The Influence Combination Of Acupuncture And Metformin On Blood Glucose Level In Diabetes Mellitus Type2

Object ive:To analyze the difference of blood glucose level in intervention of acupuncture combine with Metformin500mg tablet and intervention of just Metformin500mg tablet in Diabetes Mellitus type2.Methods:A randomised controlled trial with six weeks follow up were done. This research was randomized pre-post test. Total of85people patients with diabetes mellitus type2come as acupuncture patients in "Rungkut" private clinic Surabaya, Indonesia, from January2013to January2014. After screening73subjects who had met the inclusion criteria were invited to participate in the study.13subjects dropped out because of discontinued the treatment, the reasons were too busy to participate due to work schedule conflict, family issues, feeling unwell, moved to another town. The total sample were60patients divide into2group, group control and treatment group, each consists of30patients. The control group is given Metformin500mg tablet2times per day for6weeks. The treatment group is given Metformin500mg tablet2times daily and acupuncture three times a week for6weeks, using Huanqiu steril acupuncture needles, specification0.25x40mm (1.5cun). The acupuncture point principle use Zusanli (ST36) Location1finger breadth lateral to lower end of tibia tuberosity. Puncture-1cun perpendicularly and Taibai (Sp3) Location-Posterior and inferior to head of1st metatarsal bone at border of two colon of skin. Both group activities, exercise and diet as usual with no change. The age’s data analyzed using frequencies test; the gender’s data using fisher’s exact test; the education’s data using crosstab test; the duration of diabetes’data using descriptive test; the corellation age and Fasting Plasma Glucose (FPG) levels’data using correlate bivariate test; the corellation education and FPG levels’using correlate bivariate test; the corellation duration of diabetes and FPG levels’data using correlate bivariate test; to comparing the magnitude of decrease inFPG levels data using independent T-Test; To comparing the magnitude of decrease in2-hours post prandial (2-PP) levels’data using independent T-Test; To comparing the magnitude of decrease in total cholestrol levels’data using independent T-Test. According to TCM efficacy standards "Chinese medicine clinical research guidelines," referring to the Department of Health to develop a "Chinese medicine treatment of diabetes (diabetes mellitus) guidelines for clinical research" and郑筱英Editor (2002first edition). Electro acupuncture type KWD8081device was set at5Hz with continuous wave form. The intensity is sets according to patient preference. The length of treatment is sets for20minutes.Results:60subjects recruited are44female and16male. In control group:the age is49.87(7.74) years, Duration of diabetes is2.8(0.92) years, correlation of age-FPG is0.892mg/dl, correlation of duration od diabetes-FPG is0.815mg/dl, correlation of Education-FPG is0.611mg/dl. Otherwise, in treatment group:the age is50.03(8.48) years, Duration of diabetes is2.9(0.99) years, correlation of age-FPG is0.967mg/dl, correlation of duration od diabetes-FPG is0.595mg/dl, correlation of Education-FPG is0.793mg/dl. The calorie intake and body exercise were not controlled. Subject ate according to their daily habit. The calorie intake and the body exercise in both groups did not differ significantly between the beginning and the end of the study, sig(2-tailed)>0.05.The calorie intake and Body exercise were considered as constant along the observation period.Characteristic of subject in control group:magnitude of decrease in Fasting Plasma Glucose (FPG) levels is-12.33mg/dl, magnitude of decrease in two-hours post prandial is-15.47mg/dl, magnitude of decrease in total cholestrol level is-4.73mg/dl. While in treatment group:in Fasting Plasma Glucose (FPG) levels is-21.17mg/dl, magnitude of decrease in two-hours post prandial is-25.73mg/dl, magnitude of decrease in total cholestrol level is-14.17mg/dl.Characteristic of subject post treatment:Because of the correlation between FPG with Education, FPG with Duration of diabetes and correlation between FPG with Age, then I use anacova in assessing the magnitude of decrease in blood sugar levels by taking into account Education, Duration of diabetes, Age and FPG as a covariate. In control group there are show a decrease of the magnitude of decrease in Fasting Plasma Glucose (FPG) levels is-12.33mg/dl and treatment group Fasting Plasma Glucose (FPG)-21.17mg/dl, p=0.26, and control group of magnitude of decrease in two-hours post prandial is-15.47mg/dl, and treatment group magnitude of decrease in two-hours post prandial is-25.73mg/dl,p=0.36. Also in control group there are significantly differ in magnitude of decrease in total cholestrol level is-4.73mg/dl, treatment group in magnitude of decrease in total cholestrol level is-14.17mg/dl, p=0.001.According to the standard TCM Diabetes effectiveness in the treatment group: healing was10%, which is50%efficacious, inefficacious is40%, whereas the control group:6.67%healing is,33.33%efficacious, inefficacious is60%. The overall success rate in the treatment group was60%and the control group was40%. Standard efficacy of TCM, the comparison between treatment and control groups showed both were equally effective, meaning that symptoms improved after treatment, but in this case it is more effective in the treatment group20%greater than the control group. Conclusion:The use of acupunture points combine medicine in this research use Metformin500mg tablet twice daily, there is significant difference in the therapeutic magnitude of decrease in total cholestrol level p=0.001though for magnitude of decrease in Fasting Plasma Glucose (FPG) and two-hours post prandial (2-PP) also show the decrease. In Fasting Plasma Glucose (FPG) Since p=0.26then it can be concluded that the FPG (Fasting Plasma Glucose) is significant in treatment group rather than control group. As well as, in the magnitude of decrease in two-hours post prandial p=0.36then it can be concluded is significant in treatment group rather than control group. In addition, be based on the standard TCM diabetes effectiveness the treatment group show more effective20%greater than the control group.