Integrative care: acupuncture neuromodulation therapy for diabetes and heart failure

Acupuncture is suggested as a potential adjunct treatment, particularly for its effects on the sympathetic nervous system and nitric oxide signaling, offering new avenues for addressing these interconnected diseases. The relationship between heart failure and diabetes is complex and two-way, with diabetes increasing heart failure risk due to insulin resistance, inflammation, and metabolic issues, leading to vascular and nerve damage, atherosclerosis, and hypertension. Heart failure can also induce diabetes by affecting metabolism and increasing insulin resistance. This highlights the need for comprehensive management of both conditions.

Zhou W, Lee A, Zhou A, Lombardo D. Integrative care: acupuncture based neuromodulation therapy for diabetes and heart failure. Front Neurosci. 2024 Jan 17;18:1332957. doi: 10.3389/fnins.2024.1332957. PMID: 38298910; PMCID:

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The relationship between heart failure and diabetes is intricate and bidirectional. Individuals with diabetes face an elevated risk of developing heart failure due to factors like insulin resistance, chronic inflammation, and metabolic irregularities. Elevated blood sugar levels can harm blood vessels and nerves, culminating in the buildup of fatty deposits in arteries, atherosclerosis, and hypertension, which significantly contribute to heart failure. Furthermore, diabetes can adversely impact the structure and function of the heart muscle, impairing its pumping capacity. Conversely, heart failure can also contribute to the onset of diabetes by disrupting the body’s metabolic processes and amplifying insulin resistance. The complex interaction between these conditions mandates a comprehensive approach to managing individuals with both diabetes and heart failure, underscoring the importance of addressing both aspects for enhanced patient outcomes. Although existing pharmacological treatments are limited and frequently associated with undesirable side effects, acupuncture has established itself as a traditional practice with a legacy. It remains a supplementary option for treating cardiovascular diseases. Heart failure and diabetes are both heavily associated with chronic upregulation of the sympathetic nervous system, which has been identified as a pivotal factor in the progression of disease. Mechanistic interplays such as the attenuation of central nitric oxide signaling may interfere with the production or availability of nitric oxide in key areas of the central nervous system, including the brainstem and hypothalamus. This review will delve into the current understanding of acupuncture on the autonomic nervous system and offer insights into its potential role in the future treatment landscape for diabetes and heart failure.
Keywords: neuromodulation, acupuncture, brain stem, neurotransmitters, central nervous system, heart failure, diabetes