Does Acupuncture Prevent Diabetes?

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Transcript:

I’ve been talking a lot lately about systematic reviews and meta-analyses, so today let’s change things up and talk about…a systematic review AND meta-analysis! If that doesn’t capture your attention, what if I told you that this new systematic review and meta-analysis is about how you can avoid getting diabetes by having someone stick needles in you? That did it, I bet. Who doesn’t love the idea of becoming a pin cushion to save yourself from becoming, well, a pin cushion? That joke is only slightly out of date, since these days I think most people with diabetes don’t actually have to prick their finger to check their glucose levels but I’m leaving it, dammit.

OK, let me start by declaring a wee conflict of interest: I have been extremely skeptical of the ability of acupuncture to treat, well, anything for the past 20 years or so. It’s definitely one of those treatments that raises a lot of red flags: proponents claim it can treat pretty much any disease or complaint, that it’s based on mystical knowledge unknowable to we mortals, there is no known method by which it can work, there’s very little unbiased data suggesting it does anything, and it is difficult, if not impossible, to test using double-blinding.

That said, I do have friends who have gone for acupuncture treatments and liked it, saying it helped them with various problems, and I don’t think that in general people are lying when they say acupuncture helps them. And as I’ve recently said in another video, just because we don’t know HOW something might work and because we don’t currently have a good way to test it doesn’t mean that it doesn’t work. There were a lot of negatives in that sentence so good luck parsing it. Don’t blame me, blame my chi for not flowing properly to my mouth.

Anyway. If you’ve seen some headlines in the news proclaiming that a new study found that acupuncture can prevent Type II diabetes, it’s based on this paper titled “Should Acupuncture-Related Therapies be Considered in Prediabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials,” published this month in Holistic Nursing Practice. If the name of that journal throws up some red flags, good, it should: “holistic” SHOULD be a normal word used in medicine to describe treating patients as complete human beings with emotional and psychological as well as physical needs, but instead it has become a bit of a catchall for bullshit. I looked through some of this journal’s other articles and they range from understandable thoughtful treatises on the use of mindfulness in patient treatment to absolute moronic dreck like the use of therapeutic touch and reiki, which are surprisingly popular in the nursing profession despite the fact that they are evidence-free pointless alt-med theater that involves waving your hands over someone and pretending it cures their sickness. You have to appreciate the grift of a “therapy” that doesn’t require actually touching or interacting with a patient in any meaningful way.

As for this “systematic review and meta-analysis,” the researchers in question examined studies that looked at acupuncture and markers for prediabetes, which is a medical term for people who with higher than normal blood sugar levels, but not levels so high that they officially have type II diabetes. Most pre-diabetic people will go on to get type 2 diabetes, as well as experiencing adverse conditions like heart disease and strokes. More than 1 in 3 Americans is pre-diabetic and 80% of them don’t even know it until they have a serious problem. That may sound like a surprising number of people but it’s quite understandable when you consider that America has perfected the science of cheap, easily available ulta-processed foods that are designed by the $500 billion snack and fast-food industry to be consumed as quickly as possible while leaving us hungry and wanting more. It’s that terrible diet, plus a society that devalues physical activity by incentivizing us to drive to jobs where we sit at desks all day, that provides the perfect environment for us all to have pancreases that are begging for the (literal) sweet release of death.

The good news is that if you get tested and learn you have prediabetes, you can reverse it by changing your diet to eat healthier whole foods and by moving more. But, again, our society makes that relatively simple solution very difficult for many people, so we look to other interventions that could help. Like sticking ourselves with needles!

I’ve said this like 5 times in the past month but once more for the people in the back: systematic reviews and meta-analyses are at high risk of cherry-picking, in which researchers simply choose the studies that support their hypothesis and discard those that don’t. I can’t say that that’s what happened here but it is worth noting that they found 855 studies related to acupuncture and pre-diabetes, which…okay that seems like a lot but from those they chose 31.

