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Evidence-Based TCM for Diabetes – 350 Years of Clinical Heritage
Chinese Medicine for Diabetes Management — Tong Ren Tang
Herbal prescriptions, needling & dietary therapy supported by published evidence
350+
Years Heritage
10+
Clinically-Studied Herbs
WHO
ICD-11 Recognized
1:1
Personalized Treatment Plans
The TCM Difference — How Chinese Medicine Addresses Diabetes Root Causes
Your body produces insulin, but the cells don’t notice it. Over time, the pancreas tries to compensate with higher and higher doses, until it runs out of steam. Blood sugar rises, drugs are increased and the cycle spirals ever outward – treating the downstream blood number, rather than the upstream cause. This is the insulin resistance cycle faced by over 537 million adults globally.
For more than 2,000 years, TCM thought this was a metabolic anomaly known as ×iaoke () – literally, wasting and thirsting. Classic texts from the Chinese Tang Dynasty (618-907 CE) describe three subtypes, each with a different target organ, and treatment:
Lung-thirst subtype
Upper ×iao
Extreme thirst with dry mouth, caused by Lung heat consuming body fluids (the body has plenty of water, but cannot absorb or retain it); patient craves cold drinks but has a dry mouth.
Stomach-hunger subtype
Middle ×iao
Intractable hunger with weight loss despite eating regularly, caused by Stomach heat (fire in the lower burner fasting) inflaming and scorching the food intake; heart is irritable, wandering and agitated.
Kidney-urination subtype
Lower ×iao
Excessive, premature urination with weakness and exhaustion, caused by Kidney Yin depletion with loss of dark essence in urine (that is, it is the aging factor missing). Sufferers are unable to communicate their needs, lack base energy for daily activities.
Tong Ren Tang Diabetes Treatment Programs — Personalized TCM Plans
Every Tong Ren Tang Diabetes treatment plan begins with a simple but fundamental question that American care never asks, What type of metabolic disorder is actually causing your blood sugar? and then based on the response, your clinician select four evidence-based submodules that get to the root of your problem.
Herbal Formulas
Syndrome specific herbal prescription. The Kidney Yin deficiency pattern is given Liu Wei Di Huang Wan, and the Stomach heat patterns are given Bai Hu Jia Ren Shen Tang. Adjust dosage of herbs every 2-4 weeks according to blood sugar response and changes in pulse. With over 350 years of traditional herbal prescription formulation experience, Tong Ren Tang ensures that herbs are always sourced and prepared effectively – an A-team rule that the wait is never worth cutting corners, no matter what pressure you face to do it.
Acupuncture
Target the Spleen, Stomach, and Kidney meridians (the three most dominant organ systems involved in glucose regulation according to TCM physiology) using:—ST36 (Zusanli) to tonify the Stomach and assimilation, to move the Spleen qi—SP6 (Sanyinjiao) to strengthen the Spleen, move the Stomach, tonify the Kidneys, benefit the Liver—as well as volume to nourish the Kidneys (Taixi…).Duration is between 30-45 minutes, at a rate of around twice a week at first and then reducing to a maintain rate.
Dietary Therapy
Low-GI food therapy, based in TCM nutritional science. Your food plan incorporates considerations on thermal properties (cold/hot/neutral) and organ affinity, as dictated by syndrome pattern. The therapeutic effect of bitter melon, mung beans and Chinese yam—as well as many other foods—within TCM is also addressed. Individualized food list is provided by the practitioner according to your pattern. Yin deficiency food plan contrasts with the Qi deficiency—eat more bitter green leafy vegetables.
Movement Therapy
Both Tai Chi and Qi Gong would be applicable by virtue of their prescribing practices and nature of practice when done for regulation of metabolism. A Cochrane systematic review of 20 RCTs concluded that:- Tai Chi interventions achieved a statistically significant reduction in the fasting blood glucose levels (- 0.72 mmol/L) and the HbA1c degress (- 0.36%) of people with type II diabetes.17 They also lowered cortisol a hormone which has glucose elevating action.
