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World J Diabetes. Dec 15, 2025; 16(12): 112580
Published online Dec 15, 2025. doi: 10.4239/wjd.v16.i12.112580
Electroacupuncture in glycemic control: Transitioning from clinical controversies to potential basic research
Shuai-Yan Wang, Chen-Xi Deng, Yi-Ning Huang, Mei-Xin Tian, Si-Yu Zhuang, Yi-Fan Deng, Bin Xu, Tian-Cheng Xu
Shuai-Yan Wang, Chen-Xi Deng, Yi-Ning Huang, Mei-Xin Tian, Si-Yu Zhuang, Yi-Fan Deng, Bin Xu, Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Co-first authors: Shuai-Yan Wang and Chen-Xi Deng.
Co-corresponding authors: Bin Xu and Tian-Cheng Xu.
Author contributions: Wang SY and Deng CX conceptualized and designed this review; Wang SY, Deng CX, Huang YN, Tian MX, Zhuang SY, and Deng YF wrote the first draft of the manuscript. All authors have reviewed and approved the final version of the manuscript. Wang SY was responsible for the core conceptualization and overall framework, while Deng CX was responsible for the creation of figures in the initial draft. Both authors contributed significantly to the writing of the core content of the manuscript and coordinated the writing process, making essential and irreplaceable contributions to the completion of the project, and thus qualified as the co-first authors of the paper. Xu B and Xu TC served as the co-corresponding authors, playing key roles in quality control, academic depth enhancement, and final manuscript coordination. Xu B applied for and secured funding for the research project, playing a crucial role in the overall design and quality control, ensuring the academic value and publication quality of the review. Xu TC focused on the academic depth and content rigor of the review, assuming key responsibilities for academic oversight, coordinating feedback from all authors on revised versions, leading responses to reviewer comments during the submission process, and guiding further improvements to the manuscript, ensuring the academic quality and publication standards of the review.
Supported by The National Natural Science Foundation, Youth Science Fund Project, No. 82305376; The Youth Talent Support Project of the China Acupuncture and Moxibustion Association, No. 2024-2026ZGZJXH-QNRC005; The 2024 Jiangsu Province Youth Science and Technology Talent Support Project, No. JSTJ-2024-380; 2025 Jiangsu Provincial Science and Technology Think Tank Program Project, No. JSKX0125035; The National College Student Innovation and Entrepreneurship Training Program, No. 202410315020Z; and Provincial Undergraduate Innovation Training Program, No. 202410315149Y.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Road, Nanjing 210023, Jiangsu Province, China. xubin@njucm.edu.cn
Received: July 31, 2025
Revised: September 5, 2025
Accepted: November 6, 2025
Published online: December 15, 2025
Processing time: 137 Days and 18.6 Hours
Abstract

Diabetes is a major global metabolic disorder, with the type 2 diabetes mellitus (T2DM) population in China expected to reach 168 million by 2050. Electroacupuncture (EA) and auricular acupuncture represent safe, accessible, and multi-targeted strategies for glycemic control with strong translational potential. Clinical studies indicate that EA, targeting trunk and limb acupoints, can significantly reduce fasting plasma glucose and glycated hemoglobin. Mechanistically, EA modulates the neuro-endocrine-immune axis, regulates gut microbiota, and activates insulin signaling pathways. Auricular acupuncture, through vagal innervation, may also exert rapid effects on glucose homeostasis via autonomic modulation. The review’s objective is to synthesize and critically evaluate current clinical trials and animal studies on EA and auricular acupuncture for glycemic control in diabetes, particularly T2DM, and to highlight translational implications, mechanistic insights, and evidence gaps. This review also emphasizes translational considerations by highlighting species differences between rodents and humans - an underappreciated yet critical factor influencing the clinical applicability of preclinical findings. Through the integration of recent research advances, the present review not only consolidates clinical and preclinical evidence but also advances a deeper mechanistic framework and underscores the importance of species-specific factors in bridging experimental research and patient care. Future progress requires rigorously designed, adequately powered, multicenter randomized controlled trials with standardized protocols to validate efficacy and define their role in precision diabetes management.

Keywords: Electroacupuncture; Blood glucose management; Clinical controversies; Basic research in acupuncture; Auricular acupuncture; Body acupuncture

Core Tip: This review examines electroacupuncture (EA) for glycemic control, addressing clinical controversies and underlying mechanisms. While EA shows promise in reducing blood glucose levels in type 2 diabetes, current clinical trials are limited by small sample sizes and heterogeneous designs, lacking robust international consensus. Basic research indicates that EA’s hypoglycemic effects involve modulating the neuro-endocrine-immune axis, enhancing insulin signaling, and improving gut microbiota. Future work should focus on optimizing EA protocols and developing standardized interventions to advance its clinical application in diabetes management.