Chinese herbs are very effective in treating patients with Type II, NIDDM. When prescribed correctly, Chinese herbs lower blood glucose levels, manage common signs and symptoms, and treat the complications of diabetes mellitus. Patients generally respond to herbal treatment within three-to-four weeks, with significant reduction in blood glucose levels and little fluctuation throughout the day. However, some patients may require up to six-to-eight weeks. For patients with Type I, IDDM, Chinese herbs are used in conjunction with insulin to manage symptoms and complications. Chinese herbs can also reduce the frequency and dosage of insulin injections. However, it is important to keep in mind that herbs cannot replace insulin, and patients with IDDM will still require insulin injections.
Equilibrium is the formula of choice for treating diabetes mellitus. From the perspective of Western medicine, Equilibrium contains herbs with excellent hypoglycemic effects, lowering blood glucose levels and reducing synthesis of fatty tissues. In addition, Equilibrium contains herbs that lower blood cholesterol levels and improve blood circulation to the coronary arteries and peripheral parts of the body--thus managing common complications of diabetes, such as hyperlipidemia, atherosclerosis, coronary artery disease, peripheral neuropathy, etc.
In terms of Chinese therapeutic actions, Equilibrium nourishes Lung, Stomach and Kidney Yin, clears heat, and dries dampness. It can be used for patients with Upper, Middle or Lower Wasting (Xiao Ke) syndromes. It effectively manages the three cardinal symptoms of Wasting (Xiao Ke) syndrome: polydipsia, polyphagia and polyuria.
Equilibrium treats both the cause and the complications of diabetes mellitus. American ginseng (xi yang shen) greatly replenishes the vital essence of the body and promotes the secretion of body fluids, to treat polydipsia. Gypsum (shi gao) and anemarrhena (zhi mu) are a pair commonly used to treat heat in the Middle Burner (Jiao). They sedate Stomach fire and suppress appetite to relieve polyphagia. Scrophularia (xuan shen) enters the Lungs, Stomach and Kidneys to simultaneously replenish vital essence and clear heat. According to Oriental Medicine, an elevated glucose level is equivalent to excess retention of dampness in the body. Therefore, astragalus (huang qi) and dioscorea (shan yao) are used to tonify Qi and strengthen the Spleen to enhance its functions to dispel dampness. With their aromatic properties, white atractylodes (bai zhu) and atractylodes (cang zhu) strengthen the Spleen and directly dry dampness. Salvia root (dan shen) and carthamus (hong hua) invigorate blood circulation and enhance the overall effectiveness of the herbs by improving micro-circulation. Activation of blood circulation also reduces the risk of atherosclerosis by preventing buildup of cholesterol on the inner walls of blood vessels. Lastly, lotus embryo (lian zi xin) and lotus stamen (lian xu) tonify the Kidney and control frequent urination.
II. Modification of Herbal Treatment Based on Wasting (Xiao-Ke) Syndrome
Equilibrium is the essential herbal formula used to lower blood glucose if the patient shows no other significant complications. If diabetic patients exhibit prominent signs and symptoms of Upper, Middle or Lower Wasting (Xiao Ke) syndromes, treatment must be modified by combining Equilibrium with the following formulas:
1. Upper Wasting (Xiao-Ke) Syndrome is characterized by Lung heat drying body fluids, resulting in symptoms such as fidgeting, polydipsia, a dry red tongue (with or without cracks) with a thin, yellow coat, and a forceful, rapid, pulse (especially at the cun position). Patients with Upper Wasting (Xiao-Ke) Syndrome should combine Equilibrium with Ginseng & Gypsum Combination (Bai Hu Jia Ren Shen Tang). 2. Middle Wasting (Xiao-Ke) Syndrome is characterized by Stomach fire damaging the fluids, leading to such symptoms as polyphagia, constant hunger with good appetite, a red tongue with a yellow coat, and a slippery, forceful, rapid pulse. Patients with Middle Wasting (Xiao-Ke) Syndrome should combine Equilibrium with Rehmannia & Gypsum Combination (Yu Nu Jian). 3. Lower Wasting (Xiao Ke) Syndrome with Kidney Yin deficiency is characterized by such symptoms as polyuria (especially at night), a red tongue with little or no coat, and a deep, thready, rapid pulse. Patients with Lower Wasting (Xiao Ke) syndrome with Kidney Yin deficiency should combine Equilibrium with Rehmannia Six Formula (Liu Wei Di Huang Wan). 4. Lower Wasting (Xiao Ke) Syndrome with Kidney Yin and Yang deficiencies is characterized by polyuria (especially at night), teethmarks on both sides of the tongue, a pale red tongue with a white coat, and a deep, thready, weak pulse. Patients with Lower Wasting (Xiao Ke) Syndrome with Kidney Yin and Yang deficiencies should combine Equilibrium with Rehmannia Eight Formula (Ba Wei Di Huang Wan).
