Herbal medicine in the treatment of patients with type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM)[1] is a type of metabolic disease caused by metabolic disorders in the endocrine system and characterized by hyperglycemia. Insufficient insulin secretion and insulin resistance are the basic pathologic characteristics of T2DM. According to the International Diabetes Federation (IDF),[2] the prevalence of diabetes among adults aged 20–79 in 2017 was 8.8% from a total population of 425 million, which will reach 629 million by 2045. Additionally, it is estimated that approximately half of all adult patients worldwide have not been diagnosed as of 2017. In 2017, approximately 4 million adults died of diabetes, and 46.1% of patients died before reaching the age of 60 years. These data show that the number of patients with diabetes is increasing at an alarming rate and have come to represent a challenge for human health. In addition, T2DM accounts for approximately 95% of the total population of diabetes, which leads to significant losses for human and economic health.[3] T2DM is a chronic disease that can cause a series of complications that can lead to death.[4] Therefore, preventing or delaying the occurrence of complications is the main purpose of treating T2DM, and the key link for those suffering from diabetes is to maintain blood glucose levels within the normal range.[5] At present, the treatment of T2DM mainly depends on lifestyle intervention[6] (such as nutrition therapy and physical activity), oral medication[7] (such as biguanides, sulfonylureas, and α-glucoside inhibitors), injected drugs[8] (such as insulin and glucagon-like peptide-1 [7–36] amide [GLP-1] agonists), surgical treatment,[9] and complementary and alternative treatment.[10] T2DM is known as a major “Xiao-Ke disease” in ancient Chinese books. And Chinese have used herbal medicines to treat the diseases for more than 1500 years. There is a growing body of research showing that herbal medicine can effectively treat T2DM.[11–13] In this study, we reviewed the therapeutic action of herbal medicine in T2DM via anti-inflammatory and anti-oxidation characteristics, regulation of blood lipid metabolism, anti-glucose effects, and other mechanisms [Figures ​[Figures11–5]. Open in a separate window Figure 1 The anti-inflammatory effect of herbal medicine in type 2 diabetes mellitus. TNF-α: tumor necrosis factor-α; TLR4-MyD88: toll-like receptor 4-myeloid differential protein-88; IL-1β: interleukin-1β; NLRP3: NACHT, LRR, and PYD domain-containing protein 3; WMW: Wu-Mei-Wan; NF-κB: nuclear transcription factor kappa B; IκBα: inhibitor of NF-κB; COX2: cyclo-oxgenase 2; IL-8: interleukin-8; IL-6: interleukin-6.