Wet Cupping Therapy as A Complementary Intervention for Blood Glucose Reduction: Pre-Experimental Study

The objective of this review was to evaluate the effect of intravenous dexamethasone given intraoperatively for postoperative nausea and vomiting prophylaxis on maximal blood glucose level within the initial 24 hours following elective surgery for patients with diabetes. Postoperative nausea and vomiting is a prevalent adverse effect of anesthesia that leads to morbidity, increased health care costs, and unanticipated hospital admissions. Dexamethasone is an effective prophylactic agent that confers secondary analgesic and anti-inflammatory benefits. However, its use in patients with diabetes remains controversial due to the potential for increased postoperative blood glucose levels. This review considered studies with participants 18 years of age or older with type 1 or 2 diabetes undergoing an elective surgical procedure. Eligible studies reported postoperative blood glucose levels in adults with diabetes after receiving a single 4-10 mg prophylactic dose of intravenous dexamethasone intraoperatively for postoperative nausea and vomiting. The primary outcome was maximum blood glucose level in the first 24 hours after surgery. All study designs were eligible for inclusion. Studies were excluded if they lacked a control group with diabetes or if they did not report maximum blood glucose values in both groups. A search of MEDLINE, CINAHL Complete, Embase, Web of Science, TRIP database, and the Cochrane Database of Systematic Reviews was completed in October 2021. Gray literature resources were also searched. No date or language restrictions were applied. Methodological quality was assessed using JBI appraisal tools for randomized controlled trials, cohort studies, and case-control studies. A meta-analysis of maximal postoperative blood glucose level within 24 hours of surgery was performed, as well as subgroup analyses by dexamethasone dose, insulin treatment, and study design type. Eleven studies (4 randomized controlled trials, 6 cohort studies, and 1 case-control study) were included in this review, with 1 study excluded from meta-analysis and results reported narratively. The total sample size of studies included in meta-analysis was 2567. The administration of dexamethasone significantly increased maximal blood glucose levels in the 24 hours immediately following surgery compared with control groups with diabetes, as demonstrated by randomized controlled trials (mean difference [MD] 39.56 mg/dL; 95% CI 16.18 to 62.94; P < 0.001; I2 = 87%) and observational studies (MD 26.31 mg/dL; 95% CI 7.10 to 45.52; P = 0.007; I2 = 92%). This increase in blood glucose was significant for all doses of dexamethasone: 4 mg (MD 40.81 mg/dL; 95% CI 2.42 to 79.19; P = 0.001; I2 = 91%), 8 mg (randomized controlled trials only; MD 39.45 mg/dL; 95% CI 15.32 to 63.58; P = 0.001; I2 = 86%), and mixed 4-10 mg dose (MD 30.82 mg/dL; 95% CI 6.75 to 54.88; P < 0.012; I2 = 93%). Postoperative hyperglycemia persisted in studies using insulin treatment as well as those not using insulin protocols. The overall certainty of the findings ranged from very low for outcomes that included cohort studies to moderate when outcomes from randomized controlled trials were analyzed separately. However, the quantitative findings of the experimental and observational studies were clinically similar. Risk of bias presented minimal concerns in all included studies. Dexamethasone leads to transient postoperative hyperglycemia in patients with diabetes undergoing elective surgery when given as a single 4-10 mg intravenous dose for postoperative nausea and vomiting prophylaxis. The clinical relevance of hyperglycemia is debatable given its small magnitude and transient nature. Without more tightly controlled data, methodological consistency, and baseline blood glucose values, it is impossible to test causal links between hyperglycemia and pre-existing patient factors (eg, hemoglobin A1C levels) or postoperative complications. PROSPERO CRD42020185607.

