Alternatively speaking: Will Chinese medicine lead to a new diabetes cure?
As the blending of alternative and mainstream medicine gains traction worldwide, more studies emerge on the benefits of embracing both Eastern and Western philosophies. A recent one published in the journal PLOS ONE found that a conventional diabetes drug, when taken alongside traditional Chinese medicine herbs, was significantly more effective in treating type 2 diabetes.
The study by researchers from Peking University and Australia's University of Queensland involved 800 mainland patients with poorly controlled type 2 diabetes - which leads to complications including blindness, amputation and early death.
Patients were randomly assigned to get either the anti-diabetic drug glibenclamide alone or the "xiaoke pill", a compound of Chinese herbs and glibenclamide.
After 48 weeks, patients treated with the pill had a significant reduction in risk for hypoglycaemia (low blood sugar) and similar improvements in blood glucose control compared to patients who took only glibenclamide.
Professor Ji Linong, the study's main author and director of the department of endocrinology and metabolism at Peking University People's Hospital, believes the results add clinical support for the product's effectiveness. "Traditional Chinese medicine [TCM] is used widely in treating type 2 diabetes not only in China, but also in the other parts of the world," says Ji.
"But the role of TCM and other herbal medicines in the management of [the disease] is still not established. The absence of scientific understanding has caused scepticism and criticism about TCM, often because of the low methodological quality of trials."
He hopes the recent evidence on TCM's effectiveness in managing diabetes will contribute towards "reducing entrenched inequity in access to effective care for poor people", as more than 80 per cent of people in developing countries depend on herbal medicine for basic health care.
Eighty per cent of people with diabetes worldwide live in low- and middle-income countries, according to the International Diabetes Federation. In Hong Kong, about one in 10 individuals, or 700,000 people, have or will develop type 2 diabetes. That number is set to more than double by 2030.
Diabetes is known as xiaoke in TCM, because in chronic cases, patients usually manifest emaciation ( xiao in Chinese) and thirst ( ke). Other illnesses with these symptoms can be called xiaoke as well.
A Xiaoke pill contains 0.25 micrograms of gilbenclamide, along with the herbs Radix puerariae (Pueraria root), Radix astragali (Astragalus root), Radix rehmanniae (Rehmannia root), Radix trichosanthis (Trichosanthis root), cornsilk, dried magnolia vine fruit and Chinese yam.
Li believes there is growing evidence that the first two herbs may exert action, directly or indirectly, in two brain regions known to be involved in glucose-sensing.
Type 2 diabetes is a largely preventable metabolic condition defined by insufficient insulin and insulin resistance.
People who drink alcohol, eat sugary or high-fat foods, and lead an unhealthy or sedentary lifestyle are at greater risk of developing xiaoke. Classic symptoms include frequent urination, extreme thirst or hunger, unusual weight loss, fatigue and irritability.
Professor Juliana Chan Chung-ngor, director of Chinese University's Institute of Diabetes and Obesity, believes that some "yet to be identified" traditional herbs may prove to "work in a complex manner to reduce blood glucose with fewer side effects".
But Chan also cautions: "Some of these preparations may have severe side effects. Compared to Western medicine, the procedure of registration for TCM or herbal mixtures is less stringent and, often, exaggerated claims may give patients unrealistic expectations."
Still, there is a need for affordable and safe alternative treatment. "The scientific evaluation of TCM may advance our understanding of the disease and lead to [the] discovery of novel pathways which may address some of the unmet needs [of diabetics]," says Chan.