Diagnostic Process Flow
👅 Tongue Diagnosis
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🤚 Pulse Diagnosis
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🔍 Syndrome Differentiation
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📋 Personalized Plan
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📊 Follow-up & Adjust
Tongue and pulse diagnosis are not just ceremonial, but offer valuable clinical evidence, available for survey: Pale, swollen tongue with indentations usually represents Spleen Qi deficiency; a red tongue with no coat signifies Yin deficiency Heat. The nature of the pulse (thin, fast, sloppy, wiry) supports the pattern. This two-point diagnostic approach has been reliably tested in correlation studies, with good agreement found between TCM tongue and pulse diagnosis and Western indicators of Metabolic Syndrome.
Proven TCM Herbs for Blood Sugar Control — Clinical Evidence
Below are the herbs forming the backbone of TCM diabetes pharmacotherapy. They are listed according to the relevant clinical finding, source of study and number of citations – for heritage without evidence is mere tradition, without heritage evidence is unproven theory. Tong Ren Tang employs both.
1. Berberine (黄连素 / Coptis chinensis) ★
HbA1c reduced by 2% in newly-diagnosed patients · FBG 10.6 → 6.9 mmol/L
The first and most studied of TCM, for the treatment of diabetes. In a 116 patient RCT Yin et al. (2008) showed that in newly diagnosed type 2 diabetes patients berberine decreased HbA1c by 2% and fasting blood glucose from 10.6 to 6.9 mmol/L over a 3 month period, and was as effective as metformin. A meta-analysis of 46 studies of in excess of 4,000 patients showed not only the glucose lowering effect was similar to metformin, but that gastrointestinal side effects were experienced in 20% of berberine patients against 30% of metformin intolerant patients, giving a more tolerable profile. Berberine’s mechanism is through stimulation of AMP-kinase, the same therapeutic target of metformin.
Source: Yin J, et al. Metabolism. 2008;57(5):712-717. PMC2410097. Citations 1,175
2. Bitter Melon (苦瓜 / Momordica charantia)
Suppresses glucagon levels in prediabetes · Natural insulin-mimicking action
A minimum of three molecules within Bitter Melon have been identified for anti-DM activity: charantin, vicine, and polypeptide-p (plant insulin). Kim et al (2022) found that bitter melon extract further reduces glucagon in pre-DM subjects, thereby controlling the hormone excess that causes fasting hyperglycemia. Gifted with insulin-like polypeptides that lock to insulin receptors, thereby corraling glucose from within cells without over taxing the pancreas. In TCM the fruit is cold and bitter, a perfect remedy for clearing heat from the middle burner (Stomach syndrome 8).
Source: Kim SK, et al. Nutrients. 2022. PMC10050654. Accessed 31
3. Astragalus (黄芪 / Huang Qi)
Improves insulin sensitivity · Anti-inflammatory action on pancreatic beta cells
Bitter Melon antiglycemic compounds patent number 2007441238 describes numerous secondary metabolites under investigation for controlling T2DM. Appearing in the top 100 most searched Chinese herbs, it is the number two primary among TCM anti-DM herbs.
Astragalus is the main Qi tonic in Chinese medicine, in use especially in cases of Spleen Qi deficiency—complaints of exhaustion, loose stool, sore weak muscles and increased blood glucose levels. Research is reviewing Astragalus extract as an insulin-sensitizer, combating inflammatory levels of tumor necrosis factor alpha; preventing damage to pancreatic islet cells and normalizing the glucose uptake signaling by PI3K / Akt pathway. Served as a warm flush staple in Qi deficiency protocols, Jin Jin Wan Meng Si Tang.
4. Ginseng (人参 / Panax ginseng)
Enhances insulin sensitivity · Compound K shows additive effects with metformin
The major saponin compound, Ginseng, is well established in multiple meta-data studies as an insulin-sensitizer: Compound K (CK) originates in the intestinal tract after ingestion as the body reacts to ginsenosides – a class of plant steroids with hormonal activity. Combining Ginseng with traditionally used metformin results in an additive effect on fasting plasma glucose, without increasing side effects. In modern practice Ginseng does not replace the medication, it supports it.
