MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Should Acupuncture-Related Therapies be Considered in Prediabetes Control?

No!

If you are pre-diabetic, consult a doctor and follow his/her advice. Do NOT do what acupuncturists or other self-appointed experts tell you. Do NOT become a victim of quackery.

But the authors of a new paper disagree with my view.

So, let’s have a look at the evidence.

Their systematic review was aimed at evaluating the effects and safety of acupuncture-related therapy (AT) interventions on glycemic control for prediabetes. The Chinese researchers searched 14 databases and 5 clinical registry platforms from inception to December 2020. Randomized controlled trials involving AT interventions for managing prediabetes were included.

Of the 855 identified trials, 34 articles were included for qualitative synthesis, 31 of which were included in the final meta-analysis. Compared with usual care, sham intervention, or conventional medicine, AT treatments yielded greater reductions in the primary outcomes, including fasting plasma glucose (FPG) (standard mean difference [SMD] = -0.83; 95% confidence interval [CI], -1.06, -0.61; P < .00001), 2-hour plasma glucose (2hPG) (SMD = -0.88; 95% CI, -1.20, -0.57; P < .00001), and glycated hemoglobin (HbA1c) levels (SMD = -0.91; 95% CI, -1.31, -0.51; P < .00001), as well as a greater decline in the secondary outcome, which is the incidence of prediabetes (RR = 1.43; 95% CI, 1.26, 1.63; P < .00001).

The authors concluded that AT is a potential strategy that can contribute to better glycemic control in the management of prediabetes. Because of the substantial clinical heterogeneity, the effect estimates should be interpreted with caution. More research is required for different ethnic groups and long-term effectiveness.

But this is clearly a positive result!

Why do I not believe it?

There are several reasons:

  • There is no conceivable mechanism by which AT prevents diabetes.
  • The findings heavily rely on Chinese RCTs which are known to be of poor quality and often even fabricated. To trust such research would be a dangerous mistake.
  • Many of the primary studies were designed such that they failed to control for non-specific effects of AT. This means that a causal link between AT and the outcome is doubtful.
  • The review was published in a 3rd class journal of no impact. Its peer-review system evidently failed.

So, let’s just forget about this rubbish paper?

If only it were so easy!

Journalists always have a keen interest in exotic treatments that contradict established wisdom. Predictably, they have been reporting about the new review thus confusing or misleading the public. One journalist, for instance, stated:

Acupuncture has been used for thousands of years to treat a variety of illnesses — and now it could also help fight one of the 21st century’s biggest health challenges.

New research from Edith Cowan University has found acupuncture therapy may be a useful tool in avoiding type 2 diabetes.

The team of scientists investigated dozens of studies covering the effects of acupuncture on more than 3600 people with prediabetes. This is a condition marked by higher-than-normal blood glucose levels without being high enough to be diagnosed as diabetes.

According to the findings, acupuncture therapy significantly improved key markers, such as fasting plasma glucose, two-hour plasma glucose, and glycated hemoglobin. Additionally, acupuncture therapy resulted in a greater decline in the incidence of prediabetes.

The review can thus serve as a prime example for demonstrating how irresponsible research has the power to mislead millions. This is why I have often said that poor research is a danger to public health.

And what can be done about this more and more prevalent problem?

The answer is easy: people need to behave more responsibly; this includes:

  • trialists,
  • review authors,
  • editors,
  • peer-reviewers,
  • journalists.

Yes, the answer is easy in theory – but the practice is far from it!

8 Responses to Poor research endangers public health! Yet another example from the realm of acupuncture

  • GPs are not required to study chemistry. our bodies and minds are made from chemicals so why the hell would we consult anyone in the medical profession. we need natural health practitioners who have usually studied bio-chemistry and have a great deal more common sense when as they deal with nature (and that is a learning source of its own!). study homeopathy, diagnostic orthomolecular medicine, yoga etc. no side effects!