III. Modification of Herbal Treatment Based on Complications
If diabetic patients exhibit prominent signs and symptoms of complications, treatment must be modified by combining Equilibrium with the following formulas:
1. For patients with high cholesterol, combine with Cholisma. 2. For patients with hypertension, combine with Gentiana Complex or Gastrodia Complex. 3. For patients with chronic buildup of cholesterol leading to coronary artery disease, combine with Circulation. 4. For patients with blurred vision or vision impairment, combine with Nourish. 5. For patients with impotence due to diabetic complications, combine with Vitality For Men. 6. For patients with recurrent urinary tract infections, combine with Gentiana Complex.
Patients should not stop using drug treatments abruptly as there is a risk of hyperglycemia or diabetic ketoacidosis. Herbal and drug treatments should overlap for 1 to 2 weeks before patients are to begin tapering off drug treatments to ensure adequate control of blood glucose levels.
Concurrent use of drugs and herbal treatment may have synergistic effects on lowering the blood glucose levels. During the transition period when the patients take both drugs and herbs, their blood glucose levels should be monitored at least twice daily to assess the effectiveness of the treatment and to avoid hypoglycemia. Dosage must be adjusted as needed to keep blood glucose within the normal range. Herbal treatment may reduce the dosage and frequency of insulin injections needed; however, it can never replace insulin, especially in insulin dependent diabetes mellitus (IDDM) patients. Patients with IDDM should always be treated with insulin, or a combination of insulin and herbs.
Lifestyle adjustments are absolutely critical for short-term management and long-term recovery of diabetes. Patients should be encouraged to engage in regular daily exercise, sleep by 10 p.m. to enhance restoration of Yin elements in the body, and eliminate sugar, carbohydrates and caffeine from the diet. Additional dietary advice may be useful based on the primary organ systems affected.
For patients with Type II, NIDDM, Equilibrium in combination with diet and exercise provides excellent clinical results. Most patients will get satisfactory clinical results within three-to-four weeks of beginning herbal treatment. Maximum effectiveness may require up to six-to-eight weeks of herbal treatment. Clinical effects include a significant reduction in blood glucose levels and less fluctuation throughout the day.
Diabetes mellitus is defined simply as a rise in blood glucose levels. The clinical manifestations of the disease, however, are much more complicated than its definition. Patients with chronic diabetes mellitus are frequently plagued by various complications, such as visual disturbances, prolonged healing of wounds, frequent recurrences of infections, impotence, etc., which must be addressed within the overall treatment strategy.
Diagnosis and treatment of the most common and complex endocrinologic disorder continues to pose a challenge for health care practitioners. Diabetes mellitus commonly may go undiagnosed as patients with early stages of Type II, NIDDM are often asymptomatic. Also, as patients with chronic Type II, NIDDM often have a wide variety of complications, diabetes mellitus is frequently overlooked or mis-diagnosed. Once the correct diagnosis is made, diabetes and its complications can be effectively managed by both western drugs and herbal remedies. In conclusion, herbal medicine offers a safe and effective alternative for patients with diabetes mellitus.
Clinical Note: High cholesterol levels are a common complication of diabetes mellitus. If untreated, high cholesterol levels can lead to atherosclerosis, hypertension, coronary heart disease, angina, and myocardial infarction. Therefore, effective treatment must address both blood glucose levels and blood cholesterol levels. In combination with dietary changes, this patient showed excellent progress in reducing his blood glucose and cholesterol levels.