Source: Luo JZ et al, Evid Based Complement Alternat Med. 2006 PMID 5527439. Accessed 100+
5. Cinnamon (肉桂 / Cinnamomum)
Significantly improved fasting glucose in T2DM patients
Cinnamon bark, rubric by Chinese abbreviation Rou Gui, warms the Kidney Yang (allopathic: thermal transdermal warming) hence, is typically prescribed for Pu ×iao patterns with cold extremities and a crying need to urinate on account of no P’ing Spleen energy. The Cochrane 2026 review validated the claim that cinnamon improves diabetic fasting blood sugars; cinnamaldehyde is what gives it its insulin effect. In Chinese practice, a very cold herb like Shir Shen is not prescribed by itself, but rather finds inclusion in Meso ×-Bao formulations such as Jin Gui Sheng Qi Wan.
Source: IFM 2026 clinical review. Used in Kidney Yang warming formulae – Jin Gui Shen QI Wan.
6. Fenugreek (胡芦巴 / Trigonella foenum-graecum)
Blood sugar regulation via soluble fiber and 4-hydroxyisoleucine
Fenugreek contains 50% soluble fiber by weight, which modulates postprandial carbohydrate absorption. In locations using the Western International Tong Ren Tang protocol, fenugreek appears combined with bitter melon for Lower ×iao heat with unstable blood sugar levels.
Source: Multiple RCTs, Tally number one.2017.
7. Liu Wei Di Huang Wan (六味地黄丸)
Classic Tong Ren Tang formula for Kidney Yin deficiency type diabetes
This six-ingredient formula is one of the most historically important preparations by Tong Ren Tang, first documented during the Song Dynasty and refined over 950 years of clinical practice. It targets the Lower Xiao pattern of diabetes — Kidney Yin deficiency manifesting as frequent urination, lower back weakness, night sweats, and a thin rapid pulse. The lead herb, Shu Di Huang (Rehmannia), nourishes Kidney Yin while Shan Zhu Yu (Cornus fruit) restrains the leakage of essence. Pharmacological studies point toward the formula being able to regulate indicators of renal function in diabetic nephropathy; this possibly indicates a protective mechanism on the kidney damage pathway that would explain why earliest stages of the disease are so dangerous.
Source: Classical TCM formula. Produced according to Tong Ren Tang formulary standards established in 1669.
8. Jinlida Granule (津力达颗粒)
FOCUS RCT: 41% diabetes risk reduction · n=885 patients
Jinlida is the evolution of TCM diabetes-formulation into modern practice – a standardised multi-herbal compound validated in a Western-style double-blinded clinical trial. In its most important study, the 885-patient prediabetes FOCUS RCT, Jinlida showed a 41% risk reduction of progression to type 2 diabetes. The FOCUS trial, published in a peer-reviewed pharmacology journal, met the exact standards of trial design demanded of pharmaceutical drug registration. The multi-target action of Jinlida – gut hormone modulation, insulin action and hepatic gluconeogenesis – exemplify TCM’s modern network pharmacology of metabolic disease.
Source: FOCUS RCT. Frontiers in Pharmacology, 2025. n=885.
9. Guizhi Fuling Wan (桂枝茯苓丸)
Anti-inflammatory + insulin resistance improvement via blood stasis resolution
Designed initially for gynecological indications from the 2 nd century Treatise on Prescriptions from the Golden Cabinet, Guizhi Fuling Wan has in TCM applications now been adapted for diabetic patients with blood stasis syndrome- a pattern of dark face, fixed pain and a choppy pulse. A Forward in Pharmacology review by Zhu et al. (2020) showed the formula had anti-inflammatory properties and improved insulin resistance in mice from acting on the pathway- NF-kB. In post- modern TCM diabetes applications, blood stasis is considered both a sequale of chronic hyperglycaemiaand a etiology for diabetic complications, thus giving the formula pulse relevance in longer-term cases.
Reference: Zhu J, et al. Frontiers in Pharmacology. 2020. Accessed 87
10. Sheng Di Huang + Mai Men Dong (生地黄 + 麦门冬)
Foundation formula pair for Yin deficiency type · Nourish Yin, clear heat
This herb combination is the foundation for the Yin-nourishing diabetic formula and is indicated in the most prevalent diabetic pattern seen in TCM; Yin deficiency leading to internal heat. Sheng Di Huang (raw Rehmannia) clears heat and nourishes Yin, while Mai Men Dong (Ophiopogon) moistens the Lung and Stomach, directly addressing the ×iaoke syndrome definition of wasting and thirst. If a patient in the clinical setting presents with thirst and dry mouth, irritability, red tongue with scanty coating, this pair of herbs form the basis for the rest of the formula. Contemporary research on these herbs shows they both possess polysaccharides with hypoglycemic action.
