Application of Metabolomics and Traditional Chinese Medicine for Type 2 Diabetes Mellitus Treatment

Abstract

Diabetes is a major global public health problem with high incidence and case fatality rates. Traditional Chinese medicine (TCM) is used to help manage Type 2 Diabetes Mellitus (T2DM) and has steadily gained international acceptance. Despite being generally accepted in daily practice, the TCM methods and hypotheses for understanding diseases lack applicability in the current scientific characterization systems. To date, there is no systematic evaluation system for TCM in preventing and treating T2DM. Metabonomics is a powerful tool to predict the level of metabolites in vivo, reveal the potential mechanism, and diagnose the physiological state of patients in time to guide the follow-up intervention of T2DM. Notably, metabolomics is also effective in promoting TCM modernization and advancement in personalized medicine. This review provides updated knowledge on applying metabolomics to TCM syndrome differentiation, diagnosis, biomarker discovery, and treatment of T2DM by TCM. Its application in diabetic complications is discussed. The combination of multi-omics and microbiome to fully elucidate the use of TCM to treat T2DM is further envisioned.

Keywords: diabetic complications; diagnosis; metabolomics; traditional Chinese medicine; type 2 diabetes mellitus.

Figure 1

Application of Multi-Omics and microbiome Integration in TCM Treating T2DM. The human microbiome plays a role in the etiology and pathology of T2DM and its complications. Metabolites originating from microorganisms are potentially important compounds that mediate microbiota-host interactions in health and disease. External factors such as TCM and internal factors such as the host genome can influence microbial diversity. Changes in the microbiome later affect the metabolites that they produce. Metagenomics is suitable for determining intestinal microbiota composition, while metabolomics can find functional endpoints. Genomics obtained candidate genes related to transcriptomics, while transcriptomics obtained functional gene clusters related to disease pathogenesis. Proteomics can analyze expressed proteins and protein function in a cellular context. It will be vital to reveal the role of the microbiome in T2DM and the mechanism of traditional Chinese medicine in T2DM treatment by integrating metagenomic data and data generated by host omics in the future.