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DIABETES MELLITUS DIFFERENTIAL DIAGNOSIS (TCM & WESTERN)

Western or conventional therapies for diabetes have been geared toward regulating blood glucose with a combination of diet modification, insulin and/or oral pharmacological agents, weight loss when appropriate, and exercise. Although Western medicine and Traditional Chinese medicine (TCM) share the diabetes treatment goals of reducing symptoms and preventing complications, their approaches to conceptualizing, diagnosing, and treating the disease are very different. The Chinese language includes two terms for diabetes. The traditional name, Xiao-ke, correlates closely with diabetes in most instances. Xiao-ke syndrome means “wasting and thirsting.” The more modern term, Tang-niao-bing, means “sugar urine illness.” Reference to diabetes by the traditional term appears in the earliest texts, including the first medical text in Chinese history, Huang Di Nei Jing, or The Yellow Emperor’s Inner Classic. Diabetes is classically divided into three types: upper, middle, and lower Xiao-ke. Each has characteristic symptoms. The upper type is characterized by excessive thirst, the middle by excessive hunger, and the lower by excessive urination. These types are closely associated with the lungs, stomach, and kidneys, respectively, and all three are associated with Yin deficiency. At some point during the course of their illness, most people with diabetes manifest symptoms of all three types. According to TCM, Xiao-ke is attributed to three main factors: improper diet (consuming large quantities of sweets, fatty or greasy foods, alcohol, and hot drinks such as hot coffee or tea), emotional disturbances (stress, anxiety, depression,) and a constitutional Yin deficiency (fatigue, weakness, lethargy, pale complexion).