Diabetes: Syndrome Differentiation of Diabetes
Diabetes has been described repeatedly in the ancient Chinese medical literature. Diabetes has been mentioned and treated with Chinese herbs for at least 2,000 years, with the Huang Di Nei Jing describing the condition known as xiao ke. The translation is now known as diabetes or diabetic exhaustion, whilst the literal translation is emaciation thirst. According to this ancient text, the syndrome arises from consumption of excessive fatty, sweet, or rich foods. It is suggested that it typically occurs among wealthy people: The description is suitable that of type 2, or insulin-independent diabetes mellitus, the most common form of diabetes that exists today.
Recent trends have indicated that the number of people living with diabetes is expected to rise from 366 million in 2011 to 552 million by 2030, if no action is taken, this means that approximately 3 new cases every 10 seconds. The greatest number of people with diabetes is between 40 to 59 years of age. Diabetes mellitus is a disease that is classified as a metabolic disease which is caused by high blood sugar, either due to compromised production of insulin or because body is not responding to insulin produced. Diabetes is classed into two separate types and plus a temporary state which can regress: type 1, type 2 diabetes and Gestational diabetes.
Type 1 diabetes:
Can occur at any point in an individual’s life but diagnoses is normally seen at an early age. It is suspected to be caused by the immune system mistakenly turning on itself, destroying beta cells within the pancreas and removing the body’s ability to produce insulin , people with type 1 have severe insulin deficiency and need insulin replacement in order to live; it is caused by the body failing to produce enough insulin, and so requires the persons affected by the disease to constantly inject insulin into their system, or else the body literally starves as it cannot process food . Some may have to take over 14-15 thousand insulin injections in a 10-year period.
Symptoms of diabetes include:
- extreme thirst
- constant hunger
- sudden weight loss
- frequent urination
- blurry eyes
- extreme tiredness
Diabetic neuropathy can lead to a loss of feeling in hands and feet. High blood glucose levels inhibit the systemic circulation of blood therefore impairs the healing process which may take weeks to heal a minor injury.
Diabetic nephropathy (diabetic kidney disease) is when the kidneys gradually deteriorate and lose full function, this can lead to kidney failure in severe cases.
Cardiovascular disease is a range of blood vessel system diseases that includes both stroke and heart attack. The two most common types of cardiovascular disease are coronary heart disease, caused by fatty deposits in the arteries that feed the heart, and hypertension, or high blood pressure.
Diabetic retinopathy takes place due to the high blood pressure and high blood sugar levels weakening the walls of the retina; this causes micro-aneurysms which leaks fluid or blood into the surrounding tissue.
Type 2 diabetes:
When the body fails to recognize the insulin produced and therefore is unable to reduce the blood sugar levels of the individual. Type 2 diabetes makes up approximately 90% of all diabetes cases. In some cases people can live for months even years without any knowledge of the disease, this is because type2 comes gradually that symptoms are unrecognised. In comparison to type1 the beta cells over time gradually losses their functions of producing insulin.
Heightened risk of developing type2 diabetes if you:
- have a family history of diabetes
- are older (over 55 years of age ) – the risk increases as we age
- are over 45 years of age and are overweight
- are over 45 years of age and have high blood pressure
- are a woman who has given birth to a child over 4.5 kg (9 lbs), or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.
Symptoms of type2 diabetes:
- being very thirsty
- frequent urination
- blurry vision
- mood swings
- tingling or numbness in the hands or feet
- frequent skin, bladder or gum infections
- wounds that don’t heal
- extreme unexplained fatigue and also lethargic
- gradual weight gain
- leg cramps
Almost 60% of all type 2 cases are viewed as preventable, some suggested measures of prevention are:
- Maintaining a healthy weight
- Regular physical activity
- Making healthy food choices
- Managing cholesterol levels
- Not smoking
Syndrome Differentiation of Diabetes
QI Stagnation due to Liver Depression
Patients with diabetes often exhibit aggravated emotional tension, which is consistent with the theory of TCM that negative emotions could lead to diseases. Liver depression could lead to Qi stagnation and result in some emotional symptoms. This was the first stage of diabetes, and the characteristic was stagnancy.
