How to use Traditional Chinese Medicine for Diabetes

May
06

How to use Traditional Chinese Medicine for Diabetes

Family gathered to look at something on a phone

Brief Overview of Diabetes

Diabetes is a chronic condition that occurs when our body isn’t able to make enough insulin (type 1) or when our body doesn’t respond to insulin well (type 2), leading to high blood sugar levels. When uncontrolled, it can lead to other complications such as heart disease, vision loss, kidney disease, nerve damage, and more. Many people seek out different ways to manage their health – is Traditional Chinese Medicine for diabetes man

While conventional treatments for diabetes focus on medication, diet, exercise, and weight management; there’s growing interest in alternative approaches, particularly among Asian Americans and Pacific Islanders (AAPI), who often face higher risks for chronic diseases despite being slender and ‘appearing healthy.’ 

This post was written by Annie Dang, Dietetic Intern while she was completing her outpatient rotation. This post was reviewed and edited by Edith Yang, RD, CSR, CLT, FAND.

Doctor holding a measuring tape

Higher risk for AAPI

Strangely enough, even if you appear “healthy” (aka are slender), it might not always mean that you are healthy. Everyone is different, and it is been shown that some ethnic groups such as those falling under the AAPI population, may have increased risks for chronic diseases

Increasing research shows that Asian adults are more likely to develop type 2 diabetes at a lower body mass index compared to other ethnic groups. According to research done specifically for the Asian American Diabetes Initiative (AADI) by Joslin Diabetes Center, they found that Asians and Asian Americans could have increased chances of developing health issues at a lower BMI. 

Adjusted BMI for AAPI

BMI is adjusted for Asians and Asian Americans. The range for ‘normal’ or ‘healthy’ ranges from 18.5-22.9, compared to the CDC BMI normal range of 18.5-24.9. The adjustments for this BMI are reflected to present the different standards of health for the AAPI population. BMI is adjusted for this population because research has found that Asians have a higher body fat percentage at a lower BMI compared to other racial groups. 

Typically, BMI is often used for its connection to various metabolic and disease outcomes as a measure of body fat. BMI uses body weight as a measure, not specifically body fat itself, which can contrast against how athletes have more muscle mass that accumulates more weight than fat in the body leading to a higher BMI.

Waist circumference is also another determinant as fat accumulation occurring around the abdominal area can increase risk. The AADI suggests a waist circumference of no more than 35.5 inches or 90 cm for men and no more than 31.5 inches or 80 cm for women. The potential difference in body fat distribution and composition in Asians compared to non-Hispanic counterparts, could explain how some Asians may accumulate fat around the abdominal area and lead to higher diabetes prevalence.

Related Research

Research shows that the chances of having diabetes can be higher for certain groups of people, like South Asians, especially those from India. This is because their genes can make them more likely to have certain body features like carrying more fat around their belly, having less muscle, and having more trouble using insulin, which is a hormone that controls blood sugar levels. So, it’s not just about what they eat or how active they are; their genes also play a big role in their risk of getting diabetes.

Another study showed that the rising number of people with diabetes in Asia is partly because of a mix of genes and changes in the environment, like how people live and what they eat due to modernization. This study also suggests that Asians who move to different places might be more affected by these environmental changes. While we can’t change our genes, there are things we can do to lower the risk of getting diabetes. This includes eating healthier, staying active by exercising regularly, taking medicines if needed, and avoiding smoking and excessive drinking.

Exploring Traditional Chinese Medicine (TCM)

An arrangement of various ingredients used in Traditional Chinese Medicines

Traditional Chinese Medicine can offer a holistic framework encompassing concepts that could help with diabetes management such as:

Qi

Qi / 氣 pronounced “chee” is a concept from traditional Chinese medicine that refers to the vital energy or life force that flows through our bodies. It’s believed that when Qi is balanced and flowing smoothly, we feel healthy and well. However, if Qi becomes blocked or imbalanced, it can lead to health problems.

  • In terms of health and nutrition, the idea is to maintain a balance of Qi by eating a nutritious diet, getting enough exercise, managing stress, and getting enough rest. Certain foods and practices, like acupuncture or tai chi, are thought to help keep Qi flowing smoothly and maintain good health. So, in essence, it’s about keeping your body’s energy in harmony to stay healthy and well.

Yin and Yang

Yin and Yang are like two sides of a coin in traditional Chinese medicine. The Yin represents darkness, stillness, and coolness, while Yang represents light, activity, and warmth. Together, they create balance and harmony in our bodies.

  • When one of these energies becomes too strong or too weak, it can lead to health problems. For example, if there’s too much Yin, you might feel sluggish and cold; if there’s too much Yang, you might feel restless and overheated. Illness or imbalance occurs when Yin or Yang overpowers the other.
  • To rebalance these energies, adjustments might be needed. This could involve changes in diet, lifestyle, or even using techniques like acupuncture or herbal medicine to restore equilibrium.

