Citation: Šimat, M.; Jankovi´ c Makek, M.; Miˇ ceti´ c, M. Treatment of Diabetes Mellitus by Acupuncture: Dynamics of Blood Glucose Level and Its Mathematical Modelling. Sci 2023, 5, 38. https://doi.org/10.3390/ sci5040038 Academic Editor: Gerhard Litscher Received: 10 July 2023 Revised: 15 September 2023 Accepted: 19 September 2023 Published: 26 September 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Article Treatment of Diabetes Mellitus by Acupuncture: Dynamics of Blood Glucose Level and Its Mathematical Modelling Marija Šimat 1 , Mateja Jankovi´ c Makek 2,3 and Maja Miˇ ceti´ c 4, * 1 Acula & Sieber, Acupuncture Practice, 10000 Zagreb, Croatia; marijasimat@yahoo.com 2 Department for Lung Diseases Jordanovac, University Hospital Center Zagreb, 10000 Zagreb, Croatia; mjankovi@kbc-zagreb.hr 3 School of Medicine, University of Zagreb, 10000 Zagreb, Croatia 4 Ru ¯ der Boškovi´ c Institute, 10000 Zagreb, Croatia * Correspondence: maja.micetic@irb.hr; Tel.: +385-1-468-0224 Abstract: The aim of this research is to present the effects of acupuncture treatment on morning blood glucose level (BGL) in type 2 diabetes mellitus (T2DM) patients, and to describe them by a predictive model. The morning BGL is measured after overnight fasting during a three-month long acupuncture treatment for two persons diagnosed with T2DM and is compared with the BGL of two persons in similar health conditions taking only metformin-based drugs. It is shown that the morning BGL is highly affected by each single acupuncture treatment and by the number of the already applied treatments. Significant lowering of BGL after each treatment is observed, as well as an overall BGL lowering effect, which is the result of the repeated acupuncture. The observed BGL reduction was found to be maintained during a follow-up performed a year after the acupuncture. The measured BGL dynamics curves are analyzed and described by a model. This model describes well all of the key features of the measured BGL dynamics and provides personal parameters that describe the BGL regulation. The model is used to simulate BGL regulation by acupuncture performed with different frequencies. It can be used generally to predict the effects of acupuncture on BGL and to optimize the time between two treatments. The results will enable a better understanding of acupuncture application in diabetes, and a prediction of its effects in diabetes treatment. Keywords: diabetes mellitus; insulin resistance; treatment; blood glucose level; acupuncture; modelling; prediction 1. Introduction Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by elevated blood glucose levels (BGL) resulting from peripheral insulin resistance and pro- gressive defective insulin secretion [1] and currently affects around 537 million adults (20–79 years old) worldwide. In addition, another 541 million adults have been diagnosed with impaired glucose tolerance or prediabetes—a state in which blood glucose levels are higher than normal but not high enough to be classified as diabetes—the majority of whom will eventually develop T2DM [2,3]. Elevated and poorly regulated BGLs affect multiple organ systems, resulting in the development of complex comorbidities, including coronary disease, cerebrovascular incidents, kidney failure, and blindness, ultimately contributing to higher mortality rates. The burden on public health systems and healthcare spending associated with treating these conditions is significant and amounted to US$237 billion in 2017 in the US alone [4]. In the past years there has been a growing interest in the study of the potential benefits of acupuncture and electroacupuncture—a technique that involves the application of elec- trical stimulation to acupuncture points—in the management of diabetes and prediabetes, techniques which have shown promising results as complementary treatment options. These have been demonstrated to be effective when correcting multiple metabolic disorders Sci 2023, 5, 38. https://doi.org/10.3390/sci5040038 https://www.mdpi.com/journal/sci