Une paire-équilibre de la médecine classique chinoise. Un principe de base dans la prise en charge du diabète de la déficience par Yin.
TCM vs Conventional Diabetes Treatment — Research Comparison
Framing this as “TCM or Western medicine?” misses the point. A better question is perhaps “How do TCM and Western medicine work with each other?” This comparison, based on published quantitative data as opposed to fuzzy qualitative descriptors, indicates exactly where each medical system adds actual value.
| Factor | Conventional (Metformin) | TCM (Berberine) | Combined Approach |
|---|---|---|---|
| HbA1c Reduction | ~1.5% (typical) | ~2.0% (Yin 2008) | Enhanced via gut microbiome cooperation |
| GI Side Effects | 30% incidence | 20% incidence | Monitored; TCM herbs may buffer GI impact |
| Onset of Effect | 1–2 weeks | 2–4 weeks | 1–2 weeks (metformin provides initial response) |
| Long-term Dependency | Ongoing daily medication | Course-based (adjustable) | Potential for reduced medication dependency |
| Root Cause Approach | Symptom control (glucose output) | Syndrome-based whole-body treatment | Best of both: immediate control + systemic rebalancing |
| Annual Cost (US avg) | $3,300–$4,600 OOP | Varies by program | Potential overall cost reduction |
Complementary, Not Alternative
A 2023 pro-CCM meta-analysis combining three randomized controlled trials of TCM + Western for type 2 diabetes established that: Applying statistical meta-analysis to combine the results of three CCCTMAS trials, researchers found that the integration group performed consistently better than Western drug alone in blood glucose fasting (by up to 20mg/dL), HbA1c, and patient-based quality-of-life measures as indicated by Quality of life.
Hashara_doi:10.3389/fmats.2023.1051844 mechanism is truly synergistic, not additive the berberine remains in the gut, where its impact on microbiome composition increases the absorption of the coadministered drug, metformin. Likewise, acupuncture therapy minimizes the cortisol spikes that tend to stymie insulin therapy efficacy.
Please inform your history taking team that we partners with your current Chinese & Western caregivers. At no time will we instruct you to stop pharmacy-prescribed medicines. We merely layer TCM on top and measure visible evidence of blood sugar improvement using lab tests then blood testing at each check-in. Should the foreign endocrinologist agree that your blood sugar levels have moved downward, typically they will lower the medication dosage – but this decision rests with your primary care team.
Clinical Results — Measurable Blood Sugar Improvements with TCM
Published, peer-reviewed evidence from 3 landmark practice studies with confirmed methodology that uses gold standard design of randomized controlled trial:
HbA1c −2%
FBG −3.7 mmol/L in newly-diagnosed T2DM
Yin 2008 · n=116 · PMC2410097
41%
Diabetes risk reduction in prediabetes
FOCUS Trial · n=885 · Jinlida Granule
FBG −0.72
mmol/L + HbA1c −0.36% with Tai Chi
Cochrane 2018 · 20 RCTs · Systematic Review
Treatment Timeline — What to Expect
Week 1–2
Initial assessment, tongue & pulse diagnosis, syndrome classification
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Week 2–4
FBG changes begin; herbal formula & acupuncture in effect
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Month 2–3
HbA1c improvements measurable in blood work
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Month 3–6
Formula optimization, lifestyle integration, sustained results
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Ongoing
Maintenance phase: reduced frequency, long-term wellness
Blood sugar responds to intervention according to a predictable timetable. Fasting blood glucose results have been shown to move within 2-4 weeks of the herbal compounds reaching efficacious levels and as acupuncture begins to re-regulate autonomic nervous system activity. HbA1c, a measure of average blood sugar over 2-3 months, takes roughly the same duration before laboratory results reflect the improvement. By months 3-6, practitioner Optimizing the formula by titrating individual herbs, based upon your body’s documented response pattern.
Honest note: Individual results vary based on diabetes duration, current HbA1c level, medication use, lifestyle factors, and adherence to the treatment plan. All data cited above comes from published peer-reviewed research with stated sample sizes and methodology. Tong Ren Tang reports clinical research outcomes, not guaranteed individual results.