Non-nutritive sweeteners (NNS) are suggested to reduce sugar and energy content of diet, but there is growing evidence that they can exacerbate obesity and diabetes through increasing appetite and energy intake. Stevia (stevioside extract), a natural sweetener, is being increasingly consumed, yet limited studies have looked at their effects on satiety and energy intake. The aim of this study is to investigate the effects of preloads of stevia on food intake, satiety and postprandial blood glucose levels when compared to water and sugar. Thirty participants (10 males/20 females; 26 ± 10.5 years; BMI: 23.44 ± 3.42 Kg/m2) took part in a three-arm single-blinded crossover trial. On separate test days, they received three different preloads (300 ml) containing water, sugar (60g) and stevia (1g) followed by an ad-libitum pizza lunch after 30 minutes. Breakfast was standardized. Blood glucose samples were collected before preload and lunch, and then at 30-minute intervals until 120 min post lunch. Volunteers recorded their feelings of satiety and hunger on visual analogue scales (VAS) before preload and after meal intake. A one-day diet diary was collected for each test day. Data was analysed using repeated measures ANOVA (SPSS Inc., Chicago, IL, USA). Despite the difference in energy content between preloads, there were no significant differences in energy intake at lunch between the three interventions (F (2, 56) = 0.25, p = 0.78). Furthermore, participants did not compensate by consuming more energy during the day after the stevia preload (1660 ± 584 Kcal) compared to sugar preload (1770 ± 763 Kcal, p = 0.82). There were no significant differences in VAS scores between stevia and sugar preloads, but participants scored significantly higher rates of hunger (before and after lunch) and desire to eat (before lunch) following water preload (p &lt; 0.05). No significant differences between water, sugar and stevia were noted for postprandial glucose levels (120 min post lunch) when adjusted from baseline (F (2, 58) = 2.56, p = 0.09). Area under the curve (AUC) for glucose did not differ between water and stevia (p = 0.2). Results are in line with several clinical trials showing that the consumption of sweeteners does not lead to an increase in hunger and energy intake, and could therefore present a useful strategy to assist with weight loss. Further studies looking at long-term effects of stevia on weight regulation are needed to support these findings.

Objetivos. Probar la efectividad del ejercicio de resistencia muscular en las cifras de hemoglobina glucosilada (HbA1c), en la fuerza muscular y en la fortaleza muscular percibida; explorar la influencia de la dieta, otros ejercicios, hipoglucemiantes y manifestaciones asociadas a episodios de hipoglucemia o hiperglucemia sobre el control glucémico de adultos con diabetes mellitus tipo 2 provenientes de los consultorios de endocrinología de dos hospitales públicos de la Ciudad de Monterrey, México. Procedimientos básicos. Se usó un diseño de 12 semanas de grupo control no equivalente con dos grupos, experimental (n1 = 14) y control (n2 = 11). Los participantes contaron con la recomendación de su médico para participar. Las sesiones de ejercicio fueron de una hora, dos veces por semana. Resultados. El grupo experimental mostró decremento significativo en el porcentaje de HbA1c, e incremento en la fuerza muscular y fortaleza muscular percibida (p &lt; .001). Posterior a la intervención ocho de once alcanzaron valores normales de HbA1c. No hubo efecto de las covariables. Conclusiones. Este tipo de intervención puede ayudar al control glucémico en adultos con diabetes mellitus tipo 2.

Advances in exercise, physical activity, and diabetes mellitus.

Journal of the American Geriatrics SocietyVolume 15, Issue 1 p. 108-108 BLOOD GLUCOSE LEVELS IN ADULTS, UNITED STATES, 1960–1962 First published: January 1967 https://doi.org/10.1111/j.1532-5415.1967.tb05347.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume15, Issue1January 1967Pages 108-108 RelatedInformation

