Does Chinese Herbal Medicine Help with Blood Glucose Control in People with Type 2 Diabetes Mellitus?Complementary and Alternative Therapies Evidence-based Summary
Date of review: July 2006
View the plain language summary of this evidence review below.
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The therapy
Chinese herbal medicine, including herbs, herbal extracts, over-the-counter Chinese medicine and herbal compounds prescribed by a Chinese practitioner.
Type 2 diabetes
Diabetes mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot use it properly. Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). There are two main forms of diabetes: type 1 and type 2 diabetes. Type 2 is much more common and is increasing in frequency. The estimated number of people in New Zealand with type 2 diabetes was 81,500 in 1996 and 145,000 in 2011, an increase of 78%. Type 2 diabetes most often occurs in adults, but is becoming more common in adolescents and children. This report applies only to adults.
Being overweight or obese is a risk factor for type 2 diabetes.
Although many people with type 2 diabetes have no symptoms at all, the most common symptoms are:
- increased thirst
- passing urine frequently – especially at night
- extreme tiredness
- weight loss
- genital itchiness or frequent episodes of thrush infection
- blurred vision
A blood test can check for diabetes.
More information on type 2 diabetes can be found at http://www.diabetes.org.nz.
Background
Chinese herbal medicine forms the main part of Traditional Chinese Medicine, and has been used in diabetes for a long time. It is based on the concepts of Yin and Yang and Qi energy. Traditional Chinese Medicine includes herbal therapy, acupuncture, food therapy, and exercise for both the treatment and prevention of disease.
Source
Liu JP, Zhang M, Wang WY, Grimsgaard S. Chinese herbal medicines for type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD003642. DOI: 10.1002/14651858.CD003642.pub2. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003642/frame.html
The evidence
There is level three evidence from six studies in a systematic review that taking certain herbal medicines may have beneficial effects on blood glucose control in people with type 2 diabetes mellitus. Compared with placebo, six herbal preparations seemed to improve blood glucose control, Holy basil leaves, Xianzhen Pian, Qidan Tongmai, Traditional Chinese Medicine (TCT), Huoxue Jiangtang Pingzhi, and Inolter. However, none of the studies were of high quality and most had a high risk of bias. Therefore, these findings need to be confirmed by larger well-designed studies.
There is tentative evidence from seven studies comparing herbal medicines with hypoglycaemic drugs showing better hypoglycaemic responses for Bushen Jiangtang Tang, Composite Trichosanthis, Jiangtang Kang, Ketang Ling, Shenqi Jiangtang Yin, Xiaoke Tang, and Yishen Huoxue Tiaoganthan for hypoglycaemic drugs. A further 12 studies comparing herbal medicines with hypoglycaemic drugs showed no difference between the two.
The sixty-six randomised studies included in the Cochrane review generally had small sample sizes and few of the studies used blinding methods. None were of high quality. All herbal medicines that were tested against hypoglycaemic drugs were mixtures composed of several different herbs and no herbal medicine was tested more than once except Xianzhen Pian. Ninety per cent of the studies were conducted on Chinese participants. An interpretation of the evidence is difficult due to the low quality of the studies and the authors of the systematic review conclude that they do not recommend any of the herbs they tested for routine clinical use.
Important other issues
The herbal medicines evaluated in the systematic review generally appeared to be safe. However, the safety of using herbal medicines for type 2 diabetes was not fully assessed as adverse effects were not sufficiently reported in the studies.
Eleven Chinese medicines being sold as Chinese herbs are being withdrawn in New Zealand because they illegally contain pharmacy-only medicines and toxic substances. One of these medicines is being sold for diabetes. Xiaoke Wan pills are being withdrawn as they contain Glibenclamide (a hypoglycaemic drug) 2.5mg per 10 pills, which is a prescription medicine. More information can be found in the Ministry of Health media release Feb 2003.
Key messages
| Evidence | Level of evidence |
| There is limited evidence that compared with placebos that contain no treatment some Chinese herbal medicines might help with blood glucose control in people with type two diabetes mellitus. | 3 |
Key: Levels of evidence
| 1 | 2 | 3 | 4 |
| Evidence with a high degree of reliability | Evidence with reliability, but open to debate | Some evidence without a high degree of reliability | Some evidence, but based on studies without comparable groups. |
Additional references
DISCLAIMER: This summary does not provide specific medical advice and the information provided should not be used as a substitute for seeking medical advice from a registered health practitioner.
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