Top quality Chinese Tea and Herbs

Alternative Treatment for Diabetes – Traditional Chinese Medicine

Insulin is the cornerstone of diabetic treatment.  However, most patients are reluctant to administer insulin due to the fear of injection.  This article reviews clinical and pharmacological studies of Traditional Chinese Medicine (TCM) in the treatment of diabetes.

Traditional Chinese Medicine TCM is both an art and a science in healing patients.  Its diagnosis looks at the well-being of body, mind, and spirit.  Even though most Chinese medicines have not been tested under rigorous clinical trials, its clinical value has been evaluated in millions of Chinese patients over the past 5000 years.  The philosophy of TCM is rooted in Chinese cultures of Taoism (to follow nature’s way) and Confucius (to nurture humanity and morality) and the religion of Buddhism (to free from suffering). TCM doctors are usually pharmacists and pharmacologists who themselves identify and collect herbs, prepare formulation and follow up their patients.  TCM includes Chinese herbal medicine (CHM), acupuncture and specialized disciplines of surgery, orthopedics, pediatrics, and obstetrics and gynecology.

Chinese Herbal Medicine

CHM is the major modality in TCM practice. A prescription for CHM, referred to as compound recipe (Fu Fang), usually consists of four major types of herbs: 1) principal herbs, 2) assistant herbs, 3) adjuvant herbs, and 4) guiding herbs in order to maximize the therapeutic effectiveness and minimize the toxic effects.

The ingredients and the quantity of herbs in a CHM prescription are individualized and changed on a weekly basis to tailor for the patient’s age, gender, symptoms, anthropological characters, geological location and living environment.

TCM doctors have started documenting the efficacy of Chinese Herbal Medicine (approximately 1,200 recipes and 150 herbs for diabetes) for diabetes, metabolic syndrome and associated complications in western medicine database since 1980. Table 1 lists the Chinese herbs and classic recipes that were used commonly in clinical trials in diabetes and diabetic complications.

Table 1: Traditional Chinese medicine for diabetes mellitus

TCM formula and ingredients – Chinese Pin Yin and English name

Symptom Relief

TCM has been shown to be effective in reliving diabetic symptoms.  A systemic review of 6 clinical trials reported that most of the type-2 diabetic patients receiving CHM experienced an improvement in symptoms of dry mouth, polyphagia, polydipsia, polyuria, fatigue, sweating, constipation, numb limbs, and low back pain (table 2).

Improvement rates were higher in patients receiving CHM than those treated with antidiabetic drugs (table 2). After using either CHM alone or taking CHM with Western medicine for at least 2 months, most patients with diabetic complications (80%) experienced a substantial improvement in symptoms. 

Table 2.  Improvement rates (%) of diabetic symptoms in 35 clinical trials of Chinese medicine

Glycemic Control

Beside symptoms improvement, CHM has also been shown to improve glycemic control such as fasting (<7.3 mmol/l), postrprandial blood glucose level (<8.2mmol/l) and glycosylated hemoglobin (HbA1c) level (<7%).

Data from 78 controlled clinical trials showed that the rate of normalizing blood glucose was higher in diabetic patients using CHM compared with control subjects (table 3). As a whole, CHM appeared to be as effective as western antidiabetic drugs in reducing blood glucose level.  The blood glucose-lowering effects of CHM are probably related to enhanced ability of the pancreas to secrete insulin and to the improved insulin resistance of the muscle cells.

Table 3. Normalization of fasting blood glucose levels in 78 trials

Failure to Antidiabetic Drugs

When patients fail to respond to 3 to 4 oral antidiabetic drugs, physicians might start the patients on insulin therapy.  However, most patients often resist initiating insulin therapy due to the fear of injection and the inconvenience associated with the administration.

However, recent studies have indicated that CHM and acupuncture in combination with Western medicine might be effective in restoring glcyemic control in type 2 diabetic patients who failed to respond to oral antidiabetic agents. 

Table 4 shows rates of improvement in glycemic control, as defined by a fasting plasma glucose of <8.2 mmol/l plus symptom relief. The improvement rate was higher in patients (total number = 300) treated with integrated Chinese and Western medicine than those (total number = 296) receiving Western medicine alone in 5 controlled trials (RR = 1.1, 95% CI 1.02–1.18, p = 0.01).

Table 4.  Efficacy of Chinese medicine in rescuing secondary failure to oral antidiabetics drugs

Adverse Effects

CHM is well tolerated and relatively safe in clinical use.  Approximately 5% of the total adverse events and drug-related deaths are caused by the use of CHM.  Non-serious adverse events associated with CHM treatment include diarrhea, abdominal pain, nausea, and loss of appetite.

Like other anti-diabetic agents, CHM might also cause hypoglycemia.  For example, Xiao Ke Wan, a widely used CHM composed of  six herbs (Di Huang, Ge Gen, Huang Qi, Shan Yao, Tian Hua Fen, Wu Wei Zi) and 0.25mg glyburide  and indicated for type-2 diabetic patients with a deficiency syndrome of both Yin and Qi, has a 5% incidence of hypoglycemia.  The risk of hypoglycemia is even alarming in elderly subjects, individuals with impaired hepatic and renal function, patients with acute infection, and in patients who use insulin or other anti-diabetic drugs.

Moreover, patients who experienced hypoglycemia with Xiao Ke Wan had a high risk of death (3.3%) and stroke (9.8%). Therefore, extreme caution should be taken to prevent hypoglycemia and other serious adverse events when taking Chinese herbal medicine with anti-diabetic agents.

Conclusions

CHM is effective and relatively safe in relieving diabetic symptoms and controlling hyperglycemia in patients with diabetes.

However, patients are strongly advised to follow their Chinese medicine doctor’s directions when taking Chinese medicine and to inform their endocrinologist if they are taking Chinese medicine.  Like other anti-diabetic agents, Chinese herbs are associated with hypoglycemia and herb-drug interactions may occur if herbs are misused.

See more articles like this.