TCM and Diabetes
By Dr. Hong-Yen Hsu
Diabetes is the abnormal metabolism of sugars, lipid, and proteins in the body, resultant from absolute or relative hypoinsulinism. The exact causes of diabetes are unknown. For some reason not clear yet, the pancreas in a person with diabetes does not manufacture enough insulin to "burn up" all the sugars and starches the person eats. It frequently is seen in juvenile diabetes, or despite enough insulin somehow being produced, it is blocked from doing its job, producing a state of "relative Hypoinsulinism," frequently seen in obese subjects. Unmetabolized sugars cause the blood sugar level to rise. When it rises above the kidneys' threshold, the sugar will be passed through the kidneys into the urine.
The more severe form of diabetes is Type I, Diabetes Mellitus (insulin-dependent diabetes). It may develop any time from infancy through old age, though it normally appears in childhood. For this reason, it previously was called juvenile diabetes. Complications, especially of the kidneys, eyes, and vascular system, frequently occur with Type I diabetes. Insulin is required to control the disease. It cannot be controlled by diet and exercise alone. Chinese herbs may be used in conjunction with insulin injection.
Type II, adult-onset Diabetes Mellitus (usually non-insulin-dependent diabetes), often appears during the adult years, with no prior sign of diabetes. Its consequences can be as severe as those of Type I, but it usually can be controlled by diet and exercise, without the use of insulin. Some cases of Type II diabetes are more difficult to control because the patient refuses to follow dietary recommendations, Chinese herbs may prove useful even to those who do control their diet, for example, in persons who are especially obese or who have reduced pancreatic output of insulin.
The main clinical manifestations of diabetes are polydipsia, polyphagia, polyuria, hyperglycosuria, and hyperglycosemia. In serious cases, it may be accompanied by ketosis, dehydration, and even coma.
Traditional Chinese Medicine identifies the disease by the apellation "hsiao Ko" (or "xiao ke"). "Hsiao" means "consuming nutrient and fluid," and "ko" means "thirsty." The term "hsiao ko" can be divided into upper hsiao or "shang xiao" (Lung Heat and polydipsia), middle hisao or "zhong xiao" (Stomach Heat and polyphagia), and lower hsiao or "xia xiao" (Kidney Deficiency and polyuria). The manifestations of diabetes affecting the upper, middle, and lower portions of the body ("burners") generally appear at the same time, with the only difference
being the degrees.
Dryness and Heat due to Yin Deficiency are the basic pathological mechanisms. The principle applied is the treatment of clearing heat and nourishing deficiency in the different burners according to their involved degree. If the disease lingers for a long time, the Yin deficiency can affect the Yang, giving rise to the Kidney Yang Deficiency. Then the Yin and Yang should be reinforced at the same time to restore the balance of Yin and Yang.
Although Chinese herbs should be used in combination with Western treatment in acute and severe cases of diabetes, the initial stages and mild cases often can be dealt with quite effectively by a therapeutic approach which combines a dietary and exercise regimen with Chinese herbal therapy addressed to the patient's conformation (including physique, weakness or firmness, Heat or Cold, and configuration of symptoms). Certain symptoms of diabetes respond particularly well to this approach. Among them are sensations of numbness and weakness, severe dermal itching, and dehydration.
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