When Acupuncture Meets Diabetic Foot: From CGRP Release to Microcirculatory Repair
The Physiological Link Between Neuropeptides, Mitochondria, and Chronic Wound Healing
Chronic wounds and diabetic foot conditions commonly seen in people with diabetes are not simply cases of “broken skin.”
Rather, they reflect a local microenvironment characterized by
chronic hypoxia, low cellular energy, persistent inflammation, and neural dysfunction.
Under such conditions, even with adequate glycemic control, tissues may struggle to initiate effective repair.
Why Are Diabetic Foot Wounds Particularly Difficult to Heal?
The chronic nature of diabetic foot wounds typically involves multiple physiological barriers acting simultaneously:
- Impaired microvascular perfusion leading to long-term tissue hypoxia
- Peripheral neuropathy reducing protective reflexes and repair signaling
- Chronic low-grade inflammation and increased oxidative stress (ROS)
- Reduced energy metabolism in fibroblasts and keratinocytes
- Decreased efficiency of immune cell recruitment, increasing infection risk
When Acupuncture Intervenes: From Nerve Endings to Microcirculation
By stimulating specific acupoints, acupuncture activates sensory nerve endings and promotes the release of neuropeptides.
One of the most critical mediators in this process is
CGRP (calcitonin gene–related peptide).
CGRP is one of the most potent endogenous vasodilators known, capable of rapidly increasing blood perfusion
in local skin and soft tissues, thereby improving oxygen and nutrient delivery.
Why “Deqi” Is Especially Important in Diabetic Foot Care
Only when the stimulation intensity reaches the threshold of “Deqi” can neural activation cross sensory thresholds,
prompting C-fiber neurons to release CGRP and related neuropeptides.
This effect goes beyond vasodilation. More importantly, it
reduces oxidative stress (ROS), protects mitochondrial function, and restores the cell’s capacity for energy production.
Physiological Roles of Key Acupoints
Zusanli (ST36): Modulates systemic immune and inflammatory responses and influences the neuro–immune axis,
creating a lower-inflammatory, repair-supportive internal environment for chronic wounds.
Sanyinjiao (SP6): Closely associated with distal lower-limb circulation,
with clinical relevance for enhancing tissue oxygenation and microcirculatory efficiency.
The Turning Point from Improved Blood Flow to Cellular Repair
As local microcirculation improves, oxygen delivery increases, and mitochondrial ROS levels decline,
fibroblasts previously impaired by hyperglycemia and energy deficiency can resume collagen synthesis,
allowing the wound to enter a true reparative phase.
Clinical Note:
If a diabetic foot presents with redness, swelling, warmth, pain, foul-smelling discharge, black necrotic tissue,
or systemic discomfort, immediate medical evaluation is required.
Acupuncture is part of integrative care and should be combined with glycemic control,
appropriate wound management, and necessary medical interventions.
References
1. Grotle, A. K., et al. (2021). Acupuncture and Neuro-Immune Interactions.
2. Sarker, M. S., et al. (2022). Acupuncture for Diabetic Peripheral Neuropathy.
3. Loaiza, L. A., et al. (2002). Electro-acupuncture induces local cutaneous vasodilation through CGRP release.
4. Fan, X. L., et al. (2021). Protective effects of acupuncture on mitochondrial function.
5. Kim, J., et al. (2018). The Role of CGRP in Wound Healing and Tissue Regeneration.
Jade Health Life
Jade Health Acupuncture 
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