Introduction
Diabetes refers to disturbance of the metabolism of sugar, fat and protein due to relative or absolute insufficiency of insulin in the body marked by hyperglycemia and glycuresis. The clinical symptoms are polyuria, polydipsia, polyphagia, fatigue and emaciation. In severe cases ketosis and acidosis may be caused. It may also lead to severe complications like coronary heart disease, ischemic cerebrovascular disease, kidney disease, ocular fundus disease, acromelic gangrene and nervous lesion. This disease is similar to "Xiaoke" (diabetes) in TCM. It is usually caused by extreme changes of emotions; or by excessive intake of greasy foods and alcohol; or by intemperance of sexual life leading to consumption of yin due to dryness and heat; or by transformation of dryness from yin asthenia and interior heat that results in lung dryness, stomach heat and kidney asthenia, eventually leading to upper diabetes, middle diabetes and lower diabetes. Prolonged duration will give rise to asthenia of both qi and yin or asthenia of both yin and yang.

Syndrome Differentiation
Upper diabetes: Thirst and polydipsia, dry mouth and tongue, frequent and profuse urination, red tip and margins of the tongue, yellow and thin tongue fur, full and rapid pulse.

Middle diabetes: Polyphagia, heartburn, restlessness and fever, profuse sweating, emaciation, or constipation, profuse cloudy and yellow urine, yellow and dry tongue fur, slippery and rapid pulse.

Lower diabetes: Profuse and frequent urination, turbid urine with sweet taste, thirst and polydipsia, dizziness, blurred vision, red cheeks and vexation, aching of loins and flaccidity of knees, or dry skin, general pruritus, red tongue, thin and rapid pulse.

Asthenia of yin and yang: Frequent urination, turbid urine like paste, blackish complexion, dryness of earlobe, aversion to cold and cold limbs, sexual hypoesthesia, light and dull colored tongue with white fur, deep, thin and weak pulse.

Treatment
1. Body Acupuncture
Prescription: Weiwanxiashu (EX-B 3), Geshu (BL 17), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Zusanli (ST 36) and Sanyinjiao (SP 6).

Modification: For upper diabetes, Xinshu (BL 15), Taiyuan (LU 9) and Shaofu (HT 8) are added; for middle diabetes, Weishu (BL 21) and Neiting (ST 44) are added; for lower diabetes, Ganshu (BL 18), Taixi (KI 3) and Taichong (LR 3) are added; for asthenia of both yin and yang, Guanyuan (CV 4) and Mingmen (GV 4) are added；for thirst and dry mouth, Lianquan (CV 23) and Chengjiang (CV 24) are added; for polyphagia, Zhongwan (CV 12) and Fenglong (ST 40) are added; for profuse sweating, Fuliu (KI 7) is added; for blurred vision, Guangming (GB 37), Touwei (ST 8) and Cuanzhu (BL 2) are added; for skin itching, Fengchi (GB 20), Dazhui (GV 14), Quchi (LI 11), Xuehai (SP 10) and Zhaohai (KI 6) are added.

Performance: Weiwanxiashu (EX-B 6), a key effective acupoint for treating diabetes, should be needled 0.5-0. 8 cun obliquely toward the spinal column with reinforcing needling technique. The rest acupoints is needled with reinforcing needling technique or mild reinforcing and reducing needling techniques.

2. Ear Acupuncture
Prescription: Pancreas and gallbladder (CO11), Endocrine (CO18), Lung (CO14), Stomach (CO4), Kidney (CO10), Bladder (CO9), Thirst point (midpoint on the line joining External Nose and Ear Apex) and Hunger Point (External Nose).

Performance: Each time 3 - 4 acupoints are selected and needled with filiform needles and mild stimulation. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear acupressure. The two ears are pressed in alternation.