| Objective:In type2diabetes the pancreatic β-cell function and mass decline progressively parallel with time. Various treatment and medicine have been assigned to modulate the course of the disease. The use of acupuncture is proven to affect controlling of blood glucose level.Several researches on acupuncture for type2diabetes have been addressed to evaluate plasma glucose level. The results of the research concluded that acupuncture beneficial in controlling plasma glucose level.However assessment of the function of pancreatic p-cell with acupuncture has not been done. I address whether the application of Weiguanxiashu extrapoint (M-BW-12) or Yishu acupoint, which is literally meant islet cell of pancreas, has an effect on pancreatic β-cell function in type2diabetes.Methods:Method of research is an experimental design using random sampling method in selecting the subject.60subjects are included in the study, and randomly divided into two group each consisting of30subjects each. A control group is subject treated with glucose lowering drug only and treated group is given acupuncture treatment as an add-on therapy on subjects with oral anti glucose lowering drug. The oral anti diabetic drug did not change for at least3months prior to inclusion in the study and the dose did not change as long as the study period.Acupuncture is done in a prone position or sitting with support on the chest. The Yishu point is found1.5cun lateral to the lower border of the spinous process of the eighth thoracic vertebra. The Bilateral Yishu point is punctured perpendicular with0.25mm×40mm (32×1.5cun) needle.Electro acupuncture device is set at15Hz with continuous wave form. The negative pole (black) connected to the left side and the positive pole (red) to the right side. The intensity is set according to patient’s preference. The length of treatment is set for20minutes.The Blood tests for fasting plasma glucose and fasting plasma insulin in pre and post study are performed in Laboratory. The HOMA2-%B, HOMA2-%S and HOMA2-IR are calculated with computer model HOMA2calculator. The Disposal Index (DI) is counted by multiplying the HOMA2-%B with HOMA2-%S.Results:The60subjects recruited are65%female and35%male. The age is55.10(±5.81) years, BMI is26.08(±4.45), Duration of diabetes is68.25(±54.73) months, calorie intake mean is1570(±135.67) cal., mean fasting plasma glucose is161.10(±62.00) mg/dl, mean fasting plasma insulin is13.25(±9.96) μIU/ml and HOMA2-%B is58.72(±49.54)%. All these parameters do not differ significantly between groups.The calorie intake and body mass index were not controlled. Subject ate according to their daily habit. The calorie intake and the body mass index in both groups do not differ significantly between the beginning and the end of the study (p>0.05), p=0.315and p=0.229respectively. Therefore the calorie intake and Body mass index can be considered as constant along the observation period.Characteristic of subject of BMI and Calorie intake at the end of the study, in control group; BMI25.45(±4.27), Calorie intake1580(±134.93), and treatment group BMI26.67(±4.65), Calorie intake1553.33(±125.90) Cal. All these parameters do not significantly differ, p=0.229and p=0.432respectively.The fasting plasma insulin level between control group14.79(±10.94) and acupuncture group11.51(±7.14) μIU/ml do not differ significantly (p=0.349).There significant differences between control group and acupuncture group in:fasting plasma glucose between control group158.83(±52.12) mg/dl and acupuncture group140.40(±59.12) mg/dl, p=0.001.; control group HOMA2%-B56.99(±132.23)%and acupuncture group HOMA2%-B72.21(±63.25)%, p=0.046; and the Disposal index (DI) between control group0.34(±0.45) and acupuncture group0.57(±0.31), p=0.016.The HOMA2-%B score change between the pre and post of the study shows that there is a significant raise (p=0.007) in the acupuncture group from54.67(±25.68) at the beginning to77.88(±63.25) at the end. Compared with the control group, It shows no significant change (p=0.058),from62.78(±61.53) at the beginning to51.32(±32.23) at the end, even a decreased trend.HOMA2-%S graph shows increasing trend, although statistically showed no significant different between control group and acupuncture group, p=0.234, and no significant difference between the value at the beginning and the end of the study, p=0.499and p=0.666, respectively.HOMA-IR score is calculated using HOMA2computer model calculator. HOMA-IR graph in acupuncture group shows a decreasing trend, although evaluation of the insulin resistance using the HOMA-IR score of both group is not different significantly either at the beginning of the observation or the end of the observation, p=0.994and p=0.228, respectively. Also the evaluation of pre and post treatment HOMA-IR is not different significantly either in control or acupuncture group, the p value is0.277and0.157respectively.Observing the disposal index score, which shows the ability of pancreas β-cell to compensate for insulin resistance, the acupuncture group shows significant improvement in the score (p=0.001), on the other hand the control group shows a decrease although it is statistically not significant, p=0.252. It shows that the acupuncture has a significant effect on the improvement in Disposal Index.Conclusion:The application of Yishu acupoint (M-BW-12), which is located at1.5cun lateral to the lower border of the spinous process of the eighth thoracic vertebra (T8) give additional marked effect to the treatment of type Ⅱ diabetes. Improvement in the pancreas β-cell function could be observed through this study, it is showed by the improvement in the HOMA2-%B and Disposal Index, and decrease of the fasting plasma glucose level. This concludes that Yishu point could preserve the pancreas β-cell function in type II diabetes.The stimulation of Yishu acupoint, besides improving the pancreas β-cell function, it tends to take effect on the insulin sensitivity and insulin resistance, although it is not a prominent effect. In other words it creates the homeostasis.I hypothesize that acupuncture seems to optimize the insulin production of pancreatic β-cell paralleled to the improvement in insulin resistance, insulin sensitivity and the β-cells function. This hypothesis still has to be studied further.The Yishu acupoint may be a specific point for the islet cell, thus may become a principal point in the treatment of type2diabetes. As this point could equalize the fasting plasma glucose and keep the homeostasis of the islet cell function, the insulin resistance, insulin sensitivity and the insulin production. In TCM words it could nourish the yin and clearing the heat, which is the basic principle in treating the type2diabetes.The Yishu point could be a door to the research of actual numbers of pancreas β-cell that could be preserved in type2diabetes, that give a benefit for the treatment of type II diabetes. |
PDF Full Text Request