Metabolic and neuropathic outcomes following combined sodium-glucose cotransporter-2 inhibitor therapy and adjunctive acupuncture in obese patients with diabetic neuropathy: a case series.

Abstract

Background: Obesity and type 2 diabetes mellitus (T2DM) are associated with chronic metabolic dysregulation and microvascular complications, including diabetic peripheral neuropathy (DPN). This case series describes metabolic and patient reported outcomes during ongoing empagliflozin therapy with adjunctive acupuncture treatment.

Methods: The prospective observational case series included three adult participants with obesity, T2DM, and symptom defined DPN. All participants received empagliflozin 10 mg daily for at least 4 weeks before enrollment and continued treatment while receiving standardized acupuncture twice weekly for 10 weeks. Primary outcomes included body weight, body mass index (BMI), and waist circumference. Secondary outcomes included neuropathic pain intensity assessed using the visual analogue scale (VAS), sleep quality measured by a single-item sleep quality score, and fatigue assessed using the fatigue severity scale were recorded at baseline and week 10.

Results: All participants completed the intervention without adverse events. The body weight decreased by 4-9 kg, BMI by 1.2-3.5 kg/m², and waist circumference by 5-10 cm. VAS reduction range from 2 to 4 points, sleep quality and fatigue scores also improved consistently in all cases. Exploratory outcomes indicated enhanced mobility, reduced nocturnal neuropathic symptoms, and high treatment tolerability.

Conclusion: Combined therapy with SGLT2 inhibitors and acupuncture was associated with improvements in metabolic, neuropathic, and functional outcomes in obese patients with T2DM, and DPN. These findings suggest that a potential multidimensional therapeutic approach, however, larger controlled studies are required to confirm efficacy.