Diabetes mellitus, or simply diabetes, is a serious and potentially deadly disease with a characteristic of high blood glucose. Its classical symptoms are increased eating, increased drinking, increased urine and decreased body weight. There are mainly two types of diabetes: Type 1 diabetes is the form of diabetes that results from autoimmune destruction of insulin-producing beta cells of the pancreas []. Type 2 diabetes mellitus (T2DM) results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency [].
The development of T2DM is caused by a combination of lifestyle and genetic factors. The former includes body weight, diet, exercise, stress and urbanization. The genetic factors include age, female gender, and some genes involved in beta cell functions . After we eat carbohydrate food, such as rice, wheat, corn, and starchy vegetables (like potatoes and beans), the carbohydrate will be digested into single sugar molecules (glucose is one of them) to supply energy and to involve in the metabolisms of amino acid, proteins and fatty acids. The beta cells of pancreas secrete insulin into the blood streams in response to the high blood sugar. Insulin helps to burn the glucose inside the cells to produce energy (ATP) for the cells (Fig.1, [,]). Normally, the blood glucose peak drops 2 hours after a meal since the glucose goes into the cells. However, the cells under the condition of T2DM can’t take in the glucose from the blood, leading the blood glucose high. The high blood glucose makes blood viscous and lowers blood fluidity [], leading oxygen and nutrient deficiency, toxic accumulation, and finally causing pathological changes in a local tissue—symptoms appear in many organs (Fig.2, []).
Fig.1. Metabolism of glucose. Carbohydrates are digested into single sugar molecules (glucose) in the gut. Glucose enters into the blood stream. Pancreas secretes insulin into blood after sensing the high blood glucose. Cells (especially muscle and fat cells) take in the glucose from the blood and produce energies in the presence of insulin—lowering the blood glucose.
High blood glucose requests more insulin secretion and increases the burden of beta cells and decrease its lifetime. Food toxins, such as bad foods and preservatives in the foods, damage all cells in the body, including beta cells []. High fat intake contributes to insulin resistance. Virus infections [], non-infectious inflammation and stress [] are all the factors of damaging beta cell of pancreas islet. Finally, as all other cells of our body, the beta cells will be function-declined along with aging []. Therefore, no matter what, we all will have diabetes as we are getting old.
We can’t change the nature procedure of getting diabetes eventually, but we can slow down its pace and progress by modifying our lifestyle, including the diet (correct nutrients, toxin free foods and drinks, and eating more often but less foods each time to avoid the high peak of blood glucose), exercises (consume the glucose in muscle cells, metabolise toxins through skin and stimulate stem cells to replace the dead beta cells), relaxing your body and mind to avoid cell damages including beta cells, and supplements (including herbs) for better metabolisms of the whole body.
Cinnamon (Gui Zhi or Rou Gui), an herb in Traditional Chinese Medicine (TCM), is found to have the functions that reduces postprandial blood glucose and delays gastric emptying without affecting satiety by modern science []. It is now used as a supplement for diabetes or preventing diabetes. In Traditional Chinese Medicine, Gui Zhi has the actions of inducing sweating to expel the exogenous evils from the body surface; activating Yang by warming meridians (and blood). It is used for common cold of wind-cold type; for palpitation, precordial pain and irregular, slow and intermittent pulse due to deficiency of heart-energy; for cough due to the retention of phlegm, dizziness and palpitation caused by deficiency of heart-Yang and spleen-Yang; for arthralgia due to wind-cold-dampness; for amenorrhea and menorrhalgia due to stagnation of cold; for dysuria and edema due to hypofunction of urinary bladder [].
It can be seen from its TCM uses that Gui Zhi is not only acting on the pancreas or blood glucose but also acting on circulating, urinary, respiratory systems plus the skin mechanisms of detoxification. The modern pharmacological experiments also discover that Gui Zhi has the functions of calm, pain release, antipyretic, anticonvulsant, antibacterial, antiviral, diuretic and anti-inflammatory effects []. In addition, in TCM, Gui Zhi is always used with other herbs as a formula to balance and boost functions of the whole body (see the table below). That is the charm of the TCM for diseases including diabetes.
Fig.2. Feedback of blood glucose and insulin. High blood glucose promotes insulin release. Insulin drives glucose into tissue cells—lowering blood glucose. Low blood glucose triggers the hungery sensor for more foods and dialysis of glycogen into glucose.
Table: Common modifications of Gui Zhi Tang
It can be used when the indications are aversion to wind, sweating, and a floating pulse. If there is excessive sweating, with aversion to cold and pain in the joints, Fu Zi (Radix Aconiti Lateralis Praeparata) must be added (unfortunately, Fu Zi still needs to be scheduled in Australia). If the patient suffers from body pain and has a sunken and slow pulse after sweating, then Ren Shen (Radix et Rhizoma Ginseng) must be added. If Qi surges up into the heart from the lower abdomen, then double Gui Zhi. If there is pain in the abdomen, Shao Yao (Paeonia Lactiflora Radix or Bai Shao) should be added [, ,,].
