Acupressure Therapy May Prevent Diabetic Complications

Acupressure therapy plus diet and exercise plans may inhibit the development of diabetic complications in patients with type 2 diabetes, a report in the Journal of Alternative and Complementary Medicine suggests.

After an initial recruitment of 80 participants, the Chinese study followed 64 patients with type 2 diabetes for three years. All study participants were treated with conventional medications plus diet and exercise programs to manage high blood pressure and hyperglycemia. One group was randomly assigned to undergo 90-minute sessions of acupressure four to six times a week in addition to standard treatment.

At the end of the three-year follow up, patients in the acupressure group had lower levels of total cholesterol, triglycerides and LDL-cholesterol, and higher levels of HDL-cholesterol. Nerve conduction velocity was also significantly higher in the acupressure group, indicating preserved nerve function. Serum creatinine and urine protein, surrogate markers of kidney function, were similar between both groups at the end of study follow-up.

Given these suggestive results that acupressure may help prevent diabetic complications, such as kidney failure and nerve damage, further studies may be warranted. The Chinese diet and lifestyle may not be globally representative. However, if these results can be replicated in different populations, the authors suggest that acupressure may be an important adjunctive strategy to help prevent long-term complications of type 2 diabetes.

Non-pharmacological management already plays a significant role in the prevention of diabetic complications. Other integrative therapies have also been investigated in managing symptoms. For instance, alpha-lipoic acid (ALA) has consistently been shown to improve blood sugar levels among patients with type 2 diabetes. Ginseng and beta-glucan also have suggestive benefits in inhibiting the development of diabetes-related complications, although the data are not as compelling.

For more information about acupressure therapy, please visit Natural Standard's Health & Wellness database.

Comments

[Lania]

I've also read in the news that acupressure has been shown to help ease jet lag, reduce headache severity, and help people quit smoking. I hope someone can explain the suspected mechanism in this study on the use of acupressure to prevent complications for diabetic patients. Is it effective because it reduces stress? I'm really curious about how acupressure affects cholesterol levels, as noted here.

[gb]

The results of this study are very interesting. The patients in this study were being treated with adjunctive acupressure therapy aggressively, with 90-minute sessions several days a week. Although the mechanism of action of acupressure is unknown, I suspect that improving circulation throughout the entire body is key to the results yielded in this study.

[Pete C.]

Were the markers of improved health clinically significant or just statistically significant? The patients who had acupressure had lower triglycerides, cholesterol and LDL-cholesterol, but does that have an overall impact on the course of their diabetes? I wonder if these people tend to live longer and experience fewer physical consequences, such as loss of limbs, than people who did not have acupressure.

I also think it's important to know the participants’ subjective experience of diabetes - perhaps those who had acupuncture felt relief from the disease more so than those who did not have acupressure. Subjective experience is also an important marker of treatment effectiveness.

[M.K.]

It is interesting to note is how much acupressure was necessary to achieve significant outcomes. The patients in the study spent 90 minutes per day, for as many as six days per week. That's as much as nine hours per week for three years! Some people with diabetes might not have enough time for that.

How much does acupressure cost and would health insurance policies subsidize the cost? Do the positive health benefits of acupressure diminish as soon as sessions stop, or are those who have received acupressure in the past continue to be healthier than those who never have? A follow-up study might explore how little time spent getting acupressure is necessary while still being effective over a long term.

[Seth G.]

I wonder if the process of getting acupressure also helps people manage diabetes. I understand that getting this procedure involves lying down. Perhaps spending 90 minutes lying down leads the acupressure recipients to have lower levels of stress than the non-acupressure recipients. Less stress might be indirectly associated with some of the positive health outcomes this group demonstrated.

[LM]

What was the retention rate was for the study? People are bound to drop out of the study if it involves 9 hours per week of their time. It could be that those who completed the three-year acupressure treatment course were more dedicated to their health, and therefore, managed their disease better than those who dropped out. The study might control for differences in health habits among acupuncture recipients, the control group and those who dropped out of the study.