Five Elements

The Five Elements—fire, wood, earth, metal, and water—are another way traditional Chinese medicine categorizes aspects of our health and environment. Each element is associated with certain qualities and corresponds to different parts of our bodies, seasons, tastes, and more.

  • For example:
    • Fire represents energy and is associated with the heart and small intestine.
    • Wood represents growth and is associated with the liver and gallbladder.
    • Earth represents stability and is associated with the stomach and spleen.
    • Metal represents strength and is associated with the lungs and large intestine.
    • Water represents fluidity and is associated with the kidneys and bladder.
  • These elements are interconnected, and maintaining balance among them is believed to be crucial for overall health. So, in traditional Chinese medicine, understanding qi, balancing Yin and Yang as well as the Five Elements are key concepts for promoting health and well-being.

Traditional Chinese Medicines (TCM) for Diabetes

Acupuncture

Acupuncture is a practice of inserting and manipulating fine needles into specific points on the body. It uses the idea of living beings having an inner energy, Qi, and that illnesses/disease cause disruptions or imbalances in the flow of Qi. 

  • The main focus of acupuncture is to fix that imbalance and can be used to help with managing disease symptoms. Acupuncture has been often used for chronic pain, but further research may be needed to fully understand its effects as a method of treatment for other diseases or conditions and to provide evidence of its effects.
  • Most studies recommend acupuncture as a supplementary or adjunctive treatment to include alongside other treatments for diabetes. One study done in 2016, found that metformin used alongside acupuncture was more effective than using metformin alone for patients with type 2 diabetes. Another study done in 2018 found that using a form of acupuncture with conventional medicine effectively decreased insulin resistance in patients with metabolic syndrome. 
Group of individuals doing Tai Chi

Tai Chi

Tai Chi is a mind and body practice that includes gentle movement, meditation, physical postures, breathing and relaxing exercises. It is a form of low-impact exercise that has shown various positive effects on mental and physical health.

  • One study shows that when being compared to other aerobic exercises, there wasn’t much of a difference between effects on 2 hours post-meal blood sugars and fasting blood glucose, but found that tai chi might slightly reduce A1C better than other aerobic exercises.
  • In general, tai chi is a great option for exercise that is safe to perform and most exercises in general can help with managing diabetes and improving glucose levels.

Chinese Herbal Remedies for diabetes

A tray holding a cup of tea with a plate, a teapot, and sliced pieces of bitter melon. Whole bitter melon is on the side.

Bitter Melon/Gourd

Some Asian cultures include as a staple food in their cuisine and is often known as one of the most naturally bitter fruits/vegetables in the world. Despite its interesting and bitter taste, it has beneficial nutrients that can be good for health. Bitter melon is a good source of Vitamin C, contains potassium, is high in fiber and antioxidants. It also contains phytonutrients such as cucurbitacin and mormordin which are thought to have anti-inflammatory properties.

Studies show mixed results on the effect of bitter melon for diabetes, one study claims that it had some effect on lowering blood glucose, another concluded that it had a modest effect but wasn’t better than using conventional medicine such as metformin, while another study said that it had no effect.

Scattered dried goji berries around a  small wooden bowl filled with goji berries

Goji/Wolfberry

They are commonly used and eaten in dried, powdered, or juice forms, as it can often go bad quickly. They can be substituted for other dried fruits like raisins and cranberries. Goji berries contain beneficial nutrients such as vitamins A, C, minerals and fiber.

There isn’t very much research available on goji berries but one study involving patients with type 2 diabetes found that a component of goji berries helped to improve glucose and HDL(good cholesterol) levels. 

One green and one yellow-green guava hanging from a guava tree

Guava

Guava – is a delicious fruit that has many different varieties depending on where it was grown. Raw guava fruit is high in fiber, potassium, and vitamin C. The common guava (Psidium guajava) may refer to the pink flesh varieties of apple, lemon, and yellow guavas which could be native to tropical areas.

Unfortunately, there isn’t a lot of research done on the effects of guavas on humans, but various animal studies suggest beneficial effects on health. One study done on diabetic mice found that guava fruit helped reduce blood sugar levels and increased the amount of insulin in their bodies.

A small bowl/tray of ginseng roots

Ginseng

Ginseng is a natural herb derived from the dried root of a plant. It’s been hailed for its potential benefits to various aspects of health, including its ability to help manage blood sugar levels in people with diabetes.

Research suggests that ginseng might lower A1c levels (a measure of long-term blood sugar control), fasting blood glucose levels, and even systolic blood pressure.

However, it’s essential to be cautious because ginseng could interact with certain medications like warfarin or statins. To stay safe, it’s crucial to consult with your doctor or a dietitian before incorporating ginseng into your routine, especially if you’re on other medications.

