Diabetes
Today, many people are familiar with the symptoms and risks associated with diabetes, as well as its seemingly epidemic proportions in the United States. There are two main types of diabetes, Type 1 Diabetes and Type 2 Diabetes. In type 1 diabetes, the body does not produce insulin, while in type 2 diabetes the body either does not produce enough insulin or is unable to use insulin properly.
Diabetes is most often diagnosed with a Fasting Plasma Glucose Test (FPG). This test measures the amount of sugar in a person’s blood. With the FPG test, a person with a fasting blood glucose level of 126 mg/dl or higher has diabetes and a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes.
After a person eats or drinks something, food is digested and broken down into simple sugars or glucose. Glucose is then absorbed into the blood stream to be carried to all cells in the body. Cells perform all their different activities by converting glucose into energy. A specific hormone, insulin, signals cells to take glucose in from the surrounding blood stream. The pancreas has special cells called the Islets of Langerhorn. These cells produce insulin and release it into the blood stream once the body realizes there is an increase in the amount of glucose (that blood sugar levels have gone up). If the body does not make enough insulin or if cells do not respond to it, glucose stays in the blood and does not enter the cells that need it for energy.
How does Western Medicine treat Diabetes?
People with type 1 diabetes need to take insulin with every meal since their bodies do not produce it at all. Insulin is injected into fatty tissue in the body so it is absorbed directly into the blood. It is not available in pill form because it would be broken down during the digestive process. Type 1 diabetes has a much stronger genetic factor and is solely treated with insulin injections.
People with type 2 diabetes do produce insulin, but either do not make enough or are resistant to insulin (their bodies cannot use it properly). It is unknown what causes this to happen, but genetic factors, diet and exercise seem to play a combined role in its onset. Many doctors and hospitals use a team approach for patients diagnosed with type 2 diabetes. The team includes a primary care physician or endocrinologist to monitor blood sugar levels and prescribe appropriate medications, a registered dietician to explain healthy diabetic diets and nutrition, an exercise physiologist to create an exercise program that is safe while promoting fitness and weight loss, and possibly a podiatrist and ophthalmologist to check the condition of a patient’s feet and eyes, respectively. Most people are advised to try and control their diabetes with diet and exercise and are prescribed medications when their blood sugar levels exceed 126 mg/dl for an extended period of time.
Is Diabetes a big deal?
Common symptoms of diabetes include: excessive thirst, increased appetite, frequent urination, low energy, blurry vision, frustration or irritability, weight loss and tingling or numb sensations in the hands and feet. Many of these symptoms are attributed to other aspects of a person’s life and lifestyle, and are frequently ignored as “minor things.” If left untreated, however, diabetes can result in very serious complications such as: poor circulation, slow wound healing, heart attack, stroke, blindness, nerve damage and kidney failure.
If addressed and treated properly, people with diabetes can live long happy and healthy lives. But diabetes is not a condition that can be ignored or forgotten about, it needs to be consistently monitored. When blood sugar levels begin to go out of balance, people encounter the problems of hypoglycemia and hyperglycemia. Hypoglycemia means low blood sugar levels, and its symptoms include: shakiness, dizziness, sweating, hunger, headache, pale complexion, clumsiness, difficulty paying attention, mood change or sudden irritability. This should be treated promptly (either with glucose tablets or a small cup of fruit juice) to avoid passing out. Hyperglycemia means blood sugar levels are too high. Occasional high blood sugar levels can be due to a change in diet or the amount of food eaten, stress, illness or catching cold. Blood sugar levels that are too high for an extended period of time means a person’s diabetes is not under control and needs to be addressed.