Your First TCM Diabetes Consultation — What to Expect
Walking into TCM clinic for the first time, many practical questions arise. Here is exactly how each part of the first diabetes session works in practice – no mysteries, only transparency.
1
Initial Assessment (60 minutes)
The practitioner performs a blended TCM diagnosis and Western history review. Traditional tongue diagnosis (rough, smooth, pale, dark, thick coating, thin coating, dry, wet), pulse diagnosis (three positions on each wrist, with assessing their adaptability, slowness or rapidity), and a symptom review that discusses your blood sugar logs, medications, sleep habits, bowel habits, pain levels, and emotional states. You may be asked questions like The Bowel Guy asked about sleep and emotional states, because TCM understands you through the whole person, not just the location you have a Westin cells.
2
Syndrome Differentiation
The practitioner identifies your unique chemical balance through assessment findings. You could be Upper ×iao (Lung-thirst), Middle ×iao (Stomach-hunger), Lower ×iao (Kidney-urination), or something else – However, based upon your input above, your individual diagnosis will be determined, and treatment plan created. This diagnosis impacts all treatment plan components including herbal selection, positional targeting of acupuncture points, and your nutritional & movement recommendations. The practitioner explains your diagnosis so you understand why each recommendation was made.
3
Personalized Treatment Plan
You walk home with a detailed treatment plan that includes your herbal listing (raw herbs vs pills, individual doses, preparation method), an acupuncture schedule, a recommended food list, and eating and lifestyle adjustments. You even have specific goals for your blood sugar levels that you are tracking through following visits so everyone can evaluate your progress.
4
Treatment & Monitoring
Daily blood glucose monitoring — both fasting and post-meal — starts immediately. Herbal formulas are titrated from three to four weekly based on your data and symptom modulation. Acupuncture consists of bi-weekly sessions during the early phase of the treatment. Your practitioner screens each data point received to verify whether the indicators are improving you toward health. Increased rate of response leads to a redefinition of your syndrome and an alteration of your herbal formula.
5
Follow-up & Optimization
After the first treatment cycle (2-3 months), we review the previous work against the initial work performed in order to monitor progress of the marker levels (HbA1c, fasting glucose, other) and the according TCM diagnostic signs (pulse, tongue, symptoms). During this time, long-term aims are set, including less frequent acupuncture, the result of continued herbal formulas and an introduction of long-term self-preservation and self-cure methods to continue without reliance on the clinic.
What to Bring to Your First Visit
- Current blood sugar readings— last 3 months of HbA1c and fasting blood sugar, as well as any CGM records.
- Current medication list — including dosages and prescribing physician
- Med. Hx. summary: date diagnosed with diabetes, comorbid illnesses and long term problems.
- Diet diary (optional)– 3-7 days with the food consumed assists in evaluating dietby:
- Blood pressure readings — if you monitor at home
Treatment Investment
Cost of treatment depends on: complexity of syndrome, formula of herbs in use, frequency of acupuncture, timing of treatment… The cost of each individual treatment will depend on how many herbs are in the formula used, and the small handful of time at the beginning that is determined after your first consultation when the scope of your treatment is revealed. Please call us for a free consultation, and we will look at your individual circumstances and identify what the cost will be an open book.
Ready to explore evidence-based TCM for your diabetes management?
Book Your Free ConsultationFrequently Asked Questions — Chinese Medicine & Diabetes
TCM treats diabetes – not as a disease to be eradicated, but as a condition to be managed. In other words, if you do not have a Western perspective, no practicioner, TCM or conventional, will ever say, you are cured of your type 2 diabetes. What clinical trials reveal is what can be achieved diagnostically: you can get blood sugar markers down to better numbers: berberine appeared to achievellt 2% reduction in HbA1c in the Yin 2008 trial, Jinlida Granule carrying a 41% reduction in risk of developing type 2 diabetes in FOCUS trial and Tai Chi measured a 0.72 mmol/l reduction in fasting blood glucose in a Cochrane review on 20 trials. TCM, from a Western perspective is focused on driving down trend of Chinese Medicine syndrome patterns – with dietary and lifestyle intervention all the while aiming for long term, stable, balanced population management of your condition – requiring less and less reliance on having increased quantities of medications.
