The Effect of Acupressure on Fasting Blood Glucose and Glycosylated Hemoglobin Levels in Diabetic Patients: A Randomized Controlled Trial

Document Type: Original Article


1 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;

4 Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;


Background: Diabetes is the most common endocrine disorder. Non-pharmacological methods
can be used for treatment of these patients. The present study aimed to investigate the effect of
acupressure point on fasting blood glucose and glycosylated levels of diabetic patients.
Methods: This clinical trial was conducted on 102 patients who referred to Motahari Clinic of
Shiraz during May-June in 2018. The participants were selected based on simple random sampling
and divided into three groups via permuted block randomization. The control group only received the
pharmacological treatments. The intervention group received acupressure at ST36 point in addition
to medications. The placebo group also received medications and acupressure at a fake point. The
intervention was carried out for six minutes (three minutes for each lower extremity), three sessions
a week for 12 weeks. Fasting blood glucose and glycosylated hemoglobin levels were checked in all
patients immediately after the intervention. The data were analyzed using Chi-square, paired t-test, and
ANOVA by the SPSS statistical software, version 21, and p Results: The results showed no significant differences among the three groups’ blood glucose mean
levels before (P=0.89) and after the intervention (P=0.36). However, a significant difference was
observed in the intervention group’s glycosylated hemoglobin mean levels before (8.61±1.96) and after
the intervention (8.1±1.62) (P=0.02).
Conclusion: In sum, the study indicated that acupressure could only be effective in reducing the
glycosylated hemoglobin in the intervention group. Thus, further larger studies are recommended to
evaluate the effectiveness of this technique.


  1. Khazaei Z, Naemi H, Goodarzi E, et al. Investigating self-care performance of diabetic patients at a diabetes center; a single center pilot study. Journal of Nephropharmacology. 2018;7:24-31.
  2. Hinkle JL, Cheever KH. Brunner & Suddarth’s textbook of medical-surgical nursing. 14th ed. Philadephia: Lippincott Williams & Wilkins; 2017.
  3. Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice. 2017;128:40-50.
  4. Kaiser AB, Zhang N, Van Der Pluijm W. Global prevalence of type 2 diabetes over the next ten years (2018-2028). Diabetes. 2018;67(Supplement 1).
  5. Badran M, Laher I. Type II diabetes mellitus in Arabic-speaking countries. International Journal of Endocrinology. 2012;2012:902873.
  6. Hussain A, Hydrie MZI, Claussen B, Asghar S. Type 2 Diabetes and obesity: A review. Journal of Diabetology. 2010;2:1-7.
  7. Kasper D, Fauci A, Hauser S, et al. Harrison’s principles of internal medicine. 19th ed. New York: McGraw-Hill Education; 2015.
  8. Eeg-Olofsson K, Zethelius B, Gudbjörnsdottir S, et al. Considerably decreased risk of cardiovascular disease with combined reductions in HbA1c, blood pressure and blood lipids in type 2 diabetes: report from the Swedish National Diabetes Register. Diabetes and Vascular Disease Research. 2016;13:268-77.
  9. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140-9.
  10. Medagama AB, Bandara R. The use of complementary and alternative medicines (CAMs) in the treatment of diabetes mellitus: is continued use safe and effective? Nutrition Journal. 2014;13:102.
  11. Saidi M, Shamsi Khani S, Motavaripour P, Farahani P. Complementary medicine, alternative medicine and the role of the nurse. Tehran: Heidary; 2015. [In Persian]
  12. Fitrullah, Rousdy A. Effectiveness of Acupressure at the Zusanli (ST-36) Acupoint as a Comfortable Treatment for Diabetes Mellitus: A Pilot Study in Indonesia. Journal of Acupuncture and Meridian Studies. 2017;10:96-103.
  13. Zarvasi A, Jaberi AA, Bonabi TN, Tashakori M. Effect of self-acupressure on fasting blood sugar (FBS) and insulin level in type 2 diabetes patients: a randomized clinical trial. Electronic Physician. 2018;10:7155-63.
  14. Yodsirajinda S, Piaseu N, Nicharojana LO. Effects of Foot Reflexology Integrated with Medical use on Hemoglobin A1c and Ankle Brachial Index in Older Adults with Type 2 Diabetes Mellitus. The Bangkok Medical Journal. 2016;12:21-7.
  15. Chao HL, Miao SJ, Liu PF, et al. The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer. Oncology Nursing Forum. 2013;40:E61-8.
  16. Meng H, Hao JD, Wang HC, et al. Effects of different frequencies of electroacupuncture on blood glucose level in impaired glucose tolerance patients. Acupuncture Research. 2011;36:220-3. [In Chinese]
  17. Bay R, Bay F. Combined therapy using acupressure therapy, hypnotherapy, and transcendental meditation versus placebo in type 2 diabetes. Journal of Acupuncture and Meridian Studies. 2011;4:183-6.
  18. Guirguis SA, El-Sisi HF, Aly FA, Aly YS. Effect of Acupressure on Glycated Hemoglobin and Lipids Profile in Type 2 Diabetic Women. Med J Cairo Univ. 2016:84;69-75, 2016.
  19. Lao L, Bergman S, Hamilton GR, et al. Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. Archives of Otolaryngology–Head & Neck Surgery. 1999;125:567-72.