Diabetes From a Traditional Chinese Medicine Perspective

Do you know someone with Diabetes? The finger pricking for drops of blood to check blood glucose level. The insulin injections. Checking new foods on a glycemic index. Most people have a friend or relative with this all too common condition. There are two types of diabetes. Type 1 usually occurs during childhood or adolescence. Type 2 is the most common and usually occurs in people who are 45 years of age or older. However type 2 is being diagnosed at an increasing rate in adolescents.

The medical diagnostic of diabetes is high blood sugar or glucose in the blood. This is glucose that should be in the cells. It is this lack of cellular glucose which is the problem. Glucose provides the cell with much of the energy it needs to function. Insulin from the pancreas moves the glucose from the blood stream into the cells. Diabetes often carries with it circulatory complications involving large and small blood vessels. This can cause scarring and hardening in the arteries (arteriosclerosis), kidneys (glomerulosclerosis) , and eyes (retinopathy). The decreased circulation caused by diabetes can cause organs and soft tissue to harden or calcify. Common complications associated with soft tissue calcification are osteoporosis or osteopenia, neuropathy, and foot and leg ulcers. Western medicine seeks to regulate blood glucose through diet modification and insulin. Often recommended to increase cellular glucose uptake are weight loss (when appropriate) and exercise (1).

Let’s leap into the Traditional Chinese Medicine (TCM) view of diabetes or “Wasting and Thirsting”. TCM diagnoses diabetes as a deficiency Yin. Biomedical knowledge of diabetes reflects the TCM view. Blood is a Yin component. Yin is fluid and cooling. Yang is an active and hot component. Glucose, the cellular energy molecule correlates with Yang. When there is too much Yang (glucose) in the Yin (blood) the Yin gets heated and dried out. In TCM terms, the Yin is deficient. We’ve seen that diabetes can compromise different body parts and systems. This is recognized in TCM as well. Traditionally there are three types, or Xiao-Ke: upper, middle, and lower. The upper Xiao-Ke, associated with lungs is characterized by excessive thirst. The middle is the stomach and there is excessive hunger. The lower is paired with Kidneys and excessive urination. At some point, most people with diabetes manifest symptoms of all three types⁽¹⁾.

Sha Shen Mai Men Dong Wan

Glenna and Ophiopogonis Decoction

Upper Xiao Ke

This one is primarily for the Yin of the Lungs and secondarily for Stomach Yin. When a diabetic has excessive thirst it is the one to pick. Other indications are dry throat and dry hacking cough. Sha Shen Mai Men Dong Wan was composed over 200 years ago to eliminate dry pathogens.⁽²⁾ It contains herbs traditionally used for diabetes and herbs which modern research has found to lower blood sugar, or more accurately put glucose into the cells where it can be used.⁽³⁾ Both Mai Men Dong (Ophiopogonis) and Tian Hua Fen (Trichosantes kirilowii) are traditionally used for wasting and thirsting. In diabetic rabbit and mouse research shows Mai Men Dong lowers blood sugar and increases glycogen storage.⁽⁴⁾ Tian Hua Fen lowers blood sugar in mice.⁽⁵⁾ Gan Cao or licorice is not traditionally used for wasting thirsting, but used in a majority of Chinese herbal formulas. Research shows that it stimulates insulin secretion. This enhances glucose uptake into the cells.⁽⁶⁾

Da Bu Yin Wan

Great Tonify the Yin Pill

Middle Xiao Ke

Da Bu Yin Wan treats Stomach Yin deficiency with upward flaring fire. For the diabetic this presents with constant hunger, on and off feelings of heat in the afternoon, and night sweats. Legs and knees may feel weak, painful or hot. Yin deficiency and flaring fire can also cause irritability. Bear in mind not all indications need to be present for this to be the right formula. The TCM strategy of this formula is two-fold, to restore the Yin and direct fire downward. The herbs are split between those which nourish the Yin and those which quell the internal fire.⁽²⁾ One of the herbs which quells fire is one of great interest, Huang Bai, because one of its constituents is berberine. Research shows berberine modulates diabetic high blood sugar and helps with kidney nephropathy.⁽⁷⁾⁽⁸⁾ Berberine research show it improves insulin sensitivity and inhibits fat storage.⁽⁹⁾ In other research, Da Bu Yin Wan has been shown to be useful in Parkinson’s disease by protecting the nervous system. In TCM terms Parkinson’s is also a Yin deficiency. In the case of Parkinsons the Yin deficiency causes wind seen as tremors.⁽¹⁰⁾

Caution with poor appetite or loose stools.
Contraindicated for fever from an illness.

