Electroacupuncture and rosiglitazone combined therapy as a means of treating insulin resistance and type 2 diabetes mellitus: a randomized controlled trial

Rong-Tsung Lin, Huei-Chin Pai, Yu-Chen Lee, Chung-Yuh Tzeng, Chin-Hsien Chang, Pei-Hsiu Hung, Ying-I Chen, Tai-Hao Hsu, Chin-Chun Tsai, Jaung-Geng Lin, Shih-Liang Chang, Rong-Tsung Lin, Huei-Chin Pai, Yu-Chen Lee, Chung-Yuh Tzeng, Chin-Hsien Chang, Pei-Hsiu Hung, Ying-I Chen, Tai-Hao Hsu, Chin-Chun Tsai, Jaung-Geng Lin, Shih-Liang Chang

Abstract

Aims. To evaluate the efficacy of rosiglitazone (TZD) and electroacupuncture (EA) combined therapy as a treatment for type 2 diabetes mellitus (T2DM) patients by randomized single-blind placebo controlled clinical trial. Methods. A total of 31 newly diagnostic T2DM patients, who fulfilled the study's eligibility criteria, were recruited. The individuals were randomly assigned into two groups, the control group (TZD, N = 15) and the experimental group (TZD + EA, N = 16). Changes in their plasma free fatty acid (FFA), glucose, and insulin levels, together with their homeostasis model assessment (HOMA) indices, were statistically compared before and after treatment. Hypoglycemic activity (%) was also compared between these two groups. Results. There was no significant difference in hypoglycemic activity between the TZD and TZD + EA group. The effectiveness of the combined therapy seems to derive from an improvement in insulin resistance and a significant lowering of the secreted insulin rather than the effect of TZD alone on T2DM. The combined treatment had no significant adverse effects. A lower plasma FFA concentration is likely to be the mechanism that causes this effect. Conclusion. This combined therapy seems to suppress endogenous insulin secretion by improving insulin resistance via a mechanism involving a reduction in plasma FFA. This trial is registered with ClinicalTrials.gov NCT01577095.

Figures

Figure 1
Figure 1
The flowchart diagram of progress through the various phases of this two-arm randomized trial according to CONSORT, which stands for consolidated standard for reporting trials.
Figure 2
Figure 2
Effects of combined therapy or single therapy on plasma insulin concentration among type 2 diabetic patients before and after treatment. TZD + EA = patients receiving 8 mg rosiglitazone stat and electroacupuncture; TZD = patients receiving 8 mg rosiglitazone stat only; Wilcoxon signed-rank test was used to assess differences in the means of the groups, *P < 0.05.
Figure 3
Figure 3
Effects of combined therapy or single therapy on insulin sensitivity as evaluated by HOMA index among type 2 diabetic patients before and after treatment. TZD + EA = patients receiving 8 mg rosiglitazone stat and electroacupuncture; TZD = patients receiving 8 mg rosiglitazone stat only; HOMA index = (fasting plasma glucose × fasting plasma insulin)/22.5; Wilcoxon signed-rank test was used to assess differences in the means of each group, *P < 0.05.
Figure 4
Figure 4
Effect of combined therapy or single therapy on plasma FFA concentration among type 2 diabetic patients before and after treatment. TZD + EA = patients receiving 8 mg rosiglitazone stat and electroacupuncture; TZD = patients receiving 8 mg rosiglitazone stat only; Wilcoxon signed-rank test was used to assess differences in the means of each group, *P < 0.01.

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