6. Synergistic effects of medical Qigong with acupuncture on type 2 diabetes

Acupuncture and medical Qigong therapy work on the same energetic/Qi "map" of the body, using energy/Qi meridians and points to enhance the body's function in very specific ways. Receiving acupuncture treatments from an experienced Chinese medical practitioner supports the management of T2DM by improving the energetic function of the internal organs.

It must be noted that each individual may present differently and shift presentations over time and the acupuncture and Qigong protocols should be adjusted accordingly for best results. For example, a patient with T2DM and presenting with extreme fatigue, low back and knee pain, excess weight and low motivation may need much more focus on supporting their pancreas and kidneys and less focus on calming down excess energy of the liver. As the patient starts to feel higher energy levels and reduced pain, the acupuncturist might find that the hyperactive liver becomes much more prominent in the patient's presentation and would require an adjustment in the acupuncture treatment and medical Qigong exercises to address the shifting pattern differentiation and to make further progress.

When treating T2DM with acupuncture, practitioners of Chinese medicine may wish to consider two categories of points. The first category consists of points that harmonize and support the zang fu/organ imbalances within the body that are causing the condition. The second group consists of points that help shift unhealthy habits, behaviors and emotions that lead to unhealthy gene expression and diabetes.

From internal Qi-subtle energy-based observation, there are four common areas of zang fu/ organ disharmony and dysfunction in the body that must be shifted in order to manage T2DM. These four areas are: (1) excess energy in the liver, (2) low pancreas energy, (3) kidney energy deficiency and (4) an imbalanced autonomic nervous system (represented by the Ren and Du meridians). Although it is important to address all of these imbalances, the key to supporting the successful management of T2DM lies in addressing them at the correct time with each patient:

	- a. Important points for regulating the Qi and soothing a hyperactive liver: Liver 3, Liver 14, Liver 13, Large Intestine 4 and Large Intestine 10 [23, 44, 45].
	- a. Important points for increasing the energy of the pancreas: Pancreas 3 (Spleen 3), Pancreas 4 (Spleen 4), Pancreas 6 (Spleen 6), Bladder 20, Bladder 49, Pancreas 9 (Spleen 9), Stomach 36 and Stomach 40 [23, 44, 45].

a. Important points for increasing the energy of the kidneys: Kidney 3, Kidney 6, Kidney 7, Bladder 23, Bladder 52 and Pancreas 6 (Spleen 6) [23, 44, 45].

When treating T2DM with acupuncture, practitioners of Chinese medicine may wish to consider two categories of points. The first category consists of points that harmonize and support the zang fu/organ imbalances within the body that are causing the condition. The second group consists of points that help shift unhealthy habits, behaviors and emotions that lead to

From internal Qi-subtle energy-based observation, there are four common areas of zang fu/ organ disharmony and dysfunction in the body that must be shifted in order to manage T2DM. These four areas are: (1) excess energy in the liver, (2) low pancreas energy, (3) kidney energy deficiency and (4) an imbalanced autonomic nervous system (represented by the Ren and Du meridians). Although it is important to address all of these imbalances, the key to supporting the successful management of T2DM lies in addressing them at the correct time

1. Excess liver (wood element) energy must be released and drained to prevent it from overacting on and damaging the functions of the pancreas (earth element) and affecting the kidneys (water element). Each organ has specific connections with other organs in the body and has the ability to benefit or hinder these relationships. In T2DM, by bringing the liver energy into balance, it sets up the potential for the pancreas and kidneys to recharge and regain normal function. Also, by calming down the liver and creating balance between the liver and the pancreas, the biomedical liver can reduce the amount of glucose it is sending

a. Important points for regulating the Qi and soothing a hyperactive liver: Liver 3, Liver

a. Important points for increasing the energy of the pancreas: Pancreas 3 (Spleen 3), Pancreas 4 (Spleen 4), Pancreas 6 (Spleen 6), Bladder 20, Bladder 49, Pancreas 9 (Spleen

3. Low kidney energy creates an overall low energetic state in the body and may contribute to insulin resistance. In Chinese medicine, the kidneys are said to be the root of Qi and the foundation of yin and yang in the body [38]. If the foundation of all yin and yang is weak then the rest of the zang fu network can become weak as well. If the root of all the body's

2. Low pancreas energy leads to low insulin production and poor blood sugar management. By increasing the energy of the pancreas, its energetic function can improve and play an important part of managing T2DM. By improving the energy of the pancreas, other symptoms can also improve including a reduction in dampness and body weight, reduced fatigue, improved digestive function and less worry and anxiety. This is very important because by improving the pancreas Qi one is working on many different levels including the physiological level (insulin production), the emotional level (decreased worry and anxiety) and the physical level (weight and dampness). In addition, a stronger pancreas will have the energy to keep a potentially hyperactive liver in

14, Liver 13, Large Intestine 4 and Large Intestine 10 [23, 44, 45].

9), Stomach 36 and Stomach 40 [23, 44, 45].

energy is increased, the body can return toward its normal function.

unhealthy gene expression and diabetes.

78 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

with each patient:

into the bloodstream.

greater balance.

	- a. Important points for balancing the autonomic nervous system: Du 17: stimulates the upper parasympathetic nervous system; Du 2: stimulates the lower parasympathetic nervous system; Lung 7: confluent point of the Ren Meridian; Small Intestine 3: confluent point of the Du Meridian [44].

The second group of points to consider is points that help shift unhealthy habits, emotions and behaviors that contribute to diabetes. These include increased appetite and overeating, emotional and mental health (particularly overthinking, anxiety and worry) and a sedentary lifestyle.

One of the risk factors in T2DM is overeating. An important contribution of acupuncture is to reduce appetite and prevent overeating. Points to reduce appetite and overeating include: Stomach 44, Ren 12, appetite/hunger-control point on the ear.

Points to transform and decrease dampness are very important because dampness by nature makes one feel heavy, tired and stagnant [47]. By transforming dampness, one can feel lighter with increased energy and the desire to be less sedentary. Points include: Pancreas 9 and Stomach 40.

Points for reducing anxiety, worry and overthinking: Du 17, Heart 7 and Ren 17.
