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Acupoint injection increases the efficacy of vitamin B12 for diabetic neuropathy: a meta-analysis and trial sequential analysis

European Journal of Clinical Nutrition (2025)Cite this article

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Abstract

This study aims to systematically evaluate the efficacy and safety of vitamin B12 acupoint injections compared to other administration routes in treating diabetic neuropathy (DN). We included 20 randomized controlled trials published before March 1, 2024, sourced from eight public databases, involving 1688 participants. Subsequently, we recorded their basic data, investigated their risk of bias, and then carried out a meta-analysis and trial sequential analysis (TSA). The meta-analysis revealed that compared to other administration routes of vitamin B12, acupoint injection significantly improved the clinical effectiveness proportion by 28% (risk ratio [RR] 1.28, 95% confidence interval [CI] 1.22–1.35), peroneal nerve motor nerve conduction velocity (MNCV) by 4.43 m/s (MD 4.43, 95% CI 2.83–6.03), peroneal nerve sensory nerve conduction velocity (SNCV) by 3.82 m/s (MD 3.82, 95% CI 3.23–4.41), median nerve MNCV by 5.48 m/s (MD 5.48, 95% CI 4.71–6.24), and median nerve SNCV by 4.62 m/s (MD 4.62, 95% CI 3.84–5.39) in patients with DN, while having no significant impact on fasting blood glucose (FBG) (MD −0.18, 95% CI −0.44 to 0.08), 2-h postprandial blood glucose (2h-PBG) (MD −0.02, 95% CI −0.36 to 0.33), and the adverse event incidence (RR 1.44, 95% CI 0.44–4.70). TSA indicated that except for FBG, 2h-PBG, and adverse event incidence, the remaining meta-analysis results were conclusive. These findings indicate that compared to other administration routes of vitamin B12, acupoint injection improves neurological function in patients with DN without increasing adverse events and economic burden, suggesting that it may be the optimal administration route for vitamin B12.

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Fig. 1
Fig. 2
Fig. 3
Fig. 4: Forest plots of the meta-analysis on the nerve conduction velocity.
Fig. 5: Forest plots of the meta-analysis on the blood glucose.

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Data availability

The data from this study are available upon request to the corresponding author.

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Funding

This study was funded by the National Natural Science Foundation of China [U21A20411].

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Author notes

  1. These authors contributed equally: Yunfeng Yu, Tongyi Zhou.

Authors and Affiliations

  1. School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China

    Yunfeng Yu, Liu Li, Xiu Liu, Yuman Yin & Rong Yu

  2. The First Hospital of Hunan University of Chinese Medicine, Changsha, China

    Yunfeng Yu, Tongyi Zhou & Rong Yu

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  1. Yunfeng Yu
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Contributions

YYu and RY designed the study. YYu, TZ, and XL collected and organized data. LL and YYin performed the statistical analysis. YYu, TZ, XL, LL, and YYin wrote the manuscript. RY reviewed and revised the manuscript. All authors contributed to the article and approved the submitted version.

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Correspondence to Rong Yu.

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Yu, Y., Zhou, T., Li, L. et al. Acupoint injection increases the efficacy of vitamin B12 for diabetic neuropathy: a meta-analysis and trial sequential analysis. Eur J Clin Nutr (2025). https://doi.org/10.1038/s41430-025-01631-z

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