Can acupuncture increase microcirculation in peripheral artery disease and diabetic foot syndrome? – a pilot study

Peripheral artery disease and diabetes mellitus represent two major global public health challenges, affecting millions of people and causing serious complications that may lead to lower-limb amputation. Diabetes currently affects approximately half a billion people worldwide, with projections to grow to more than three-quarters of a billion by 2045. Likewise, peripheral artery disease shows rising prevalence, especially in people over 80 years of age, where it may affect more than 20% of the population. One of the most dreaded complications of these conditions is the development of diabetic foot syndrome and chronic non-healing wounds.

These wounds represent a true medical dilemma, as they frequently fail to respond to conventional treatments and may progress to severe infections, requiring amputation. Impaired blood circulation, both in large vessels and in the microcirculation, is considered a crucial factor in the healing process, making the search for new therapeutic approaches urgent.

This pilot study aimed to investigate whether acupuncture can improve microcirculation in patients with diabetic foot syndrome and peripheral artery disease. Researchers conducted a prospective study with 18 patients hospitalized at a German hospital, with 9 having diabetic foot syndrome and 9 having peripheral artery disease, all with chronic non-healing wounds. The methodology involved applying acupuncture at specific points on the thorax, between Stomach 14 and Stomach 15 points, located in the chest region. This selection followed traditional Chinese medicine principles, considering that these points are connected to the Stomach meridian, which extends down to the feet.

The technique used was relatively simple, with very fine needles inserted for only 5 minutes, with no prolonged retention. The researchers measured eight different microcirculation parameters using a device called O2C, which combines laser Doppler and white-light spectroscopy, allowing assessment of oxygen saturation, hemoglobin content, blood flow, and blood velocity at different skin depths near the wound.

The results obtained were surprisingly positive and statistically significant. After applying acupuncture on only one side of the body (ipsilateral to the wound side), there was significant improvement in seven of the eight microcirculation parameters measured. When acupuncture was applied bilaterally (on both sides of the body), all eight parameters showed statistically significant improvement compared with baseline measurements. This means that blood flow, tissue oxygenation, and other vascular health indicators improved measurably near the wounds.

The effects were observed at both superficial and deep skin depths, suggesting a comprehensive impact on local microcirculation. Interestingly, researchers also observed differences in response between diabetic patients and those with peripheral artery disease, with diabetic patients showing better responses on superficial measurements and patients with peripheral artery disease responding better on deep measurements.

These findings have potentially important clinical implications for both patients and healthcare providers. The demonstrated improvement in microcirculation may represent a fundamental step in the chronic wound healing process, since adequate blood circulation is essential to deliver the oxygen and nutrients needed for tissue regeneration. For patients, this may mean a new complementary therapeutic option that is safe and low-cost, and that could easily be integrated into conventional treatment. The technique was shown to be safe, with no reported adverse events, and relatively simple to apply, requiring only professionals trained in acupuncture.

For healthcare providers, especially those working with diabetic patients or patients with circulatory problems, acupuncture may represent a valuable additional tool in the therapeutic arsenal, especially in cases where conventional options prove limited. The simplicity of the technique, requiring only a 5-minute session, makes it potentially viable for both inpatients and outpatients.

It is important to acknowledge the significant limitations of this pilot study. The sample size was small, with only 18 participants, and it did not include a control group, which limits the ability to draw definitive conclusions about acupuncture's efficacy. In addition, the study measured only the immediate effects of acupuncture, without following the patients over a longer period to verify whether the benefits are sustained over time or whether they actually result in faster wound healing. The mechanisms by which acupuncture produces these effects on microcirculation are not yet fully understood, although the researchers suggest they may be related to autonomic nervous system regulation.

Future studies will need to include larger control groups, different acupuncture application techniques, and most importantly, to assess whether these microcirculation improvements translate into actual wound healing and better clinical outcomes for patients. Despite these limitations, this study represents a promising first step in investigating a potentially valuable complementary approach to a complex and challenging health problem.