Developments in the study of Chinese herbal medicine's assessment index and action mechanism for diabetes mellitus

In traditional Chinese medicine (TCM), based on various pathogenic symptoms and the 'golden chamber' medical text, Huangdi Neijing, diabetes mellitus falls under the category 'collateral disease'. TCM, with its wealth of experience, has been treating diabetes for over two millennia. Different antidiabetic Chinese herbal medicines reduce blood sugar, with their effective ingredients exerting unique advantages. As well as a glucose lowering effect, TCM also regulates bodily functions to prevent diabetes associated complications, with reduced side effects compared to western synthetic drugs. Chinese herbal medicine is usually composed of polysaccharides, saponins, alkaloids, flavonoids, and terpenoids. These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion, enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals. These actions regulate glycolipid metabolism in the body, eventually achieving the goal of normalizing blood glucose. Using different animal models, a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer. Nonetheless, there is a dearth of scientific data about the pharmacology, dose-effect relationship, and structure-activity relationship of TCM and its constituents. Further research into the efficacy, toxicity and mode of action of TCM, using different metabolic and molecular markers, is key to developing novel TCM antidiabetic formulations. The endocrine disorder diabetes mellitus (DM) is a global phenomenon significantly influencing human health. Traditional Chinese medicine (TCM), with its long history, has been treating diabetes for over two millennia. The main types of animal used to model diabetes are rodents, zebrafish and primates. Using different animal models, the number of molecular markers available for the detection of diabetes induction, such as fasting blood sugar, postprandial blood glucose, glycated hemoglobin, glucose tolerance test, and lipid metabolism abnormalities, among others, is increasing. In addition, different antidiabetic Chinese herbal medicines reduce blood sugar and their effective ingredients have unique advantages. Besides their glucose lowering effects, antidiabetic TCM formulations also regulate human bodily functions to prevent diabetes associated complications, with reduced side effects compared to western synthetic drugs. The active ingredients of Chinese herbal medicine are mainly polysaccharides, saponins, alkaloids, flavonoids, terpenoids. These ingredients act via various mechanisms, including boosting endogenous insulin secretion, enhancing insulin sensitivity, adjusting key enzyme activity and scavenging free radicals, which regulate glycolipid metabolism in the body, to eventually normalize blood glucose.image