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Traditional Chinese Medicine (TCM) refers to diabetes as Wasting-Thirst syndrome. The root of Wasting-Thirst is said to be a deficiency of Yin in the body and the presence of a Heat pathogen affecting the Lungs, Stomach, and Kidneys. When Yin is deficient, Heat from deficiency is produced; likewise, when Heat is present, it "burns up" Yin. It is common for people diagnosed with diabetes to have a constitutional Yin Deficiency, but the deficiency may develop over time as well. Frequent causes are a diet that includes too many spicy and drying foods, insufficient rest, overwork, and sexual over indulgence. Deficiency of Yin and the presence of the Heat Pathogen lead to the symptoms of diabetes.

Traditional Chinese Medicine Categories of Diabetes

The most common manifestations of diabetes are excessive thirst, hunger, and urination, associated, respectively, with the upper, middle, and lower aspects of the body (known as the Triple Burners in TCM), so the disorder is commonly categorized as Upper Burner, Middle Burner, and Lower Burner Wasting-Thirst Patterns of Disharmony.

• Upper Burner: Known as Heat in the Lungs, the primary symptom of this pattern is excessive thirst. The pulse is usually rapid and may be thin; the tongue is red and dry, possibly with a thin yellow coat.
• Middle Burner: Related to Stomach Fire, the primary symptom of this pattern is excessive hunger. The pulse usually is forceful and rapid; the tongue is red with a yellow coat.
• Lower Burner: Related to Kidney Yin Deficiency, the primary symptom of this pattern is excessive urination. The pulse is usually rapid and thin; the tongue is red with little coating.

Patients who have been given a conventional diagnosis of diabetes, but who do not fall into these patterns, are diagnosed in TCM according to their particular signs and symptoms and are treated accordingly.

Traditional Chinese Medicine Treatment of Diabetes

Traditional Chinese Medicine treatments for diabetes focus on nourishing Yin, clearing the Heat, and resolving the Patterns of Disharmony in each of the Triple Burners. Because it is common for more than one Burner to be affected at the same time, treatment may be complex. While resolving the underlying condition, secondary treatment strategies for accompanying patterns such as Qi deficiency and Blood Stasis are carried out as well.

Traditional Chinese Medicine does not offer a cure for diabetes, and it is necessary for patients with diabetes to continue taking their medication and follow the diet prescribed by their physician. However, in many cases, TCM can help lower glucose levels in the body and thus reduce the need for medication. This reduction must be monitored carefully in a joint effort by conventional physicians and practitioners of TCM. Of the three modalities, herbal medicine is the modality of choice and offers the most potential benefit. Acupuncture and Qi Gong also may offer some benefit to diabetes patients.

Acupuncture
Acupuncture treatment for diabetes focuses on treating the Patterns of Disharmony and any other symptoms.

• Upper Burner patterns affecting the Lung are treated with points such as Lung 5 (Chi Ze), UB13 (Fei Shu), and Sp 6 (San Yin Jiao).
• Middle Burner patterns affecting the Stomach are treated with points such as Ren 12 (Zhong Wan), Stomach 44 (Nei Ting), and Sp 6 (San Yin Jiao).
• Lower Burner patterns affecting the Kidneys are treated with points such as Ki3 (Tai Xi) and Sp 6 (San Yin Jiao).

Empirical points may be used as well. Yi Shu, which has an effect on the pancreas (the organ as understood in conventional medicine), is a common addition to all acupuncture treatments of diabetes. Likewise, a point on the sole of the foot, Ki 1 (Yong Quan), may be treated. As this is a painful point to needle, it may be massaged or treated with electricity alone. Other symptoms, such as Qi deficiency and Blood Stasis, may be treated with points such as St 36 (Zu San Li) and Sp 10 (Xue Hai).

Acupuncture treatment in diabetic patients may be contraindicated, depending on the patient's symptoms. For example, in patients whose cuts and wounds do not heal, acupuncture points needled on the lower extremities are not advised.

Herbal Medicine
Herbal medicine treatment for diabetes focuses on creating formulas that treat the underlying Zang Fu Patterns of Disharmony in the Triple Burners, while treating symptoms as well.

• Lung Heat: Formulas employ herbs such as Sheng Di Huang (Radix rehmannia Recens) and Tian Hua Fen (Radix Trichosanthis) to nourish Yin, clear Heat, and relieve thirst.
• Stomach Fire: Formulas use herbs such as Shi Gao (gypsum) and Zhi Mu (Rhizoma anemmarrhenae) to clear Stomach Fire, nourish Yin, and thus reduce the excess hunger Stomach Fire generates.
• Kidney Yin Deficiency: Formulas use herbs such as Shu Di Huang (Radix rehmannia Glutinosae), Zhi Mu (Rhizoma anemmarrhenae), and Shan Zhu Yu (Fructus Corni) to nourish Kidney Yin, clear Heat, and reduce excessive urination.
• Herbs such as Xi Yang Shen (American ginseng) and Dan Shen (salvia) may be added to formulas as well to tonify the Qi and prevent Blood Stasis.

From the perspective of conventional research, specific herbs for other symptoms, in particular Xi Yang Shen (American ginseng) and Zhi Mu (Rhizoma anemmarrhenae) have a powerful effect in lowering blood glucose levels. The addition of herbs such as Dan Shen (salvia) is important in these formulas, as prevention of Blood Stasis has a beneficial effect on the circulatory disorders that are often a complication of diabetes.

Qi Gong
While Qi Gong is not typically used as a major treatment modality for diabetes, the use of a Qi Gong routine as part of a regular exercise program may promote health. Different Organ Sound may be employed as well, depending on the Burner involved: the Lung sound for the Upper Burner; the Spleen Sound for the Middle Burner; and the Kidney Sound for the Lower Burner. The Spleen Sound is used for the Stomach, as the Spleen and Stomach are paired in Traditional Chinese Medicine. Finally, the Triple Burner sound may be used to clear Heat from the body.

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