Traditional Chinese medicine in the prevention of diabetes mellitus and cardiovascular complications: mechanisms and therapeutic approaches

Abstract

Diabetes mellitus (DM) is a chronic endocrine and metabolic disorder characterized by persistent hyperglycemia that poses serious threats to human health and quality of life. The morbidity, disability, and mortality rates of cardiovascular complications stemming from chronic hyperglycemia are primary factors affecting the lifespan of patients with diabetes. Currently, there is no cure for DM. Standard biomedical treatments mostly control the symptoms using insulin injections or oral hypoglycemic drugs. Although the effect of standard biomedical therapy is remarkable, its long-term use is prone to toxic side effects. Numerous studies have recently found that Traditional Chinese Medicine (TCM) has strong advantages in the prevention and treatment of DM and cardiovascular complications (DACC). The collection, processing, preparation and clinical use of TCM are guided by the theory of TCM and follow the "holistic concept." Multiple components, pathways, and targets form the basis for the use of TCM in treating multiple parts and organs of the body simultaneously. TCM is mainly derived from natural medicines and their processed products and has fewer side effects. TCM is clinically used as compound prescriptions, botanical drugs, and monomers. TCM, either independently or in combination with standard biomedical treatments, has shown unique therapeutic advantages. This review aimed to explore the recently reported mechanisms of action of TCM in the prevention and treatment of DACC. These findings will aid the optimization of the current therapy or formation of a therapeutic schedule for integrated TCM and standard biomedical treatments.

Keywords: TCM botanical drugs; TCM compound prescriptions; TCM monomers; diabetes mellitus and cardiovascular complications (DACC); traditional Chinese medicine (TCM).

FIGURE 1

Schematic Diagram of the Pathogenesis of DACC. The pathogenesis of DACC involves multiple interconnected mechanisms, including insulin resistance, gut microbiota dysbiosis, oxidative stress, disorders of glucose and lipid metabolism, inflammation, and apoptosis. These factors interact synergistically, contributing to the initiation and progression of DACC. In the diagram, the red upward arrow (↑) indicates an elevation or increase in a specific factor. The red downward arrow (↓) signifies a reduction or decrease. The red “×” denotes an inhibitory effect. The blue curved arrow represents promotion or generation of a process. The black arrow illustrates the occurrence of a biochemical process. The red halo symbolizes inflammation, while the skull icon represents apoptosis. This schematic highlights the complex interplay of these mechanisms, providing a comprehensive overview of the multifactorial nature of DACC pathogenes.