🍬 TCM Herbs for Diabetes?

published 6 MONTHS AGO | 5 MINS READ

With the rise in popularity of Ozempic, a lot of people have been asking about Chinese herbs for diabetes.

(Apparently berberine, an active ingredient in Huang Lian, is being touted as "nature's ozempic.")

But rather than prescribing large amounts of an herb that could easily destroy a your Spleen, let's talk about gentler pair: Huang Qi and Shan Yao.

 

Herbs for Diabetic Patients

You probably learned in school that diabetes corresponds to the TCM disease Xiao Ke (消渴, wasting-thirst).

This condition was first mentioned in the Huang Di Nei Jing as a disease caused by eating too much sweet or fatty food, typically affecting the wealthy and noble who were reluctant to change their habits.

Later, Zhang Zhongjing described three patterns of Xiao Ke based on the predominant symptom:

  • Upper Wasting (Lung) - increased thirst 🥤
  • Middle Wasting (Stomach) - excessive hunger 🍔
  • Lower Wasting (Kidney) - frequent urination 🚰

And he had formulas to treat each of these patterns.

 

The Modern Challenge

The problem is that modern patients rarely present with these classical symptoms. I've never really had a patient come in saying they're thirsty and they pee a lot.

Instead, patients typically arrive with bloodwork showing diabetes or pre-diabetes. They know their A1C is elevated, but they just don't have the classical Xiao Ke symptoms.

And besides that, I don't usually see the Lung or Stomach heat patterns that Zhang Zhongjing described. Most modern diabetic patients I've seen present with Spleen deficiency and dampness.

Perhaps modern diabetes requires a different approach than the classical Xiao Ke treatment...

 

A Modern Herb Pair: Huang Qi and Shan Yao

Both Huang Qi (astragali radix) and Shan Yao (dioscoreae rhizoma) belong to the category Herbs that Tonify the Qi, making them excellent choices for deficiency patterns.

According to Chen & Chen in Chinese Medical Herbology and Pharmacology:

The combination of Shan Yao and Huang Qi has excellent effects to lower plasma glucose levels in diabetes mellitus patients. These two herbs are especially effective in individuals with diabetes characterized by qi and yin deficiencies.
 
 

Traditional Uses for Xiao Ke

Both herbs have classical applications for wasting-thirst disorders:

For Huang Qi, Bensky notes its use "in appropriate circumstances, for wasting and thirsting disorder."

Then we Huang Qi come up in the Song dynasty formula Jade Spring Decoction (1264), where Huang Qi and Ren Shen tonify the Spleen and Lung to properly transport and transform fluids, thus alleviating thirst.

For Shan Yao, Bensky explains...

...because this herb moistens and is neither hot nor cold, it benefits both the yin and yang of the Lungs and Kidneys. It is therefore often used in treating wasting and thirsting disorder, sometimes in large dosage as a stand-alone herb.
 
 

Classical Formula: Jade Fluid Decoction

These herbs come together as chief ingredients in a more modern formula, Jade Fluid Decoction (Yu Ye Tang), created by Zhang Xi-Chun in the early 20th century.

(He published this formula in his work, Essays on Medicine Esteeming the Chinese and Respecting the Western [1918-1934])

Zhang combined Western scientific knowledge with Classical Chinese physiology, believing Xiao Ke resulted from primal qi's failure to ascend. By tonifying the middle, clear yang qi could ascend and help transform water in the Lung.

(This formula also contains Zhi Mu, Ge Gen, and Tian Hua Fen, so thirst is still an important indication for its use.)

 

Modern Research Support

Is there evidence to support the use of these herbs?

Kind of...

While most existing studies were performed on diabetic mice or rats, some promising research exists:

Huang Qi (Astragalus)

  • Type 1 diabetes: One ​meta-analysis​ found that "APS [astragalus polysaccharide] may protect pancreatic beta cells from autoimmune destruction through regulation of inflammatory and apoptotic responses"
  • Type 2 diabetes: The same meta-analysis found several studies showing it may improve insulin sensitivity and reduce fasting blood glucose
Delivery method matters: Interestingly, ​another meta-analysis​ found that, while Huang Qi in decoction could lower HbA1c, injection didn't have the same effect.
 

Shan Yao (Dioscorea)

Research is more limited, with most studies in animal models.

Chen & Chen cite one study where: "oral ingestion of the decoction at 30 g/kg/day for 10 days lowered blood glucose levels in mice by approximately 10-30 mg/dL."

(That's a lot of Shan Yao. For me that would be like 6 1/2 pounds of Shan Yao.)

 

Clinical Applications

So that's an example of one pair of herbs which may be able to help with diabetes (especially type 2 diabetes). I think they're especially useful in modern cases where you want to tonify deficiency instead of clear heat.

Others have also been suggested, such as Cang Zhu and Xuan Shen, or Shi Gao and Zhi Mu.

But I think this is good news. It means that we have options to help diabetic patients, even if they don't fit neatly into the classical patterns of Xiao Ke.

 

Want to Learn More?

My friend Patrick from Kentucky has developed his own approach to Type 2 diabetes mellitus. Over the past ten years, he's created a custom formula that he's been prescribing to diabetic patients with excellent results.

We've recorded a comprehensive mini-course covering:

  • How the formula was created and the clinical results he's achieved
  • Complete ingredient breakdown and selection rationale
  • Modifications for specific symptom presentations
  • Food therapy recommendations to enhance the formula's effectiveness

Course Details:

  • 4 CEUs (approved by California Acupuncture Board, NCCAOM approval pending)
  • Price: $30
  • Bonus content: Patrick's point prescription for COVID-related loss of smell and herbal treatment for vulvodynia

​Join the Waiting List​ to be notified as soon as the course receives full approval and launches.