[Mike D.]

These results are interesting because it is more evidence that non-pharmacological means of managing diabetes is unbelievably important. Although the way that acupressure prevents the development of diabetic complications is not completely understood, it is clear that a change in lifestyle is crucial to handling the progression of the condition. If it is indeed caused by circulatory improvements, then 9 hours of acupressure may not be the only way of causing this. Thirty-minute jogs three days a week might be just as effective in terms of improving circulation, which may or may not have the same benefits. It is interesting how much a little exercise can improve health, but a change in lifestyle is usually easier said than done.

[david]

What’s the difference between getting acupressure and getting a massage? Is there such a thing as a licensed ‘acupressurist’ (I’ve only heard of acupuncturists). I know that acupressure utilizes special pressure points in the human body, but can massage therapy work in a similar way? Also, I wonder how the prices per treatment session vary between the two therapies. As of now, most insurances are not covering such CAM treatments, and many more studies with similar results need to occur before I think we’ll see a change.

[lauren]

Diabetes is a major risk factor for many other health complications, such as heart disease, peripheral neuropathy and hypertension. Any technique that shows potential of reducing the occurrence of these complications should be aggressively pursued. CAM methods such as acupressure were developed thousands of years ago in China and have recently become more accepted in the Western hemisphere, but there is still a long way to go. I think that tackling the diabetes issue from a multifaceted approach that utilizes pharmacotherapy, behavioral therapy and alternative medicine will be the true solution at managing this disease.

[rob]

After doing a little research about acupressure online, it sounds like this is a type of therapy that can be self-administered. There are various trigger points located around the wrists and ankles that will reduce muscle tension and increase blood circulation when pressed. Helping our bodies to deeply relax awakens our life force energy, which helps with the healing process. This can be a cheap and easily accessible treatment option for patients who are willing to explore the idea.

[Tom Brady]

Currently, there is strong scientific evidence in support of acupressure's efficacy in the prevention and treatment of acute nausea of diverse etiology in both adult and pediatric populations: postoperative, intraoperative, chemotherapy-induced, and pregnancy-related (morning sickness). There is promising early evidence for the use of acupressure in the improvement of sleep and exercise performance and in the treatment of pain (lower back and postoperative), headaches, paralysis (poststroke), pediatric enuresis, pediatric epilepsy, cerebral birth injuries in infants, menstrual concerns, respiratory disorders, and Parkinson's disease. Although evidence is currently inconclusive, research suggests that acupressure may not be effective in the direct treatment of obesity but may help to maintain weight loss.

[ctaye]

Acupressure and acupuncture both work on the same pressure points (aka “chi spots”) in the body --- the only difference is that acupressure involves finger tips, while acupuncture involves needles. I wonder if these study results would be seen with acupuncture as well. Why do patients chose one technique over the other? Are there issues that are better handled with a certain technique?

[Dean]

LM:

I looked at the paper and saw a 20% dropout rate. One interesting point is that both groups (AT treatment or no AT treatment) have eight dropouts, and so each group has 32 participants. The reason given in the paper was they moved out of the area. But I do agree that individual habits/lifestyle can affect this study, and a bigger study is needed for longitudinal studies like this one.

[Brianne]

I wonder how acupressure helps with diabetes neuropathy. I would assume if by stimulating the nerves regularly, it will prevent nerve function deterioration. And also, perhaps by improving blood circulation to various body parts, it may also be beneficial. I hope more research can be done in this area because currently, there's still no cure for diabetes, and any new effective treatments will be valuable options for diabetic patients.

[JJ]

I noticed the study enrolled patients that were relatively healthy. Their LDL was around 100, TG was less than 150, HDL was in the upper 30s and their total cholesterol was around 200 -- these are all nearly at goal for diabetic patients. I am curious what the rates of diabetes neuropathy would be among these types of patients. I also wonder if the effects of acupuncture is really clinically significant when these people are managing the diabetes quite well.

