Efficacy and optimal acupoints of auricular acupressure for treating prediabetes: a meta-analysis and data mining

Background and purpose Auricular acupressure has potential in treating prediabetes ; however, its effectiveness remains unclear. We aimed to evaluate the effect of auricular acupressure on blood glucose levels in patients with prediabetes and to identify optimal acupoints . Methods We searched nine public databases for randomized controlled trials published before March 1, 2025, according to pre-established inclusion and exclusion criteria. The risk of bias was assessed using the Risk of Bias 2 tool. RevMan 5.3 was employed to conduct a meta-analysis on glycosylated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and 2-h postprandial blood glucose (2h-PBG) levels, and body mass index (BMI). We used a Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Data mining was used to determine optimal acupoints . Results This meta-analysis involved eight studies (694 participants). Compared with lifestyle intervention alone, auricular acupressure combined with lifestyle intervention significantly reduced HbA1c (mean difference [MD] - 0.51, 95 % CI -0.84 to -0.18), FBG (MD -0.63, 95 % CI -0.94 to -0.31), and 2h-PBG (MD -0.78, 95 % CI -0.95 to -0.62) levels in patients with prediabetes but no significant effect was observed concerning BMI (MD -0.26, 95 % CI -1.15 to 0.63). The GRADE showed low to very low certainty levels of evidence. Data mining indicated that CO 4 , CO 10 , CO 11 , CO 13 , CO 14 , and CO 17 were core acupoints for prediabetes. Conclusion Auricular acupressure demonstrates potential as a complementary approach for prediabetes, with CO 4 , CO 10 , CO 11 , CO 13 , CO 14 , and CO 17 identified as optimal acupoints. However, due to methodological limitations, these findings require further validation through high-quality evidence.