Gastrointestinal symptoms, including diarrhea, chronic constipation, and fecal incontinence, are all common in people with diabetes, with chronic constipation the most common. Patients with diabetes who also have chronic constipation often experience impaired general health, social functioning, and mental health.
Currently available treatments include nonpharmacological treatment, changes in food and dietary habits, and lifestyle changes, in addition to medical management. These solutions, though, may be unsatisfying for patients and lead to side effects.
The current study protocol, published in Medicine, will result in a high-quality systematic review of the evidence for the use of acupuncture as a treatment for chronic severe functional constipation.
Researchers will evaluate randomized controlled trials of acupuncture therapy for chronic constipation in people adults with diabetes regardless of race, gender, education level, or socioeconomic status. Therapies will include acupuncture therapy, body acupuncture, electroacupuncture, plum blossom needle, warm needling, and fire needling; methods including transcutaneous electrical nerve stimulation, laser acupuncture, dry needling, cupping, and moxibustion will be excluded.
Researchers will then compare interventions including sham acupuncture, placebo, usual care, medication, no treatment, and other conventional therapies with acupuncture treatment.
Outcome measures include the Bristol stool scale, spontaneous complete bowel movements, and symptom observation, including defecation feeling, defecation weakness, the feeling of incomplete evaluation, bloating, and flatulence. Treatment efficacy per the Bristol stool scale was a secondary measure.
The investigators for this review and meta-analysis will search electronic databases from inception through December 1, 2020. All studies will be reviewed for risk bias, study quality, measures of treatment effect, issues with unit of analysis, missing data, and heterogeneity, in addition to sensitivity analyses and a Grading of Recommendations Assessment approach to judge the quality of evidence for the outcomes.
“This review will help [physicians] choose acupuncture as an alternative treatment for chronic constipation in patients with diabetes mellitus, and offer the patients more options to relieve their symptoms,” the researchers concluded.
Cui S, Yang Q, Xie S, Liu Q, Zhou G. Acupuncture for chronic constipation in patients with diabetes mellitus: A protocol for systematic review. Published online March 5, 2021. Medicine. doi: 10.1097/MD.0000000000024886