukin-12 doubled. Levels of pro-inflammatory interleukin-4 fell. T cell activity also significantly increased. (Regular Tai Chi Chuan exercise improves T cell helper function of type 2 DM patients with an increase in T-bet transcription factor and IL-12 production. Br J Sports Med. 2008 Apr 2 [Epub ahead of print]). In a second study, a 12-week programme of tai chi and qigong prompted a significant fall in blood glucose levels and significant improvements in other indicators of metabolic syndrome in 11 middle-aged to older adults. At the end of 12 weeks, they had lost an average of 3kg in weight and their waist size had dropped by an average of 3cm. Their blood pressure and insulin resistance also improved significantly. Participants said they slept better, had more energy, felt less pain and had fewer food cravings while on the programme. (A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome and glycaemic control in adults with elevated blood glucose. Br J Sports Med. 2008 Apr 2 [Epub ahead of print]). Two other studies that failed to find benefit on diabetic symptoms from tai chi concluded that the forms of tai chi used might not have been sufficiently intense to produce an effect. (Effects of Tai Chi on glucose homeostasis and insulin sensitivity in older adults with type 2 diabetes: a randomised double-blind sham-exercise-controlled trial. Age Ageing. 2008 Jan;37(1):64-71. Health benefits of Tai Chi for older patients with type 2 diabetes: the "Move It For Diabetes study"- a randomized controlled trial. Clin Interv Aging. 2007;2(3):429-39).
TAI CHI IMPROVES DIABETIC HEALTH
Practising tai chi may help boost immune function and improve blood sugar control in people with type-2 diabetes. Thirty-two people participated in three hour-long tai chi sessions each week, for a period of 12 weeks. Investigators found statistically significant reductions in levels of glycosylated haemoglobin (A1C) in the blood of participants, indicating improved long-term blood glucose control. Increased numbers of regulatory and killer T cells were also found. (Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease of cytotoxic T-cell population in type 2 diabetic patients. Diabetes Care. 2007 Mar;30(3):716-8).
CHINESE MEDICINE AND DIABETIC FOOT ULCERS
A team from the Prince of Wales Hospital in Hong Kong reports dramatic success in the treatment of diabetic foot ulcers using gradual surgery and Chinese herbs. The technique, adapted from the work of Dr. Jiu-yiu Shi of the Shanghai Hospital for Integrated Medicine, involves gradual removal of necrotic ligamentous tissues combined with Chinese herbs to “improve circulation” and “improve warmth and granulation”. In a study involving 30 patients who had been labelled “untreatable by limited surgery” and were on the amputation list, 85% were able to avoid amputation after being treated in this way.
ACUPUNCTURE AND CHRONIC PAINFUL PERIPHERAL DIABETIC NEUROPATHY
In a study carried out at the University of Manchester, UK, forty-six diabetic patients with chronic painful peripheral neuropathy were treated with acupuncture to determine its efficacy and long-term effectiveness. Patients initially received up to six courses of classical acupuncture over a period of 10 weeks, using traditional Chinese Medicine acupuncture points. Of forty-four patients who completed the study, 34 (77%) showed significant improvement in their primary and/or secondary symptoms. These patients were followed up for a period of up to a year, with 67% able to stop or reduce their medications significantly. During the follow-up period only eight (24%) patients required further acupuncture treatment. Although 34 patients noted significant improvement in their symptoms, only seven reported complete disappearance of symptoms. All the patients but one finished the full course of acupuncture treatment without reported or observed side effects. There were no significant changes either in the peripheral neurological examination scores, VPT or in HbA1c during the course of treatment. The data suggested that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy, although its mechanism of action remains speculative. (Diabetes Res Clin Pract, 39(2):115-21 1998 Feb).