[Robin]

This is encouraging to know that the prevention of diabetic complications is a possibility without having to add more drugs on top of the treatment. It is possible that the sensation of touch is relieving tension in the patient and helping decrease stress. When there is less stress, there is less cortisol released and less hyperglycemia occurring. Also, increasing blood circulation may be leading to less peripheral neuropathy. I hope to see more studies about this topic, including ones that possibly compare acupressure with basic massages in diabetic patients.

[Daniel]

I wonder how compliant the subjects in this study were since each one of them has to get acupressure four to six times a week, for three years. In addition, the authors also mentioned the patients and acupressure practitioners were not blinded in this study, which can influence their habits or ways of managing their diabetes.

[CD]

I am not surprised to see positive results from this study since I do believe that acupressure can definitely cause positive results. There are some things that I would like to know about these patients though. I know that all of them have type 2 diabetes and are all medicated. I would like to know if their medications are all fairly similar. Were some on much higher doses or more than one antidiabetic agent? Would this cause a difference in readings?

Additionally (and the article mentioned this briefly), I wonder if the results would apply to Americans since it took place in China, where diets are so different from here in the US. For example, the fact that their cholesterol levels are lower is no surprise to me since they eat much different foods. I don't know that we would see those types of results here.

Also, I would think that the patients involved in the study would maybe have more time (and money?) available to them to partake in such a study, so I wonder if their lifestyles in general, are more healthy (more relaxation time/ better eating, etc.) than others. Overall though, I do believe that this natural type of healing could only boast positive results for many disease states, if only to decrease the level of stress in all patients with disease.

[TM]

I would have to agree with previous comments. The acupressure treatment was very aggressive. It mentioned patients receiving treatment 4-6 times per week in addition to standard treatment. What was the standard treatment? I find it unrealistic with our busy lifestyles to receive once-a-week treatments, never mind six times weekly.

I would like to see a study on acupressure as a treatment for diabetic neuropathy. This study indicated preservation of nerve function. It only makes me think it maybe beneficial for diabetic neuropathy.

[Jim]

This study evaluated the effect of acupressure on complications in patients with type 2 diabetes. Is acupressure effective in patients with type 1 diabetes as well? Since most cases of type 1 diabetes are diagnosed in children, is acupressure a useful health modality in children? Children would probably be much more receptive to acupressure as opposed to acupuncture, since it does not involve needles. However, I doubt many kids would sit still for a 90-minute session and not want to repeat it 4-6 times per week.

[AR]

I would have to agree with MK regarding the time aspect of this study. It's great that it showed that acupressure may help prevent certain complications associated with DM, but in reality, who has an extra 9 hrs a week?

Also, keep in mind that these non-traditional practices, such as acupressure, are often not covered by insurance. Does anyone know about rates for acupressure? It may be feasible for patients to obtain such therapy in China, but is it feasible here? I would like to see more studies evaluating this practice in a U.S. population with a larger sample size.

[RPH]

JJ, thanks for that information regarding the baseline characteristics of the patient population in this study. I think it is great that we are looking into non-pharm methods such as acupressure therapy to help manage DM complications, but I feel this study is quite limited. Just based on the info regarding cholesterol, those values are nearly at goal, so how applicable are the results to the general population? Also, what medications were used in this study? Are the doses typical of those used in our patient population? There may be some potential in the management of neuropathy, but I would like to see more studies with a larger and more realistic population.

[Kendra]

I agree that 4-6 times a week is a lot, but acupressure feels fantastic. If I could participate in a study and get free acupressure several times a week, I would be all for it.

[Karina Gordin]

I am interested in the variety of techniques that revolutionized acupressure applications in the modern setting. The acupressure mat is effective and simple to use as an acupressure pain relief device, which stimulates the body's internal abilities to heal itself via meticulously arranged high-density plastic spines.

Another application that I have tried in the past to relieve muscle and joint pain is the Acu Ball, which is a small rubber ball with protuberances that are heatable.