Additive effects have been reported in multiple studies when TCM is combined with standard anti-diabetic medication. Ginseng plus metformin demonstrated additive benefits without increased risk of side effects (PMC5527439). Berberine works through the same AMPK pathway as metformin but via a different molecular mechanism. To avoid redundancy, combination of berberine with standard medication should be discussed with your prescribing physician. Tong Ren Tang practitioners review your herbal prescription based on your current medication list and will communicate with your physician if needed. Some herb-drug interactions are documented — for example, berberine influences blood concentrations of certain medications — which are screened during your initial consultation.
By volume of published clinical evidence, berberine leads, with a meta-analysis of 46 berberine studies covering over 4000 patients showing glucose lowering comparabilities to standard drug therapy such as metformin. Apart from berberine, the most well-supported herbs are bitter melon (glucagon lowering), Astragalus (insulin resistance), ginseng (activation of insulin receptor gene via Compound K) and cinnamon (fasting glucose reduction). Again, the “best” herb depends on your TCM pattern syndrome: a Kidney Yin deficiency patient will have the best effect from Liu Wei Di Huang Wan, while a Stomach heat patient will respond more favorably to bitter melon and Coptis combinations. All our full herb evidence citations above.
Repeatedly over study duration, fasting blood glucose level changes were observed around 2-4 weeks of beginning herbal prescription and acupuncture. HbA1c occurred around 2-3 months, roughly predictive of the 90 day measure reflecting systemic blood sugars. Energy and bowel pattern improvements were observed to occur within 1 week. The 3-6 month full course of herbal prescription effects was then maintained with a returning to less frequent visits and reduced herbs prescription adjustment.
Costs vary by syndrome complexity (simple vs complex patterns of disharmony), number of herbs components (standard formula vs. advanced formula), frequency of acupuncture (once weekly vs. twice weekly), and length of time on prescription. As comparison, we note average out-of-pocket annual mean diabetes-related care cost in US is . TCM costs are variable, adjusting lower than these averages when reduced medication needs are factored in. After first consulting for 30-60 minutes, Tong Ren Tang reminds potential patients of an estimated overall cost before first starting treatment.
By volume of evidence, berberine(,) a compound isolated and purified from Coptis chinensis, stands alone. The Yin 2008 significant HbA1c reduction of 2% and fasting blood glucose falling from 10.6 to 6.9 mmol/L elicited berberine as “comparable to metformin” (PMC2410097, cited 1,175 times). Berberine activates the cellular energy sensor AMP kinase, increases both total and insulin-mimetic insulin receptor G, and affects the microbiome. The strongest evidence base formula varies by syndrome. For Kidney Yin deficiency, Liu Wei Di Huang Wan has by far the strongest evidence. For long-term Diabetes Prevention prediabetes, Jinlida Granule over 5000 patient years has the highest evidence of reduction in risk for progression.
Coverage is region- and insurer-dependent. In the United States, Medicare began paying for acupuncture for chronic low back pain under 2020 CMS ruling, but this does not extend to coverage for TCM in diabetes. Herbal medicine is less reliably covered. If you have a HSA or FSA savings account, you may be able to be reimbursed. In other national healthcare systems with Integrated Medicine models, TCM gets greater support. Practical suggestions: (1) contact your insurance and find out regarding coverage, call ahead when possible; (2) get a superbill for out-of-network services from Tong Ren Tang to submit to insurance for potential reimbursement; (3) see if your employer offers a wellness benefit plan containing payment for alternative medicine.
Chinese stands for “wasting and thirsting,” a syndrome documented in TCM Chinese herbal texts for over 2000 years years ago. It has been mapped to the condition known in modern medicine as “diabetes mellitus” and the earliest description of the condition can be found in the Huangdi Neijing (Yellow Emperor’s Classic of Internal medicine 200 BCE). It contained each symptoms experienced in DM and also explained its linked clinical basis to the overconsumption of rich foods and mental and emotional factors leading to depletion of function of the organ systems. Ancient Chinese physicians categorized the syndrome into three groups according to the affected organ system; the Lung affected in the Upper ×iao creating palpitations, worry and thirst, the Stomach affected in the Middle ×iao creating hunger, and the Kidney in the Lower ×iao creating excessive urinatioon, all modes that predate the discovery of insulin by about 2100 years.