Cupping glass therapy is rarely discussed in modern medical literature. It was commonly used for producing negative pressure in the field of oriental (Chinese) medicine. Cupping dates back over 3000 years, and is still believed to relieve pain and is used by alternative medicine practitioners, although evidence from well-designed randomised trials is lacking. Two representative forms of cupping therapy are popular. One is dry cupping. Cups are placed on the candidate's skin area to be treated and suction is applied using negative pressure. The other is wet cupping, which involves minimal incisions at the acupuncture points followed by placement of cups over the incisions, with small volume of bleeding. Keloids are a proliferative ailment of fibrous tissue secondary to trauma, infection, surgery and other various causes 1. Although cupping therapy is popular in an Asian population to relieve pain and other symptoms, no keloid cases have been reported in the literature. As trauma is one of the major causes, keloids can develop when wet cupping therapy is performed. We report a recent case of a patient who suffered from keloids on her scapular area caused by dry cupping therapy performed by an oriental medicine practitioner (Figure 1). The patient complained of intermittent itchiness and pain. She refused corticosteroid injection therapy because of the pain due to injection. Keloid in the scapular area can result in severe aesthetic problems, posing a significant burden on the patient 2, 3. Apart from its extreme rarity, we report this case to remind the clinician that both wet and dry cupping therapy by regulated oriental practitioners can result in unexpected keloids. Therefore, we stress the importance of exercising caution during cupping therapy and providing sufficient preexplanation to the patient regarding the possibility of keloid formations. Tae Hwan Park1,2 1Deokjeok Health Care Center, Incheon, Republic of Korea 2Department of Plastic Surgery, Keloid Research Foundation, New York, NY, USA [email protected]

Background &amp; objectives: Fatigue is one of the most common complaints in the population and a normal response to physical exertion or stress, but can also be a sign of a physical disorder. Besides taking rest and massage therapy, various other modalities have been employed to combat severe or perpetual fatigue. This study aims to investigate the effectiveness of wet cupping therapy (WCT) in general body fatigue. Methodology: We used a quasi-experimental design, a purposive sampling technique (non-probability) for sampling methods. A total of 50 participants from both genders were included. All participants were aged between 20 and 50 years and completed the questionnaire as a self-report measure. Data collection took place in multiple private nursing clinics, selected from different locations and during varied time intervals, to ensure broader coverage and accessibility. Individuals presenting with general body fatigue were identified and invited to report to clinical settings. Socio-demographic information, general health status, and score on a 10-point Fatigue Severity Scale (FSS), rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), were recorded and documented for each participant. Based upon these observations, the fatigue severity was classified as low or severe fatigue. The study’s aims and the intended procedures were clearly explained, and only those who voluntarily agreed to participate and fulfilled the inclusion criteria were enrolled in the final sample. Results: WCT was effective in alleviating fatigue in the participants of this study. There was a highly significant difference between pre- and post-wet cupping, as the percentage of participants with low fatigue assessment fell from 38% to 74%, and in participants with severe fatigue, it decreased from 18% to 0%. Conclusion: Wet cupping therapy has a statistically significant positive effect on reducing general fatigue among participants. The post-treatment assessments indicated a marked improvement in fatigue levels, highlighting the therapeutic potential of this traditional intervention in managing non-specific fatigue symptoms. Abbreviations: CAM: complementary and alternative medicine, FSS: Fatigue Severity Scale, WCT: wet cupping therapy, Keywords: General Fatigue; Hijama; Likert scale; Purposive sampling technique; Traditional Complementary Medicine; Wet Cupping Therapy Citation: Aziz AA, Falah MA. Wet cupping therapy is effective in alleviating general body fatigue. Anaesth. pain intensive care 2025;29(6):588-593. DOI: 10.35975/apic.v29i6.2918 Received: July 20, 2025; Revised: August 22, 2025; Accepted: August 27, 2025

The purpose of this study is to evaluate the effects of wet cupping therapy (WCT) on post-exercise recovery in active athletes. A total of 11 healthy and active athletes, with a mean age of 21.4 ± 1.77 years, an average height of 1.77 ± 0.1 m, a mean body weight of 75.4 ± 5.65 kg, and an average training experience of 10.6 ± 2.35 years, voluntarily participated in the study. Initially, the participants' resting heart rate and blood lactate levels were measured, followed by the Yoyo-1 test conducted until exhaustion. During the first measurement, heart rate and blood lactate levels were recorded post-exercise recovery at 3, 6, 9, 12, 15, 20, and 30 minutes. In the second measurement, the same test protocol was applied; however, this time, WCT was administered post-exercise recovery, and the same measurements were repeated at identical intervals. The data were analyzed using SPSS 26.0, and groups were compared using the Paired-Samples T-Test, with a significance level set at p&amp;lt;0.05. The results indicated that WCT had a significant effect on reducing blood lactate levels and heart rate after exercise. These findings suggest that WCT may be an effective method for enhancing recovery.