Ginseng can be consumed in different ways, such as brewing it into a tea, adding it to soups for flavor and potential health benefits, or taking it in supplement form, like pills. So, if you’re looking for a natural way to support your health and potentially manage blood sugar levels, ginseng might be worth considering, but always remember to consult with a healthcare professional first.

A health provider holding a bottle of medicine, explaining something to another individual across from the desk. The desk contains various items such as colorful papers with information, open laptop, various jars holding some dried items, and a small basket of fresh produce.


Considerations

  1. Consultation with Healthcare Providers: Before integrating Traditional Chinese Medicine (TCM) into diabetes management, it’s crucial to consult with healthcare providers. They can provide guidance on the safest and most effective approaches tailored to individual health needs.
  2. Complementing Conventional Care: TCM should complement rather than replace conventional care. It’s essential to continue with prescribed medications, dietary recommendations, and lifestyle modifications as advised by healthcare professionals.
  3. Dietary Guidance from Dietitians: Dietitians play a crucial role in providing guidance on dietary modifications, including incorporating TCM foods and remedies. They can help individuals navigate nutritional choices that support overall health and diabetes management.
  4. Mixed Results of TCM Studies: Research on the effectiveness of TCM for diabetes management presents mixed results. While some studies show promising outcomes, others may not demonstrate significant benefits. It’s important to approach TCM with realistic expectations and an understanding of its potential limitations.
  5. Combining TCM with Conventional Medicine: Combining TCM with conventional medicine may yield promising outcomes for diabetes management. By integrating both approaches, individuals can optimize control over blood sugar levels and mitigate associated complications.
  6. Caution with Natural Remedies: Caution is advised when using natural remedies, including TCM herbs and supplements, especially when concurrently using conventional medications. Potential interactions could occur, emphasizing the importance of consulting healthcare providers before starting any new treatment regimen.

Summary

  • Diabetes is a chronic condition that requires careful management to prevent complications such as heart disease, vision loss, and kidney disease.
    • While conventional treatments focus on medication, diet, exercise, and weight management, there’s growing interest in alternative approaches like Traditional Chinese Medicine (TCM).
  • Research suggests that certain ethnic groups, such as Asian Americans and Pacific Islanders (AAPI), may face higher risks for chronic diseases like diabetes, even at lower body mass indexes.
    • TCM offers a holistic framework, including concepts like Qi, Yin and Yang balance, and the Five Elements, which aim to restore balance and harmony within the body.
  • Exploring TCM modalities such as acupuncture and tai chi, as well as incorporating TCM foods like bitter melon, goji berries, and guava, may offer additional support for diabetes management.
    • However, caution is advised, and consultation with healthcare providers, including dietitians, is crucial to ensure safe and effective integration of TCM alongside conventional care.
  • By embracing diverse treatment modalities and combining TCM with conventional therapies, individuals can optimize diabetes control and improve overall health outcomes.

Resources:

  1. Vicks, W. S., Lo, J. C., Guo, L., Rana, J. S., Zhang, S., Ramalingam, N. D., & Gordon, N. P. (2022). Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study. BMC public health, 22(1), 1954. https://doi.org/10.1186/s12889-022-14362-8 
  2. AADI BMI Calculator. (n.d.). Joslin Diabetes Center. https://www.joslin.org/patient-care/multicultural-programs/asian-american-diabetes-initiative/am-i-risk/aadi-bmi 
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  6. Marshall A. C. (2020). Traditional Chinese Medicine and Clinical Pharmacology. Drug Discovery and Evaluation: Methods in Clinical Pharmacology, 455–482. https://doi.org/10.1007/978-3-319-68864-0_60 
  7. TCM World. (2024, February 9). What is TCM? – TCM World. https://www.tcmworld.org/what-is-tcm/ 
  8. Qi in Chinese Medicine. (n.d.). https://www.meandqi.com/tcm-education-center/basic-concepts/qi 
  9. Firouzjaei, A., Li, G. -., Wang, N., Liu, W. -., & Zhu, B. -. (2016). Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients. Nutrition & Diabetes, 6, 9. https://doi.org/10.1038/nutd.2016.16 
  10. Binahayati, Srilestari, A., Abdurrohim, K., & Perkasa, S. (2018). Effect of electroacupuncture combined with medical treatment on insulin resistance (HOMA-IR) of patients with metabolic syndrome. Journal of Physics: Conference Series, 1073, 062030. https://doi.org/10.1088/1742-6596/1073/6/062030 
  11. Chao, M., Wang, C., Dong, X., & Ding, M. (2018). The Effects of Tai Chi on Type 2 Diabetes Mellitus: A Meta-Analysis. Journal of diabetes research, 2018, 7350567. https://doi.org/10.1155/2018/7350567 
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  16. Lin, C. Y., & Yin, M. C. (2012). Renal protective effects of extracts from guava fruit (Psidium guajava L.) in diabetic mice. Plant foods for human nutrition (Dordrecht, Netherlands), 67(3), 303–308. https://doi.org/10.1007/s11130-012-0294-0 
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