Gui Zhi formulas
Composition or comments
|Gui Zhi Tang||Gui Zhi, Bai Shao, Gan Cao, Sheng Jiang, Da Zao.|
|Gui Zhi Shao Yao Zhi Mu Tang||Gui Zhi, Bai Shao, Zhi Mu, Fang Feng, Bai Zhu, Sehng Jiang, Fu Zi, Ma Huang, Gan Cao.|
|Gui Zhi Sheng Jiang Zhi Shi Tang||Gui Zhi, Sheng Jiang, Zhi Shi.|
|Gui Ling Wu Wei Gan Cao Tang||Gui Zhi, Fu Ling, Zhi Gan Cao, Wu Wei Zi.|
|Gui Zhi jia Ge Gen Tang||Gui Zhi, Sheng Jiang, Ge Gen, Da Zao, Bai Shao, Zhi Gan Cao.|
|Gui Zhi jia Huang Qi Tang||Gui Zhi, Bai Shao, Sheng Jiang, Da Zao, Zhi Gan Cao, Huang Qi.|
|Gui Zhi Xin jia Tang||Gui Zhi, Bai Shao, Gan Cao, Sheng Jiang, Da Zao, Ren Shen.|
|Gui Zhi Ren Shen Tang||Gui Zhi, Ren Shen, Bai Zhu, Gan Cao, Gan Jiang.|
|Gui Zhi jia Ling Zhu Fu Tang||Gui Zhi, Bai Shao, Zhi Gan Cao, Sheng Jiang, Da Zao, Cang Zhu, Fu Ling, Pao Fu Zi.|
|Gui Zhi Fu Ling Tang||Gui Zhi, Fu Ling, Gan Cao, Mu Dan Pi, Bai Shao, Tao Ren.|
|Gui Zhi Fu Zhi Tang||Gui Zhi, Fu Zi, Sheng Jiang, Da Zao, Zhi Gan Cao.|
|Gui Zhi Gan Cao Long Gu Mu Li Tang||Gui Zhi, Zhi Gan Cao, Long Gu, Mu Li.|
|Gui Zhi Qu Shao Yao Tang||Gui Zhi, Gan Cao, Sheng Jiang, Da Zao.|
|Gui Zhi Jia Hou Po Xing Ren Tang||Gui Zhi, Bai Shao, Sheng Jiang, Gan Cao, Da Zao, Hou Po, Xing Ren.|
|Gui Zhi Qu Shao Yao Jia Fu Zi Tang||Gui Zhi, Sheng Jiang, Gan Cao, Da Zao, Fu Zi.|
|Gui Zhi Qu Shao Yao jia Ma Huang Xi Xin Tang||Gui Zhi, Sheng Jiang, Gan Cao, Da Zao, Ma Huang, Xi Xin.|
|Gui Zhi jia Da Huang Tang||Gui Zhi, Bai Shao, Gan Cao, Sheng Jiang, Da Zao, Da Huang.|
|Gui Zhi jia Gui Tang||Gui Zhi, Bai Shao, Gan Cao, Sheng Jiang, Da Zao.|
Herbal indications are strict. Herbs can only be used when the appropriate indications exist. If there are no such indications, the corresponding herbs should not be used. The modification of herbs should change according to the changing clinical indications, but not randomly. Applying this principle is the key to modify herbs, regardless of how the disease changes. The strict guidelines for prescribing formulas account for the variations in these clinical classical prescriptions .
 Diabetes mellitus type I, Wikipedia: http://en.wikipedia.org/wiki/Diabetes_mellitus_type_1
 Diabetes mellitus type 2, Wikipedia: http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2
 Schut NH et al: Blood and plasma viscosity in diabetes: possible contribution to late organ complications? Diabetes Res. 1992 Jan;19(1):31-5.
 Rob M. van Dam et al: Dietary Fat and Meat Intake in Relation to Risk of Type 2 Diabetes in Men. Diabetes Care March 2002 vol. 25 no. 3 417-424.
 J W Yoon, T Onodera, and A L Notkins: Virus-induced diabetes mellitus. XV. Beta cell damage and insulin-dependent hyperglycemia in mice infected with coxsackie virus B4. THE JOURNAL OF EXPERIMENTAL MEDICINE, VOLUME 148:1068, 1978
 Kathryn E. Wellen and Gökhan S. Hotamisligil: Inflammation, stress, and diabetes. J Clin Invest. 2005;115(5): 1111–1119.
 E P Reaven, G Gold, and G M Reaven: Effect of age on glucose-stimulated insulin release by the beta-cell of the rat. J Clin Invest. 1979 August; 64(2): 591–599.
 Joanna Hlebowicz et al: Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr, Jun 2007; 85: 1552 – 1556.
 Chinese-English Manual of Common-Used in Traditional Chinese Medicine. Ming Ou et al. Guangdong Science and Technology Publishing House Co., Ltd, June,1992:417-8.
 Chinese-English Manual of Common-Used Prescriptions in Traditional Chinese Medicine. Ming Ou et al. Guangdong Science and Technology Publishing House Co., Ltd, December, 1991:410-2
 Modification of Gui Zhi Tang-2: http://www.chinesemedicinecases.com/2010/09/hu-xi-shus-commonly-used-formulas-for.html
 Modification of Gui Zhi Tang-3: http://eagleherbs.com/buy/cinnamon-and-ginseng-decoction-gui-zhi-ren-shen-tang-1097