Background: According to the international diabetes federation, 629 million adults will suffer from diabetes by 2045. Wet cupping therapy is a combination of bleeding and dry cupping and has been used in traditional medicine as a complementary therapy for diabetes. Limonene was shown to have both antioxidant and antidiabetic activity but its potential alongside other treatments has not been thoroughly explored. Objectives: Although wet-cupping therapy is widely used under different conditions, its potential in the treatment of diabetes is not well-examined. Methods: Male Wistar rats were then injected with alloxan and nicotinamide to induce diabetes. After cupping, the rats’ serum nitric oxide, creatinine, SGPT, SGOT, cholesterol, triglyceride, glucose, GPX, urea, and HDL levels were determined. The glutathione, catalase, glutathione peroxidase, malondialdehyde, and protein level of the serum, renal, and liver were then measured. Results: The results showed a significant differences in serum glucose levels among the diabetic rats receiving wet cupping and limonene, in serum glutathione levels in diabetic rats receiving limonene or limonene and wet cupping compared to the diabetic rats, in liver GSH levels in control rats receiving limonene and wet cupping, in the liver GPX activity in control rats receiving limonene, and in liver catalase activity in control rats receiving limonene and wet cupping compared to control group. There was no significant change in serum NO, protein, creatinine, SGPT, SGOT, cholesterol, triglyceride MDA, urea, catalase, HDL, renal GSH, MDA, catalase, liver protein, and MDA Level. Conclusions: The findings of the present study suggested that a combination of limonene and wet cupping therapy could be presented as an agent to lower elevated blood glucose levels in diabetic rats. Further clinical studies are required to confirm the findings.

Vertigo is one of common complaints in the primary health care in the world. The common modern therapy for vertigo is using chemical pharmacological therapy yet having unwanted side effect. One of the wellknown complementary medicine that has been proven for relieving and curing many diseases is cupping therapy, especially wet cupping therapy. However, wet cupping therapy is not commonly applied in Indonesia healthcare. The causes may be due to the scarcity of the high quality scientific sources of the cupping therapy use for vertigo as well as the boundary between complementary and modern medicine in Indonesia. This review aimed to find out the use of wet cupping therapy against vertigo. A systematic review was obtained from NCBI and Google Scholar database (1999-2017) according to topic of interest. Yet Yunani, Persia, and China medicines recommend this therapy for treating vertigo as it had high level safety and effectivity. Wet cupping therapy has a potential effect in treating vertigo which the mechanism using negative pressure from vacuum cupping thus opening the skin barrier and removing causative pathology substances (CPS). Researchers and health practitioners essentially need to improve research in large scale towards the use of wet cupping against vertigo so the effectivity will be more optimal.Â

Background. Wet cupping therapy (WCT) is an ancient therapeutic practice involving suction cups and controlled incisions. It is widely used in traditional and complementary medicine systems for treating diverse conditions. This narrative review aimed to summarize the current evidence on the effects of WCT and provide an overview of its therapeutic potential. Methods. A comprehensive literature search was conducted using PubMed, Embase, and Scopus databases to identify studies published from January 2000 to March 2023, evaluating the therapeutic effects of WCT in various health conditions. The retrieved studies were critically reviewed and analyzed to identify key findings. Results. The findings suggest that WCT has potential therapeutic effects across different health conditions. It has been reported to alleviate pain, reduce inflammation, modulate the immune response, improve blood circulation, and enhance overall well-being. Efficacy of WCT has been demonstrated in managing musculoskeletal disorders (e.g., low back pain, rheumatoid arthritis), respiratory conditions (e.g., asthma, chronic obstructive pulmonary disease), and mental health issues (e.g., anxiety, sleep quality). Additionally, WCT has shown promise as a complementary therapy for metabolic disorders, cardiovascular diseases, and infertility. Conclusion. WCT exhibits potential benefits as a traditional therapeutic modality. Accumulated evidence suggests it can provide symptomatic relief, improve quality of life, and complement conventional treatments. However, it is important to acknowledge the limitations of the reviewed studies. The absence of a standardized cup placement protocol hinders determining optimal placement for specific health conditions. Further investigation considering anatomical descriptions and individual variations is necessary to enhance treatment effectiveness. Moreover, the underlying mechanisms of WCT's therapeutic effects are still hypothetical, warranting more direct and accurate evidence. Future research should focus on elucidating these mechanisms to establish a comprehensive understanding of WCT's effects.

