Disease and Condition Overview
Type 2 diabetes is a metabolic and endocrine disease characterized by increased thirst and hunger, frequent urination, weight loss and elevated blood sugar. In Chinese medicine, its root cause is yin deficiency while dryness and heat are the manifestations. Dry heat resides in lung, damages fluids, leading to thirst. Heat stagnates within stomach, scorches fluid in the stomach and leads to frequent hunger. Empty fire in kidney and kidney deficiency leads to the inability to store urine and results in frequent urination. In a vicious cycle where excess dry heat leads to yin deficiency, the more deficiency of yin then the greater the excess dry heat until lung dryness, stomach heat and kidney deficiency all tangle into one. After a prolonged period the yin deficiency can lead to yang deficiency which can result in the qi and yin deficiency and yin and yang deficiency.

Diabetes is differentiated into primary and secondary diabetes. Within the primary diabetes category, the disease is further differentiated into Type 1 and 2 diabetes. Most cases are Type 2 diabetes which includes elevated blood sugar but not the typical symptoms of excess hunger, thirst, urination and weight loss.

Pair-point Treatment Combinations

(1) Pishu (BL20), Weishu (BL21) (Fig 23)
Pishu (BL20), Weishu (BL21) are the back-shu points of spleen and stomach. Spleen governs transformation and transportation while stomach governs the ascending and descending of nutrients. This pair point combination, one elevating and one lowering, strengthens spleen, harmonizes stomach and tonifies deficiency. This treatment is appropriate for all types of diabetes.

Needling techniques:
1. Pishu (BL20), Weishu (BL21) both points perpendicular insertion to a depth of 1 cun, manipulate using "dao qi" method.
2. Warm needle, or after needling, apply moxibustion for 15 minutes.

(2) Xingjian (LR2), Yongquan (KI1) (Fig 117)
Xingjian (LR2): on the dorsum of the foot, between the first and second toe, proximal to the margin of the web, at the junction of the red and white skin.
Yongquan (KI1): on the sole, in a depression formed when the foot is planter flexed, at the junction of the anterior third and posterior two-thirds of the line connecting the base of the second and third toes and the heel.

Xingjian (LR2) clears and reduces liver fire and heat in the blood. Yongquan (KI1) clears heat and tonifies yin. This pair point combination, one liver and one kidney, clears heat and tonifies yin and kidney, nourishes liver, clears heat and stops leaks. This treatment is appropriate for diabetes accompanied by inner heat syndrome.

Needling techniques:
1. Xingjian (LR2) perpendicular insertion to a depth of 0.5 cun.
2. Yongquan (KI1) perpendicular insertion to a depth of 1 cun.

Commentaries
Acupuncture treatment for diabetes has a long history. The treatment of Type 2 diabetes using acupuncture has excellent results; however, for type 1 diabetes and secondary diabetes, it has minimal effects.

Pishu (BL20) and Weishu (BL21) are appropriate for all types of Type 2 diabetes. Using moxibustion can improve clinical symptoms and also regulate blood sugar as well. For cases accompanied by inner heat syndromes, select Xingjian (LR2), Yongquan (KI1).