Liver and Stomach Heat Stagnation
Liver and stomach heat stagnation belong to the stagnancy and heat stages of diabetes. The patients of this type showed some emotional and digestive symptoms such as irritability, distention and fullness in the chest and rib-side, drinking too much fluids and the production of increased urine, eating too much food, hunger, experiencing a bitter taste, dry mouth, and constipation. And patients usually have a red tongue, and a rapid and stringy pulse.
Phlegm and Heat Stasis
This syndrome often appears in the “heat” stage of diabetes, and the patients are relatively obese because in the theory of Chinese medicine, “obese people tend to have copious phlegm.” Patients with this type may have some symptoms such as abdominal obesity, a sense of chest suppression, abdominal distention, and dry mouth. They might also prefer cold drinks, drink much more fluids, and be irritable and have a bitter taste in their mouth as well as constipation. Patients also have a red and fat tongue with yellowish greasy moss, yellow urine, and a stringy and smooth pulse.
Excess Heat in the Stomach and Intestine
This syndrome generally occurs in the diabetic middle stage or in the “heat” stage. In the middle stage of diabetes, patients eat large amounts of food, which stagnate and form heat in the stomach and intestine. As such, its principal symptoms are abdominal fullness and distention, constipation, a bitter taste and dry mouth, halitosis, thirst with a desire for cool water, drinking and eating too much, and hunger. Patients usually have a red tongue with yellow moss and a rapid strong pulse.
Intestinal Damp and Heat Syndromes
This syndrome has unique features, intestinal damp and heat syndromes always appear in the diabetic middle stage or during the heat stage. Its principal symptoms are thirst with no desire to drink, hunger with no desire to eat, a bitter taste, a sticky and greasy sensation in the mouth, and abdominal distention. Patients also show a red tongue with yellow and greasy moss and a slippery pulse. When damp and heat affect the large intestine, smelly greasy stools might also form.
Deficiency of Body Liquid due to Excessive Heat Syndrome
The deficiency of body liquids due to excessive heat syndrome is more commonly found in the diabetic middle-late stage or the heat and deficiency stages. Impacted by the fire and heat pathogens from the early and middle stages of diabetes, qi is consumed and liquids are injured gradually. As such, its principle symptoms are dry throat and mouth, thirst with a desire for cool water, overeating and hunger, frequent micturition volume, irritability, bitter taste, red urine, and constipation. Patients also commonly have a red tongue with yellow fur and a rapid pulse
Dual Deficiency of Qi and Yin
The dual deficiency of qi and yin syndrome occurs in the late diabetic or the deficiency stage. The fire and heat pathogens further dissipate the primordial qi of zang-fu organs, and then the generalized qi is consumed. In addition, fire and heat pathogens scorch liquids and damage yin. Therefore, the main symptoms are dry throat and mouth, thirst with a large intake of fluid, fatigued spirit and lack of strength, shortness of breath and reluctance to speak, emaciation of the body, aching lumber and knees, spontaneous and night sweats, feeling palm and arch fever, upset, palpitations, insomnia, a red tongue with scant liquids and thin white dry tongue fur, and a fine rapid pulse.
Traditional Chinese Medicine does not offer a cure for diabetes, but instead aims to optimise the body’s ability to function normally. There is still a great need for more and better research on the efficacy and safety to integrate the two forms of care must all recognize the importance of careful monitoring of blood glucose levels, as well as monitoring for potential side effects such as drug-herb interactions.
- Syndrome Differentiation of Diabetes by the Traditional Chinese Medicine according to Evidence-Based Medicine and Expert Consensus Opinion: Jing Guo, Hongdong Chen, Jun Song, Jia Wang, Linhua Zhao, and Xiaolin Tong; Evidence-Based Complementary and Alternative Medicine Volume 2014 (2014),