Catgut Embedding Therapy Alleviates Diabetic Cardiomyopathy and Diabetic Nephropathy by Regulating Glycolipid Metabolism and Inhibiting Ferroptosis

Background: Diabetic cardiomyopathy (DCM) and diabetic nephropathy (DN) are serious yet common diabetes complications. The imbalance of glucolipid metabolism is a key mechanism underlying the pathogenesis of DCM and DN. Acupoint Catgut Embedding (ACE), a major form of acupuncture therapy, exerts its effects through sustained acupoint stimulation and is clinically recognized as an effective type 2 diabetes mellitus (T2DM) treatment. However, whether ACE can regulate glucolipid metabolism to alleviate diabetic complications is still unclarified. Objective: This study aimed to investigate the therapeutic effects of ACE on DCM and DN and to explore its potential underlying mechanisms. Materials and Methods: A rat model of T2DM-related complications was created, and catgut embedding was performed at acupoints, including Shenshu (BL23), Yishu (EX-B5), Zusanli (ST36, He-Sea Point), and Sanyinjiao (SP6). Enzyme-linked immunosorbent assay (ELISA) was used to assess glucolipid metabolism; cardiac and renal function, along with the relevant pathway mechanisms, were evaluated by ultrasound, pathological staining, Western blotting, and qPCR analyses. Results: Compared with the model group, ACE therapy significantly improved cardiac and renal function. ELISA results further demonstrated that ACE balanced glucolipid metabolism. Additionally, the model group exhibited ferroptosis and heightened inflammation, whereas ACE reversed these effects. Mechanistically, ACE significantly activated the PI3K/AKT pathway in both DCM and DN. Conclusions: In summary, our outcomes illustrate that ACE activates the PI3K/AKT pathway to maintain glucolipid metabolic homeostasis, thereby inhibiting ferroptosis, alleviating inflammation, and ultimately improving DCM and DN. This study provides novel therapeutic strategies and potential targets for treating DCM and DN.