    • thanks for demonstrating how ill-informed you are

    • study homeopathy, diagnostic orthomolecular medicine, yoga etc. no side effects!

      No side effects? I have been studying the modalities you mention here (and many more) for several decades now, and I see a LOT of side effects:
      – Tunnel vision
      – Severely increased gullibility
      – Development of serious Dunning-Kruger syndrome, often leading to
      – Delusional arrogance(*), often resulting in
      – Diagnosing conditions that patients do not have, ranging from fictitious deficiencies all the way up to cancer, and
      – Missed diagnoses of real conditions, including heart disease and again cancer
      – Avoidable deaths

      Don’t believe this? Just visit an arbitrary orthomolecular practitioner for a ‘check-up’: they will ALWAYS diagnose some sort of deficiency or imbalance, that of course should be corrected, preferably with products sold by practitioners themselves, or by affiliated supplement suppliers. And, of course, you are supposed to keep taking those supplements regularly ‘for maintenance’.
      Or visit a chiropractor for the exact same reason, i.e. a check-up ‘just to make sure’: they too will ALWAYS find something to ‘adjust’ – and they too will always suggest that you return regularly for ‘maintenance’.
      Or visit a homeopath …

      I recall a bit of investigative journalism where four reporters with a completely clean bill of health each visited several practitioners (naturopaths, orthomolecular practitioners, homeopaths). Not only did almost all practitioners try to convince them that there were things wrong with them, but not two practitioners reached identical diagnoses for the same ‘patient’. I believe that there was only one out of a dozen or so who said that he couldn’t find anything wrong, and subsequently only charged for the actual consultation. All the others tried to sell the reporters all kinds of treatments that they didn’t need at all – in addition to the consultation fee, of course.
      I’ll try and see if I can still find the article …

      *: Here is a horrible example showing how a very stupid yet hugely arrogant quack kills his patients: https://www.ad.nl/utrecht/omstreden-natuurgenezer-ziet-geen-reden-te-stoppen~a6f93560/

      Summary translation:
      Controversial naturopath sees no reason to stop
      Undercover reporter Alberto Stegeman used a hidden camera to record that Broekhuyse, who lost his title as a doctor after the death of actress Sylvia Millecam, carries on regardless, still firmly believing in his VEGA Test device and his ultra molecular frequency therapy, with which he also treated Millecam at the beginning of this century. Millecam died of breast cancer shortly afterwards.
      Anaesthesiologist Catherina de Jong visited his practice, disguised as a patient with a non-metastatic tumour in her liver, which a surgeon told her could be operated on easily. However, she told Broekhuyse that she wasn’t looking forward to surgery, which was why she consulted him.
      Using his VEGA Test device (an electromagnetic measurement, ed.), Broekhuyse concluded that there was no tumour, but just infections caused by low resistance. If she would take his granules for seven weeks, ‘the critter’ would be gone, he told the fake patient.
      Broekhuyse went on to claim that half of cancer cases diagnosed by regular doctors are not cancer at all, but merely inflammation. About Millecam: “That person had no cancer at all.” And about his sentence: “Those judges didn’t know shit about it.”

      And unfortunately, this highly arrogant, delusional mindset appears to be the rule, not the exception among alternative practitioners. I have NEVER met an alternative practitioner who would at least consider the possibility that they might be wrong about what they were doing.
      Then again, the ones who actually discover that they are indeed wrong usually stop working as an alternative practitioner and pursue a more useful career.

      • I believe the Canadian Broadcasting Corporation did a similar study with 4 “healthy” automobiles and got similar results across mechanics.

        • No surprise at all, although even dodgy car mechanics are usually better educated than most alternative practitioners – at least those mechanics know how to fix problems. It’s just that they overcharge their victims and/or botch the job because that’s cheaper than the full works.

    • I was a premed student for a couple years. I can assure that we took plenty of chemistry. We were required to take general chem, organic chem, bio chem and quantitative and qualitative analysis.

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