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What is Diabetes and How to Live with It

What is diabetes? While it's a severe disease, people can learn to live with it by ensuring a healthy lifestyle.

A partial view of a woman injecting insulin into her arm

In Malaysia, a survey by the National Health and Morbidity in 2019 shows that approximately 3.9 million people live with diabetes. This means there is one diabetic in every five adults.

So, what is diabetes? According to World Health Organization (WHO), diabetes is a chronic disease that occurs when the pancreas cannot generate enough insulin or when the body is unable to use the insulin it produces. Over time, this condition can harm the heart, blood vessels, eyes, kidneys, and nerves. 

Historically, ancient Chinese medical text in the Yellow Emperor’s Inner Classic (Huang Di Nei Jing) included references to a disease named “xiao-ke,” which meant “wasting thirst.” It was believed that xiao-ke manifested from too much fatty, sweet or rich food and caused continuous thirst and hunger. Today, Traditional Chinese Medicine (TCM) describes diabetes as a combination of depleted yin (passive energy) and excessive asthenic fire in the body.

Types of Diabetes

There are two main types of diabetes. Type 1 is characterised by low insulin production. The exact cause is still unknown, and therefore, there is no way of knowing how to prevent it. 

Type 2 diabetes happens when the body can’t effectively use insulin. WHO states that being overweight, a severe lack of physical activity, and an unhealthy diet increase the risk of Type 2 diabetes.

A side view of a woman staring at a doughnut
People with diabetes need to be careful about their sugar intake.

From a TCM’s point of view, four factors can deplete yin (passive energy), trigger too much fire, and ultimately cause diabetes: 

  1. Unhealthy diet: Consuming alcohol and greasy, sweet, and spicy food can exhaust the spleen and produce damp heat. 
  2. Fluctuating emotional state: Unstable mental health can disturb the flow of the qi (vital life energy), inducing internal fire in the body. 
  3. Birth defects: Some people are born with energy imbalances and disruptions that increase the risk of this disease.  
  4. Excessive sexual activity: TCM believes this can reduce kidney essence, rendering it incapable of providing yin to the body.

Diabetes Treatment

Generally, doctors will prescribe medication based on your type of diabetes and how well the medicine can keep your blood sugar under control.

  • Type 1 diabetes: Insulin is required because your body can no longer produce this hormone. Insulin pumps or pens or needles and syringes are commonly used to administer small, steady doses of insulin throughout the day.  
  • Type 2 diabetes: In some cases, this type of diabetes can be managed via a healthy lifestyle and diet. However, medicine like metformin may also be prescribed. Metformin lowers the amount of glucose that your liver makes so that your body can use insulin more effectively.

An Eastern Approach to Diabetes

Medication aside, TCM can also manage diabetes. A Taiwanese study reports that a combination of TCM with Western medicines offers good control of Type 2 diabetes. The result also shows a 33% lower risk of developing stroke.

In TCM, herbal treatment for diabetes is based on a set of symptoms, which relate to a specific organ:

Upper wasting

Diagnosis: Heat in the lungs from a deficiency in the jin (body fluids). 

Symptoms: Thirst, dry mouth, irritability, tongue turning red with a thin yellow coating and rapid pulse. 

Treatment: A concoction made with Coptis Chinesis (Huang Lian), Ophiopogon Japonicas (Mai Dong), and Radix Rehmannia (Sheng Di Huang).

Middle wasting

Diagnosis: Also called stomach fire syndrome. 

Symptoms: Hunger, bad breath, weight loss, mouth ulcers, thirst, frequent urination, constipation with dry stools, red tongue with yellow coating, and a strong rapid pulse. 

Treatment: Jade Maiden Decoction comprising Gypsum Fibrosum (Shi Gao), Rhizoma Anemarrhenae (Zhi Mu), and Rehmania Root (Processed) (Shu Di Huang).

Lower wasting

Diagnosis: Yin deficiency in the kidney. 

Symptoms: Frequent turbid urination, lower lumbar pain, weak knees, fatigue, dizziness, ringing in the ears, dry lips, dry, itchy skin, red tongue with little to no coating, and a thin rapid pulse. 

Treatment: Six-flavour Rehmannia Pills, composed of Processed Rehmannia Root (shu di huang), Cornus Fruit (shan yu rou) and Chinese Yam (shan yao). 

If you would like to complement your diabetes medication with TCM herbs, talk to your doctor and TCM physician to ensure the treatment is safe and appropriate for you.

Living with Diabetes

Man exercising in his living room
Regular exercise improves blood glucose control.

Diabetes is a severe disease. However, you can learn to manage this condition and maintain a good quality of life. Start with making healthy food choices, exercising, and monitoring your blood sugar regularly. 

One of the ways to keep your blood glucose in check is a low GI diet. According to the National Health Service (NHS), the glycaemic index (GI) measures how quickly foods containing carbohydrates raise blood glucose levels on a scale from 1 to 100.

People with diabetes should consume foods with low GI (55 or less). For example, oats, wholemeal bread, brown rice, lentils, soy, and walnuts. It’s also important to reduce the starch, fat, and salt in your daily meals. 

Regular exercise is essential too. You can start with low impact workouts like walking, yoga, Tai Chi or Qi Gong. Maintain a healthy weight and make sure you take your diabetes medicines consistently. Also, learn how to manage stress and your emotions.

What is diabetes? It can be a debilitating disease that negatively impacts your life if you don’t treat or manage it. As overwhelming as it may seem, there are many ways to cope and live with diabetes. Take the first step by getting professional advice from a healthcare provider or TCM physician to get your disease under control.

This is an adaptation of an article, “Better Diabetes Treatment with TCM”, which first appeared on Eu Yan Sang website.


  1. AstraZeneca. 2021. The First-ever Malaysian Diabetes Index Survey Uncovers Awareness Gaps on Diabetes Amongst Malaysians [online].  [Accessed 15 November 2021] 
  2. World Health Organization. 2021. Diabetes [online].  [Accessed 15 November 2021] 
  3. National Health Service. 2018. What is the Glycaemic Index? [online] [Accessed 16 November 2021] 
  4. National Institute of Diabetes and Digestive and Kidney Diseases. 2016. Insulin, Medicines, & Other Diabetes Treatments. [online]  [Accessed 21 December 2021] 

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