DIABETES TREATMENT w/CHINESE HERBS #8

by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

COMBINING INSULIN AND OTHER DRUGS WITH HERBS

While Chinese literature sometimes mentions, in passing, the use of Chinese herbs along with insulin, specific strategies for combining the two are not commonly presented in English-language publications. A report on integrated Chinese and Western treatment of diabetes was published in 1987 (27). For insulin-dependent diabetics, a formula made with codonopsis, astragalus, atractylodes, rehmannia, ophiopogon, and lycium fruit was given (the formula tonifies qi and nourishes yin). For those with non-insulin-dependent type, they were treated with the same mixture either alone or with tolbutamide or glyburide. The herbs, prepared in liquid form, were given twice daily for three months. It was reported that the herbs exhibited a hypoglycemic effect and synergized with insulin and other drugs. For the group of 53 patients treated, the average fasting blood glucose at the beginning was 177 and at the end of the three months was 135.

In one clinical trial (18), a group of 10 patients was identified who had responded poorly to Western drugs and also failed to respond to Chinese herbs. They were then given both the herbs and drugs concurrently. Significant improvements were observed in eight of the ten patients.

Ginseng is reported to reduce the dosage of insulin needed by patients and to prolong the action of a dose of insulin (13).

EXPECTED OUTCOMES

According to a representative clinical evaluations mentioned in this article, about 70-80% of those using the appropriate formulations at the high Chinese-style dosages achieve some degree of improvement in their diabetic condition. Blood sugar levels may not reach the normal zone for many so treated, but they are reduced sufficiently to ameliorate symptoms and to decrease the risk of serious secondary effects of the higher blood sugar levels maintained over a long period of time. Still, 20-30% of patients may fail to respond or show only a marginal response. If the dosages are lowered, due to poor compliance with the protocols, the success rate is likely to be even less. Among those who showed some degree of improvement in the Chinese trials, there are certainly some responses which would be deemed inadequate to justify continuing with the herb therapy due to its inconvenience. These factors need to be taken into account when describing outcomes to diabetics who are about to begin a course of therapy.

It may be of greater interest, for many diabetics seeking the benefits of Chinese herbs, to pursue the treatment of complications of diabetes. For example, diabetic neuropathy has been reportedly helped by a modification of the Rehmannia Eight Formula (Achyranthes and Plantago Formula), which itself may contribute to lowering blood sugar and aiding insulin regulation. Similarly, diabetic retinopathy is treated by herb combinations, such as one reported in the Liaoning Journal of Traditional Chinese Medicine (28), that incorporate herbs helpful in lowering blood sugar (e.g., astragalus, rehmannia, scrophularia, salvia, pueraria, and atractylodes (cangzhu) along with some other ingredients aimed at the symptom (tang-kuei, chrysanthemum, eriocaulon, and laminaria), with reasonable success: about 80% of treated eyes showing improvement; plasma viscosity and blood sugar were also reduced.

One of the factors causing diabetic complications is believed to be increased aldose reductase activity. In a laboratory study of herbal inhibition of aldose reductase, it was shown that the active constituents of pueraria, scute, and sylibum, and the whole herb extracts of licorice, salvia, astragalus, gentiana, and cnidium had significant activity (31). Pueraria, salvia, and astragalus are frequently employed in modern Chinese herb treatments for diabetes.

Depending on the type of diabetic syndrome and other health factors, the use of the Chinese herbs would likely have to be continued for quite some time (the exception might be some cases of lowered insulin production, which could possibly be remedied by one or two months of therapy with herbs). However, positive effects on symptomatic manifestation of diabetes is reported to occur in the first few weeks of treatment. It is possible that after an initial high-dosage treatment to lower blood sugar significantly that a more convenient low dosage maintenance program could be used as follow-up.

In the most common type of diabetes, which has late onset, a combination of herb therapy, dietary control, and obesity reduction could result in the cure of diabetes (not requiring continued ingestion of herbs), though the tendency for it to recur as a result of weight gain, dietary indiscretion, or emotional stress would remain.

Along with Chinese herb therapy, acupuncture can be used to treat risk factors for diabetes (e.g., obesity), the diabetic syndrome, and the secondary effects of diabetes (7, 32). Further, the use of nutritional supplements (9) and Oriental dietetic practices (10) could greatly improve the outcomes attained by traditional acupuncture and herbal medicine. Unfortunately, the effects of a comprehensive program of treatment has not been studied, so the degree of effectiveness is not yet known. One can only suggest that the outcomes would likely be somewhat better than those reported in this article.

REFERENCES

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