Metformin improved insulin resistance more than acupuncture, while acupuncture showed greater potential for lowering fasting blood glucose in women with polycystic ovary syndrome.
Researchers systematically searched international and Chinese medical databases for randomized controlled trials comparing acupuncture-based treatments with metformin for insulin resistance in women with polycystic ovary syndrome. Two reviewers independently selected studies, extracted outcome data, and assessed risk of bias using Cochrane guidance. They combined findings through meta-analysis and compared different acupuncture approaches using network analysis, examining insulin resistance, fasting glucose, fasting insulin, body mass index, and waist-to-hip ratio.
Across the included trials, metformin produced greater reductions in insulin resistance and fasting insulin than acupuncture, whereas acupuncture tended to produce larger reductions in fasting blood glucose, body mass index, and waist-to-hip ratio, although most differences were not statistically significant. When placebo controls were considered, metformin with sham acupuncture was more effective for insulin resistance, while acupuncture with placebo was more effective for fasting glucose. Electroacupuncture ranked as the most promising acupuncture approach for reducing insulin resistance, followed by abdominal acupuncture, but neither clearly outperformed metformin.
