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Amir Firouzjaei is currently working as a Dean of acupuncture department at pardis multiple pain clinic, Acupuncturist, Tehran, Iran. He completed his Clinical Ph.D in Chinese Medicine, Acupuncture and Moxibustion specialty, Nanjing at the University of Chinese Medicine (Full time Clinical Ph.D.). Doctorate in Medicine, General Physician Specialty (full term M.D. study).
Objective: Obesity induces insulin resistance (IR), the key etiologic defect of type 2 diabetes mellitus (T2DM). Therefore, an incidence of obesity-induced diabetes is expected to decrease if obesity is controlled. Although, Metformin is currently one of the main treatment options for T2DM in obese patients, resulting in an average of 5% weight loss, adequate weight control in all patients cannot be achieved with Metformin alone. Thus, additional therapies with a weight loss effect, such as acupuncture, may improve the effectiveness of Metformin. Subjective: We designed this randomized clinical trial (RCT) to compare the effects of Metformin monotherapy with that of Metformin and acupuncture combined therapy on weight loss and insulin sensitivity among overweight/obese T2DM patients, to understand whether acupuncture plus Metformin is a better approach then Metformin only on treating diabetes. To understand whether acupuncture can be an insulin-sensitizer and, if so, its therapeutic mechanism. Results: Our results show that Metformin and acupuncture combined therapy significantly improves body weight, body mass index (BMI), fasting blood sugar (FBS), fasting insulin (FINS), homeostasis model assessment index (HOMA), interleukin-6 (IL-6), tumor necrosis factor-? (TNF-?), leptin, adiponectin, glucagon-like peptide-1 (GLP-1), resistin, serotonin, free fatty acids (FFAs), triglyceride (TG), low density lipoprotein cholesterol (LDLc), high density lipoprotein cholesterol (HDLc), and ceramides. Conclusion: Consequently, Metformin and acupuncture combined therapy is more effective than Metformin only, proving that acupuncture is an insulin-sensitizer and is able to improves insulin sensitivity possibly by reducing body weight and inflammation, while improving lipid metabolism and adipokines. As a result, electro-acupuncture (EA) might be useful in controlling the ongoing epidemics in obesity and T2DM.