Another favorite, for which I've seen demonstrations, is the Energy Roller. It is a small cylinder with protuberances that is held between the hands and rolled back and forth to apply acupressure.

The Foot Roller, also known as the "krupa chakra," is a round, cylindrical roller also with protuberances, on which the foot is placed and rolled back and forth on the floor.

In the same vain, The Power Mat, also known as Pyramid Mat, is pyramid shaped with small bumps that are walked upon for relief of joint-related tension and to massage particular points to relieve upper body injuries.

The spine roller is a bumpy roller containing magnets that is rolled up and down the spine.

Lastly, Teishein is one of the original nine classical acupuncture needles described in the original texts of acupuncture. Even though it is described as an acupuncture needle, it did not pierce the skin, but rather was used to apply rapid percussion pressure to the points being treated.

And which pressure points would you use these devices on? Generally, to control diabetes, it is recommended to apply pressure to point number 25, which corresponds to the pancreas; point number 16, which corresponds to the lymph nodes and endocrine glands.

[Mery]

This is curious. How does acupressure decrease total cholesterol, triglycerides and LDL and increase HDL? Can this be explained through a mechanism of action? The article suggests that the nerve and kidney functions are preserved, but does not explain how. In my opinion, not only further studies aren't just warranted, they're necessary until you can explain or have at least a plausible mechanism of action. I completely disagree with this study because it does not explain how these results are scientifically accomplished.

[Ulrich]

It seems that the unknown link in research around preventing cardiovascular events is stress. There is no doubt that stress can be relieved with massage and acupressure, so perhaps it is the stress reduction that is improving the outcomes in patients with type 2 diabetes.

It is interesting that one patient could experience one of these events with certain blood sugar levels, yet the next person with the same levels could be absolutely fine. If there was a way to evaluate stress as a risk factor for diabetic complications, as it is in hypertension, then our evaluations of risk for developing neuropathies or nephropathies would be more complete.

[ps]

We already know that diet and exercise are key to maintain healthy blood sugar levels and overall well-being. It’s interesting that research is finding that acupressure may prevent the long-term complications of diabetes; however, we still need a little more insight as to how acupressure is exactly working. Is it just by normalizing a person’s energy flow? By applying pressure at certain points to get the ‘qi’ flowing, does a patient have to visit a specialist that specializes in acupressure? How cost effective will this be? Rather, I’m wondering if a patient would be able to learn which ‘pressure points’ are imperative to concentrate on and do it at home.

It’s exciting to even ponder that an alternative modality can possibly prevent long-term complications of diabetes — something that affects so many people globally.

[AB]

In response to the multiple curiosities about the mechanism of lipid-lowering effects, I wonder if the key may be in the statement “acupressure therapy plus diet and exercise plans…” It has definitely been shown that dietary changes and exercise will improve lipid panels. The acupressure likely had more of an effect on circulation and prevention of neuropathy than lipid effects.

[nina]

The study brings more awareness to the effectiveness of this Chinese healing art, which has been practiced for over 5000 years. Western minds need to see the effectiveness in a scientifically proven study before they will engage in incorporating this long-proven healing art in their own practice of medicine. Acupressure or laser acupressure are wonderful methods to improve the chi flow for the needle phobic.

[praparat]

I wonder if the process of getting acupressure also helps people manage diabetes. I understand that getting this procedure involves lying down. Perhaps spending 90 minutes lying down leads the acupressure recipients to have lower levels of stress than the non-acupressure recipients.

[acai]

Acupressure is very good therapy and this is very good news for the diabetic patients. Thanks for this article.

[Kayla]

AB, I would agree with you, but the study implies that cholesterol levels were lower among those who received acupressure. The acupressure itself doesn’t change a person’s cholesterol level. Yes, I would agree that it may help in the circulation, thus preventing neuropathy.

[Rebecca Swan]

I read that "acupressure wear" may be helpful for conditions like headaches, migraines, hot flashes, nausea, indigestion, hangovers and more. I know that acupressure does not work for everyone, but I must say that I use it for nausea, headaches and heartburn, and acupressure wear works for me. I never believed in any of this before until it was my last option, and now I am a believer.