Abstract. Cupping is one of the complementary therapies that can reduce blood pressure in people with hypertension. Wet cupping therapy is a cupping process by making a fine incision or stabbing to remove dirty blood in the epidermal capillaries and plays a role in controlling vasodilation so that blood pressure can decrease. The purpose of this study was to determine the effectiveness of complementary wet cupping therapy on reducing blood pressure in hypertensive patients at the Pomaala Public Health Center, Kolaka Regency. This study is a quantitative study, with a quasi-experimental design with a "pre-post test design" without a control group which was carried out in June to July 2022. The population in this study was carried out at the Pomalaa Health Center, Kolaka Regency with a total of 25 people. The statistical test method uses 2 different test models, namely the t test for systole and the Wilcoxon for diastole due to the normality test with the results of systole &gt;0.05 and diastole &lt;0.05. The results showed that pre-post obtained p value 0.001&lt; 0.05, on diastolic blood pressure obtained p value 0.001&lt; 0.05 indicating that Ha was accepted. Thus, it can be concluded that there is an effectiveness of complementary wet cupping therapy on reducing blood pressure in hypertensive patients. blood at the Pomalaa Health Center.

The Interactions Between Physicians and Dentists in Managing the Care of Patients With Diabetes Mellitus

Background: Type 2 diabetes has become a major global public health concern characterized by dysregulation of carbohydrate, lipid and protein metabolism, and results from impaired insulin secretion, insulin resistance or a combination of both Abstract: Acupressure lowers the blood glucose level through a massage at the point of the meridian, which can trigger the calming and uplifting response in the body, Resistive exercise is often recommended for patients with type 2 diabetes to improve physical conditioning and glycemic control. Aim of Study: The current study was conducted to compare between: Effect of resistive exercise and Acupressure on blood glucose level in type 2 diabetes. Subjects and Methods: Sixty patients (34 male 26 female) with type 2 diabetes participated in this study their age ranging from 35 to 60 years. They were selected from outpatient clinic in Internal Medicine, Luxor General Hospital. Group A: Received acupressure therapy (AT on point (Sp-6) which found atone palm width above the tip of inner ankle bone on the back of the shinbone, 3 minutes and repeated 3 times per session on both legs for three times per week for 12 weeks, in addition to hypoglycemic drugs. Group B: Received resistive exercise using dumbbell and sandbag, intensity of exercise for each muscle group determined after assessment of ten repetition maximum (10RM) 40% to 60% of 1RM (1 set 10 repetitions) used for 30 minute 3 time per week for 12 week beside their medication. 10RM reevaluated every 2 week and after 2 week load increase to 2 set 10 repetitions. Method of evaluation was measurement of random blood glucose level measured before starting and after each session glycosylated hemoglobin (HbA1c) fasting blood glucose level, 2 hour post prandial and glucose level and insulin level measured before starting and after end of program. Results: There was a significant decrease in randomized blood glucose, fasting blood glucose and increase in insulin level with no significant differences in HA 1 C and 2 hour post prandial in acupressure group when compared with resistive exercise group. Conclusion: Acupressure is more effective than resistive exercise as a complementary alternative medicine & can be helpful in reducing blood glucose level and increasing insulin levels in type 2 diabetic patients.

Type 1 Diabetes Mellitus