The Diabetes Dilemma
The key to Western Medicine’s effective treatment of diabetes is early diagnosis and consistent attention to diet, exercise and prescription compliance. But what if a person has complications like fatigue or neuropathy (nerve pain) that make it hard to exercise? Or acid reflux, poor digestion and a low appetite that do not allow for a consistent diet? Or what if other factors like stress, insomnia or hot flashes add to the problem? An even more common development is that many diabetes medications decline in their effectiveness over time. Many people do not or are unable to fit neatly into pre-packaged diabetes programs. Others do not like to take pharmaceuticals long-term, suffer severe side-effects to medications or are put on an increasing number of medications. And then there are those people that just do not respond to Western drug therapy at all. Traditional Chinese Medicine (TCM), which encompasses acupuncture and Chinese herbal therapy, provides a safe and effective alternative for people with diabetes.
History of Traditional Chinese Medicine and Diabetes
What doctors today term type 2 diabetes was called xiao ke, or “flowing away and thirsting” in ancient China. It was first identified as a disease in Chinese medical texts in the 2nd century BCE. The name refers to the larger than normal amount of urination, loss of weight and the increased thirst that represent three of the hallmark symptoms of diabetes. They considered xiao ke the result of lifestyle changes from physically active agricultural work in remote villages to more sedentary administrative work in city centers. Specifically, they attributed the disease to the long-term over-consumption of rich, sweet and fatty foods.
Modern Chinese medical texts use the term tang niao bing, or “sugar urine disease.” This is closer in meaning to the Greek word diabetes and the Latin word mellitus, which together mean “flowing through of honey,” or urine that has a sweet smell to it. The name in Chinese medicine has shifted to a more accurate reflection of the high levels of sugar in the blood and urine of people with diabetes.
The change in name reflects the evolving understanding of diabetes in traditional Chinese medicine. Over 2000 years of treating people with various symptoms of diabetes resulted in an immense clinical record that grew as their knowledge and experience did. Today this culminates in an in-depth diagnostic framework of individual symptoms and characteristics that correspond to specific acupuncture protocols and herbal formulas which address each person’s manifestation of diabetes.
Acupuncture and Diabetes
Licensed acupuncturists are trained in Traditional Chinese Medicine (TCM) and use acupuncture and Chinese herbal therapy in combination to help diabetes patients. TCM provides good results for diabetes because it has a diagnostic framework based on specific symptom pictures, which lead to individualized treatment regimens. All Western medications focus on reducing blood sugar levels, but different drugs do so through different physiological mechanisms. TCM success with diabetes is measured by a decrease in blood sugar levels as well, but is achieved by reconciling all the imbalances a person presents with. This means that there is no single acupuncture point or herb that lowers blood sugar levels, but rather, several acupuncture points and Chinese herbs are combined to treat each individual manifestation of diabetes.
Individualized treatments are selected after a patient discusses several details of his/her health and lifestyle. These details are first looked at under the broad umbrella of what body area is most affected. The three main signs of diabetes (excess eating, drinking and urination) all correspond to one of three body areas in TCM. An example of this differentiation would be severe thirst shows upper body involvement (everything above the diaphragm), big appetite or weight loss shows middle body involvement (peritoneal cavity) and an increase in urination shows lower body involvement (everything below the navel).
Once the principle location of the imbalance is determined, all remaining details and complaints are taken into consideration to decide which TCM pattern most accurately fits a person. There are 12 distinct patterns someone might fall into, but most cases are complex and many people show signs of multiple patterns. Once the correct pattern(s) have been identified within the main body area involved, treatment focuses on the underlying disharmony or mechanism that is responsible for that specific set of symptoms.
An example of how this differentiation of signs and symptoms works in TCM is a woman that has consistently high blood sugar levels of 200 mg/dl, constantly needs to urinate, has night sweats, hot flashes, high blood pressure, insomnia, is overweight, and easily angers. She initially falls into the broad category of lower body involvement because of her frequent urination, while her other symptoms point to a more specific pattern that acupuncturists call yin xu yang khan. Compare that to a man with consistently high blood sugar levels of 180 mg/dl, persistent thirst, poor memory, numbness and tingling in his extremities, stiffness in most of his joints and frequent headaches. His severe thirst first points to upper body involvement and his collection of symptoms point to patterns of liver blood xu and blood stagnation in TCM terminology. Both examples present with a main complaint of high blood sugar levels, but each has a much different set of additional symptoms and imbalances. By looking at all the details that make up each person’s big picture, TCM offers individualized acupuncture and herbal treatments to target high blood sugar levels differently in each case. It is this ability to treat the individual within the disease that allows acupuncture to be both popular and effective.