[AB]

In response to the multiple curiosities about the mechanism of lipid-lowering effects, I wonder if the key may be in the statement: “Acupressure therapy PLUS diet and exercise plans…” It has definitely been shown that dietary changes and exercise will improve lipid panels. The acupressure likely had more of an effect on circulation and prevention of neuropathy than lipid effects.

[AJ]

I would have to agree with the above statements by Mery. It is difficult to draw a conclusion about acupressure’s effects on diabetic complications when the mechanism of action is not explained. It is easy to correlate acupressure with the relief of musculoskeletal problems and link that with relief of neuropathic pain, but that is all speculation until the mechanism of action can be properly studied. And how acupressure affects cholesterol levels is even more ambiguous. More scientific studies are needed.

[cc]

Very interesting study. I was surprised to learn that approximately 37 million people in China are afflicted with Type 2 diabetes because I imagined the Chinese to have very healthy diets and lifestyles. With that being said, I am curious to know what diet this Chinese study implemented. Did it incorporate fish, rice, vegetables, etc? If so, that is a very different eating habit from what Americans are accustomed to, so it makes one wonder if this study can be generalized globally. While acupuncture therapy seems to be a promising alternative modality in preventing diabetes complications, the fundamentals (such as diet and lifestyle) must be accounted for.

[MT]

There have been studies that have demonstrated the benefits of acupuncture in various illnesses such as migraine headaches, chronic pains, etc. This is the first study that I have seen that claims acupressure to be beneficial in treating a chronic illness. This is the type of study that certainly needs support from other research before any conclusions and/or recommendations can be made.

[SK]

I wonder what the follow-up plan for this study is. Alhough there was improvement after three years of regular treatment with 90-minute sessions of acupressure, it would be interesting to see if this effect was maintained after the cessation of treatment. If the lowered cholesterol levels are maintained after the end of the study, acupressure would be a feasible adjunct treatment option for some patients.

[MC]

Just like many of the posted comments have already mentioned, although it's great that acupressure may help to prevent complications in diabetic patients, it requires up to nine hours of time per week, and more importantly, I doubt many people could afford this as adjunctive therapy. In the United States, many alternative therapies are not covered by insurance and also tend to be expensive as well. These factors all make acupressure a difficult option to pursue in the therapy of diabetes.

However I do think it helps emphasize again how important non-pharmacological measures can be in the prevention and treatment of various conditions and diseases. Patients shouldn’t simply depend on the drugs to take care of all their health problems. Medications are just one component that may be necessary in the quest to maintain one’s health, and they can usually be even more effective when combined with a healthier lifestyle.

[glucosamine chondroitine]

Acupressure is generally a well-tolerated, natural treatment for diabetes. If you experience any pain or discomfort, you should report this with your practitioner. Acupressure can very well offer you the kind of results you've been looking for.

[Loira]

MT, I could see how acupressure may help with migraine because the belief is that there are points in the body that when they touched, release pressure and help with migraines. My question is, how would that work for diabetes? And what about cholesterol?

[DF]

Whether or not the stress-reducing effects of acupressure are responsible for the benefits seen in people with type 2 diabetes, several relaxation techniques have shown promise. Progressive muscle relaxation (Surwit, 2002), mindfulness meditation (Rosenzweig, 2007), yoga (Malhotra, 2005), and even attending comedy shows (Hayashi, 2003) have been linked to decreased glucose levels in preliminary studies. It’s possible that reducing levels of stress hormones (cortisol and adrenaline) may reduce blood sugar.

[Luba]

Although the results of this study sound very interesting, I am still quite skeptical. I don't believe that a 64-person trial is large enough to show a statistically significant difference between the 2 groups. I am a true believer in diet and exercise for diabetes control. However, it would be nice to see this study on a larger scale to truly prove the significance behind the use of acupressure in diabetes.