Liu Wei Di Huang Wan

Six Ingredient Pill with Rehmannia

Lower Xiao Ke

The prime directive of Liu Wei Di Huang Wan is to add to the Yin of the Kidneys. It’s secondary mission is to boost the Yin of the Liver. It is the first formula that comes to mind with a diagnosis of diabetes because it focuses on the Kidneys. In TCM Kidney Yin is seen as the center for the Yin of the whole body. In the biomedical view the kidneys are damaged by the condition. In addition to high blood sugar, indications for this formula include sore and weak low back, night sweats, lightheadedness, tinnitus, diminished hearing. Depending on the depth of deficiency there could also be hot hands and feet, flushed face, sore throat and copious urination.⁽²⁾ Research loves this formula and there are plenty of studies. First let’s take a look at the main herb in the formula, Shu Di Huang or Rehmannia. This is the prepared root of Chinese foxglove. It has a decided lowering effect with high blood sugar in diabetic ratties.⁽¹¹⁾ A Liu Wei Di Haung study shows the formula preventing diabetes, this is still in rats.⁽¹²⁾ Liu Wei Di Huang Wan helps rats reduce their visceral fat without going to the gym.⁽¹³⁾ A human study shows Liu Wei Di Huang Wan reduces the risk of kidney failure in Type 2 diabetic patients.⁽¹⁴⁾

Caution: If formula causes loose stools add in a digestive formula or try a different formula.

Serving size: For all the formulas mentioned consume according to label directions or instructions from your knowledgeable healthcare practitioner.

Disclaimer: Use herbs wisely. If you have questions or special considerations, work with your practitioner. If symptoms worsen or you have concerns, contact a knowledgeable practitioner. There is no evidence that Chinese herbal therapies and diabetes drugs and are incompatible. It is a concern that when combining the two, the blood sugar may decline too far. To avoid this problem herbs should be added gradually over a few days with continued monitoring of blood sugar. Once the herbs have successfully lowered the blood sugar, drug dosage may be reduced under a physician’s instructions. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

References

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5 Hikino H, Yoshizawa M, Suzuki Y, Oshima Y, Konno C. Isolation and hypoglycemic activity of trichosans A, B, C, D, and E: glycans of Trichosanthes kirilowii roots. Planta Medica. 1989;55(4):349–350

6 Ko BS, Jang JS, Hong SM, et al. Changes in components, glycyrrhizin and glycyrrhetinic acid, in raw Glycyrrhiza uralensis fisch, modify insulin sensitizing and insulinotropic actions. Bioscience, Biotechnology, and Biochemistry. 2007;71(6):1452–1461

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9 Jing Yang, Jinhua Yin, Hongfei Gao, Linxin Xu, Yan Wang, Lu Xu and Ming Li 2 , Published online 2012 Mar 8. Berberine Improves Insulin Sensitivity by Inhibiting Fat Store and Adjusting Adipokines Profile in Human Preadipocytes and Metabolic Syndrome Patients, Evid Based Complement Alternat Med. 2012; 2012: 363845.

10 Xiao-Gang Gong, Hong-Mei Sun, Yi Zhang, Shu-Jing Zhang, Yu-Shan Gao, Jing Feng, Jing-Hong Hu, Cong Gai, Zhen-Yu Guo, Hong Xu, Ling Ma, Da-Bu-Yin-Wan and Qian-Zheng-San to Neuroprotect the Mouse Model of Parkinson’s Disease, Evidence-Based Complementary and Alternative Medicine, Volume 2014

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