Diabetes

DEFINITION IN WESTERN MEDICINE: Diabetes is a hereditary disease characterized by a variable degree of carbohydrate intolerance and a specific vascular lesion (i.e., thickening of the capillary basement membrane); The carbohydrate intolerance is due to an absolute or relative insufficiency of insulin and may appear at any age. 

SYMPTOMS AND SIGNS: Onset may be abrupt in children or young adults, but in older patients it is usually insidious, with evidence of diabetes discovered only on routine urine and blood examination. When symptoms occur in older patients, they are usually so mild that they do not cause the patients to seek medical advice. Often the disease is first discovered when a complication arises. Symptoms include polyuria, thirst, itching, hunger, weakness  and weight loss. Large amounts of urine are passed daily, resulting in excessive thirst and dryness of the skin.

ETIOLOGY AND PATHOLOGY: Diabetes is called Xiao Ke (Consuming and Thirsty) in Chinese medicine. According to its symptoms of thirsty, hunger, and frequent urination, it is called Shang Xiao (Upper Consuming), Zhong Xiao (Middle Consuming) and Xia Xiao (Lower Consuming) respectively. Its causes are irregular diet habit; unstable emotions, and Yin deficient body type. So for the diabetes, the basic factor is Yin deficiency of kidney; at the same time, the irregular diet and unstable emotions create inner heat or fire, which consumes Yin and creates in a constant aggressive Yin deficient state in the body.

In the Upper Consuming stage, the heat and the Yin deficiency of lung makes it lose its normal function of descending and spreading the body fluid. Symptoms and signs show thirsty, frequent drinking and urination, restlessness, red tongue tip, thin and yellow tongue coating, rapid and forceful pulse.

In the Middle Consuming stage, heat and fire of the stomach creates digestion quicker than usual. Symptoms and signs show frequent hunger, good appetite, thirsty, frequent drinking and urination, thin body, constipation, dry and yellow tongue coating, forceful and rolling pulse. 

In the Lower Consuming, the Yin deficiency and fire of kidney cause its fire flaming upward to lung and stomach; at the same time, it loses its function of storage Jin (essence) and its control of water metabolism. The symptoms and signs show frequent urination and drinking, turbid and sweet urine, dry mouth, red tongue, deep and rapid pulse. 

DIFFERENTIATION: 

1. Shang Xiao (Upper Consuming)

Indications: Thirsty, frequent drinking and urination, restlessness, red tongue tip, thin and yellow tongue coating, rapid and forceful pulse. 

Treatment & Formulas: Clear lung heat and tonify the body fluid. 

Products:

    • Yu Quan Wan (Jade Spring Pill, Item No. 5013): This is the most common used formula for diabetes.
    • Gan Lu Yin (Sweet Combination, Item No. 2075): It treats the symptoms of lung heat with Yin deficiency. 
    • Huang Lian Di Huang Tang (Coptis and Trichosanthes Combination, Item No. 2211): It treats the symptoms of Yin deficiency of lung, stomach, and kidney with Qi deficiency at same time.
    •  Shan Sheng Mai Dong Tang (Adenophore and Ophiopogon Combination, Item No. 2107): It treats pure lung or stomach Yin deficiency symptoms. 

2. Zhong Xiao (Middle Consuming):

Indications: Hunger easily, good appetite, thirsty, frequent drinking and urination, thin body, constipation, dry and yellow tongue coating, forceful and rolling pulse. 

Treatment & Formulas: Clear the stomach fire and nourish the body fluid.

Products:

    • Yu Quan Wan (Jade Spring Pill, Item No. 5013) Huang Lian Di Huang Tang (Coptis and Trichosanthes Combination, Item No. 2211 ): It treats Yin deficiency of stomach, lung and kidney with Qi deficiency at the same time. 
    • Shan Sheng Mai Dong Tang (Adenophore and Ophiopogon Combination, Item No. 2107): This treats pure lung or stomach Yin deficiency 

3. Xia Xiao (Lower Consuming): 

(1). Kidney Yin Deficiency: 

Indications: Frequent and profuse urination, turbid and sweet urine. Other symptoms are dizziness, tinnitus, nocturnal emission, night perspiration, heat sensation in the palm and soles, dry mouth, red
tongue, deep, thready and rapid pulse. 

Treatments & Formulas: Tonify the kidney Yin. 

Products:

    • Liu Wei Di Huang Wan (Rehmannia Six Formula, Item No. 2051): This treats the pure kidney Yin deficiency.
    • Zhi Po Pa Wei Wan (Anemarrhena, Phellodendron,and Rehmannia Formula, Item No. 2123): lt treats kidney Yin deficiency with deficient fire.
    • Ji Ju Di Huang Wan (Lycium, Chrysanthemum and Rehmannia Six Formula, Item No. 2290): It treats kidney Yin deficiency with liver Yin deficiency at the same time. Sympt0ms show blurry vision, dizziness, dry eyes with aversion to wind, runny eyes in wind. 

(2). Both Kidney Yin and Yang Deficiency:

Indications: Frequent urination and drinking, turbid nocturia, dull and dark face, dry and small auricle, lumbago, coldness sensation in the lower part of the body, impotence and seminal emission, pale tongue body, white tongue coating, deep, thready, and weak pulse

Treatments & Formulas: Tonify the kidney Yin and Yang, astringe the kidney essence

Products:

    • Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011 ): It is good for tonifying kidney Yin and Yang.

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