Date Last Updated: 06/07/06
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Does Chinese herbal medicine help with blood glucose control in
people with type 2 diabetes mellitus?
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% (Ministry
of Health, 2002) 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:
A blood test can check for
diabetes.
More information on type 2
diabetes can be found on the
Diabetes New Zealand.
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 Tiaogan than
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 (Ministry of Health, 2003).
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 on the
Ministry of Health media release Feb 2003
Key Messages
|
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
Additional References
Ministry of Health.
Modelling Diabetes: Forecasts to 2011. Public Health Intelligence Bulletin
No.9. March 2002.
Ministry of Health.
Director-General's Privileged
Statement Under Section 98 of the Medicines Act 1981.
Media Release. 14 February 2003.
http://www.moh.govt.nz/moh.nsf/aa6c02e6249e7359cc256e7f0005521d/0de600666a1711a8cc256ccf0064d574?OpenDocument
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