Evidence map construction of acupuncture for type 2 diabetes mellitus and depression

Clinical trials employed acupuncture to manage depression complicated with type 2 diabetes mellitus (T2DM). This study conducted a comprehensive meta-analysis to construct the evidence map of acupuncture in treating patients with T2DM and depression based on RCTs. Randomized controlled trials (RCTs) comparing acupuncture against T2DM and depression with outcome measures of HAMD, HbA1c, and FPG were search from database. The Cochrane RoB 2 tool was selected to evaluate the quality of included RCTs and the GRADE approach was selected to assess the evidence strength. Meta-analysis was conducted to estimate standardized mean differences (SMD) with 95% confidence intervals (CIs). A total of 5 eligible RCTs was included and evaluated as acceptable quality. The SMD between acupuncture and controls was -1.56 (95% CI: [-2.23, -0.89]) with statistical significance (p<0.0001) on HAMD. The SMD between groups was -0.96 (95% CI: [-2.20, 0.29]; p=0.13) on HbA1c and -0.23 (95% CI: [-0.56, 0.09]; p=0.16) on FPG. The overall evidence strength was assessed as low-to-moderate. These findings indicated that acupuncture may be efficacy for patients with T2DM and depression. However, future studies should design and complete more RCTs with low risk of bias to strengthen the evidence quality.