Worryingly, those 31 studies did not all use the same method of testing acupuncture. This is something I referenced earlier: it is difficult, if not impossible, to test acupuncture in a double-blinded way. “Blinding” is how scientists can remove bias from their research, by making sure that the participants aren’t unconsciously influenced by knowing certain details, and also making sure that no one can purposely “cheat” to get the results they want. For instance, if I’m testing your psychic ability to tell which cup has a ball underneath it, I for sure want to blind YOU: I’ll put the ball under the cup when you aren’t looking. But if I know which cup has the ball, you might be able to pick up on little hints from me, even if I’m trying to be super chill about it. So the better test is to “double blind,” meaning that even I don’t know which cup has the ball under it until the experiment is over.

That’s easy for that kind of test but it’s pretty tough for something like acupuncture, which involves practitioners placing small needles into the skin of patients in specific spots that they think related to specific parts of the body or flows of energy, and sometimes manipulating those needles after feedback from the patient. You can blind the patient pretty easily just by choosing people who don’t know anything about acupuncture, but the practitioners DO know. They will know if they’re placing needles in the “wrong” place, or if they’re using sham needles that only tap the skin and don’t actually enter the skin.

So, it’s tricky. And this review compared studies, some of which put acupuncture against these sham acupuncture needles, some of which put it against completely different treatments, and some of which put it against absolutely nothing, meaning their collection of 31 studies ranged from “maybe useful” all the way to “completely useless.” But they say that these studies suggest that acupuncture reduces “fasting plasma glucose, two-hour plasma glucose, and glycated hemoglobin, as well as a greater decline in the incidence of prediabetes.”

Here’s something that might surprise you: I wouldn’t be surprised if acupuncture really DID have this effect. Yes, bad diet and poor exercise habits are the most significant factors in developing type 2 diabetes, but your glucose levels, which is what this was testing, can also be elevated by stress. “Stress” is just your stupid monkey brain telling you there is a threat, and so your liver pumps a bunch of sugar into your blood for you to use as energy so you can fight that tiger that’s about to attack you, or so you can get those TPS reports to your boss by Monday morning. And what reduces stress? Lots of things, depending on the person, and many people feel less stress when they get to lay down on a soft bench while a kind and preternaturally wise man uses an ancient practice to heal not just your body but your very soul, maybe while soothing music plays and the lights are low and there are nice-smelling candles lit. Meanwhile the last time I went to the doctor for stress I had to sit naked in a paper gown in a too-cold room reading pamphlets about anal warts because I left my phone in my purse in the other room and I was bored because the doctor was seeing someone else and I had 30 minutes to kill before I finally saw someone – not the doctor, maybe a nurse? Some kind of assistant? Who spent a minute asking me some questions and then told me to take this prescription to Walgreen’s.

It’s not pleasant! And that’s a GOOD story, in that I have insurance and a doctor who fills my prescription for anti-anxiety drugs without grilling me about whether or not I’m going to walk outside and sell my pills to teenagers.

So. Does acupuncture prevent type 2 diabetes? I mean, probably not in the long term, any more than a nice massage or a long warm bath or a good night of sleep does. If you are prediabetic, your best bet is being even more “holistic” and all-natural than acupuncture, since there’s really nothing “natural” about sticking needles in your back. The most natural thing you can do is stop buying Whoppers and Frappucinos and Flaming Hot Cheeto Kraft Mac and Cheese, and instead buy stupid boring fruits and vegetables and beans and stuff, and maybe go for a walk. I know, it sucks, and honestly I get angry when I wake up the day after taking care of myself and realize I DO feel better. Yes, I would have failed the marshmallow test. But now that I think of it, failing the marshmallow test means I would only eat one marshmallow instead of the much less healthy two marshmallows, so isn’t that better?

I’m getting side-tracked. No. The answer is no, acupuncture isn’t going to prevent you from getting type 2 diabetes. Just try to take care of your body because as of right now it’s the only one you get.