The Use of Acupuncture and Chinese Herbs
Once a person’s specific TCM pattern has been identified, acupuncture and Chinese herbs are selected to correct the imbalance that causes them. Unlike pain conditions and other common disorders, TCM focuses on Chinese herbal therapy over acupuncture in diabetes. Acupuncture points are used during each session, but the majority of diabetes patients will take Chinese herbal formulas daily. This dual approach, with an emphasis on Chinese herbs, allows TCM to treat people holistically, or treating the “root” and “branch” at the same time in TCM terms. Several seemingly unconnected symptoms (branches) commonly have a shared root in TCM. Acupuncture points are selected to treat the root or core imbalance and its main manifestations or symptoms at the same time. Diabetes is not like catching a cold, it developed over a long period of time and caused far-reaching systemic changes. Weekly acupuncture treatments are not sufficient to rectify these types of changes in the case of diabetes. Chinese herbs provide a way to continually address the root and branches of diabetes between acupuncture treatments. They also provide the daily exposure necessary to change long-standing imbalances.
Chinese herbal formulas for diabetes typically contain between 6 and 13 different herbs that are combined together according to each person’s specific TCM diagnosis. They mirror and strengthen the effects of acupuncture by targeting the same patterns. Daily use of herbal formulas continues the positive change evoked with acupuncture, maintains new systemic balance and produces little if any negative side-effects.
Triangle Acupuncture Clinic, LLC uses Chinese herbs in granule (powder) form, from KPC. KPC is one of the few companies that use Good Manufacturing Practices (GMP) in their processing of Chinese herbs. This means they meet the highest standards for both clean and sterile facilities and for guaranteeing that the active ingredients in each herb are present in every batch. KPC carefully monitors the entire process, from harvesting each herb at the appropriate time, verifying herb identification with experts in botanical pharmacology, using High Performance Liquid Chromatography (HPLC) to confirm consistent levels of active ingredients and analyzing each batch of herbs for heavy metals and other contaminants.
Triangle Acupuncture Clinic, LLC has a comprehensive Chinese herbal pharmacy with over 220 individual Chinese herbs in granule form. All acupuncturists are trained and certified Chinese herbalists that tailor herbal formulas to a person’s individual concerns. All Chinese herbal formulas are hand-crafted at the clinic and given to patients with easy-to-follow instructions. Typically, someone will go home with a bottle of powdered herbs and be instructed to scoop 2-4 grams of the formula into a tea-cup and then add 6 oz. of hot water before drinking.
Combining TCM and Western Treatments
Most people use acupuncture and herbal medicine as an adjunct in their overall diabetes treatment because they are already using Western medications, but are still unable to control their blood sugar levels. TCM works well with Western treatments and patients are never asked to choose one over the other. The primary goal is to get someone’s diabetes under control. This usually involves concurrent use of Western medications, Chinese herbal formulas and acupuncture. Each person’s individual goals and circumstances are taken into consideration so that treatment reflects his/her needs and desires. Combining TCM and Western treatments produces better results and does not conflict. Chinese herbal formulas are created not to interfere with medications, instead producing enhanced synergistic effects. This approach often helps those people that are otherwise unable to control their diabetes.
Emphasis is also placed on lifestyle, diet and exercise, but in the context of someone’s actual present situation. Those factors that keep a person from exercising or eating properly are addressed and incorporated into acupuncture and Chinese herbal treatments. This provides a bridge between what a person is able to do now and what he/she needs to do to in the future.