Diabetes
A Chinese Medicine Perspective
Thin people can also get Diabetes! Chinese Medicine holds that Diabetes can come from multiple causes including inherited genetics, diet and even emotional wellbeing. Although illnesses like Diabetes and High Blood Pressure are more common in heavier people, they also frequently effect those who are of thinner build. Diabetes is a very complex illness in Chinese Medical thought, so this article is meant to serve as a basic introduction and give you some tools to help prevent Diabetes as well as guiding you to eat healthier if you currently suffer from this illness.
In Chinese Medicine Diabetes is known as Xiao Ke (消渴) which means “Wasting Thirst.”
This illness was first mentioned in the Internal Classic, China's first omnibus of Acupuncture.
The Internal Classic defined three types of Wasting Thirst which it hypothesized were located in three different organs including:
Upper Wasting: located in the heart,
Middle Wasting: located in the spleen,
Lower Wasting: located in the kidneys,
The reason for the terms upper, middle and lower was as a result of the illness occurring in descending order from the heart in the upper torso, spleen in the middle abdomen, and kidneys in the lower back.
The 16th century text “Amended Collection of Illness Conditions and Treatments” (证治汇补) explained Wasting Thirst as follows:
“上消者心也，多饮 少食，大便如常，溺多而频。
Upper wasting is in the heart, the patient drinks much, eats little, their defecation is normal, and their urine is copious and frequent.
Middle wasting is in the spleen, patients are frequently thirsty and hungry, they are able to eat and yet are thin, their urine is red and there is constipation.
下消者肾也，精枯髓竭，引水自救，随即溺下，稠 浊 如膏。
Lower wasting is in the kidneys, the vital essence is withered and the marrow is dry, they dry to drink to save themselves, following this they urinate it out, their urine is muddy and turbid like paste.”
We can see from this that Chinese Medicine has been developing ideas about diabetes for nearly 2000 years and that like in Western Medicine, Diabetes is seen as an illness with more than one variation.
Generally speaking, in old times Wasting Thirst was seen as an illness which would cause people to become thin and emaciated, which is why it is called wasting.
Part of the reason for this is that people in those times were less likely to be obese and did not eat processed sugar which meant that type one Diabetes was more common (although you will see in a moment that the ancient doctors of China certainly knew about type two Diabetes as well).
It is interesting to note that some researchers claim the original organ referred to as Spleen in Chinese Medicine might have actually been the Pancreas since type one Diabetes is a genetic illness which effects the pancreas and insulin production.
Modern Chinese Traditional Medicine understands Wasting Thirst as an illness with the following characteristics:
patients are prone to eating and drinking more,
urinating frequently,
having sweet smelling urine,
they are frequently thirsty,
the illness is often caused by excess consumption of fatty and sweet foods (type two),
They suffer from a depleted emotional state leading to stagnant Qi and inner heat,
The Yin (fluid metabolism) of the body is damaged,
They tend to suffer from dry mouth and exhibit a red tongue coat which is evenly spread over the sides and tips of the tongue,
They tend to have a rushing and fast pulse.
Chinese Medicine holds that the most important way to treat Wasting Thirst is through dietary prevention which is why I wanted to write about it on my blog.
Since this blog is mainly about dietary medicine I will avoid speaking about type one Diabetes and only discuss type two since it is largely diet related, preventable, and can be helped greatly by following healthy eating habits.
Type two Diabetes is seen as usually having two main causes in Chinese Medicine and the Internal Classic said the following:
此肥美之所发也，此人必数食甘美而多肥也，肥者令人内热，甘者令人中满， 故其气上溢，转为 消渴。
“this occurs as a result of people indulging in fatty tasty foods. It happens in people who prefer to eat sweet foods who become obese. These people who have excess fat generate inner heat, and the sweetness they eat accumulates around their centers, filling them. This is why the Qi overflows upward causing them to become ill with Wasting Thirst.”
The Text “Directive of Facing Illness Patterns” (临证指南医案) says:
心境愁郁，内火自燃，乃消症大病。
“the emotions are bothered and stagnant so inner fire flares up on its own, this leads to the great illness of wasting.”
We can see here that these two types of Wasting Thirst are caused by completely different causes with the first relating to our diet and excess consumption of sweet and fatty foods, and the second being related to the consumption of Yin fluids as a result of emotional fatigue.
This tells us that not only obese people can be Diabetic, even with type two.
We should understand Chinese Medicine illness patterns as explanations of what kind of people are more likely to become sick with a particular illness than definitive explanations of every single cause of illness.
In the case of people who's emotional turmoil such as anger and emotional fatigue lead to Wasting Thirst, there is indirect evidence that heightened Cortisol (the stress hormone) can lead to insulin resistance, a major feature of pre-Diabetes, so it isn't outlandish that people with higher levels of stress are more likely to become ill, especially since a high stress lifestyle also usually makes it harder to focus on diet, exercise and rest.
Chinese Medicine shines in its analysis of the preconditions in people's lives that lead to illness, so it is very important to understand its ideas in this way rather than looking at them in the reductionist way that we understand modern Biomedicine.
Diabetes is a complex illness in Chinese Medicine and it can effect multiple organ systems, since this blog post is mainly concerned with how we can treat illness using diet, I'll stop my explanation about the causes and physiology of Wasting Thirst and move on to how to prevent it with dietary intervention.
Key point:
For non Diabetic people type two Diabetes is preventable with proper diet. For those already ill with Pre-Diabetes are full blown Diabetes, the illness can be treated either by prevention alone or a combination of prevention and pharmaceutical medicine.
Chinese Medicine can also be used to assist in the full spectrum of Diabetes related conditions and should be used as a complimentary therapy to the use of modern Biomedical intervention.
Basic dietary rules surrounding Diabetes:
Following these dietary rules can prevent Diabetes as well as help you if you are already sick:
Eat light tasting foods which nourish Yin and lubricate the body,
Eat more green vegetables in order to satiate hunger and provide sufficient fiber to assist digestion,
if you have diabetes it is important to eat healthy snacks throughout the day to maintain your blood sugar and avoid insulin issues,
it is important to avoid spicy, deep fried, and sweet foods which are hard to digest and can negatively impact blood sugar levels as well as damaging your Yin Fluids,
You should avoid drinking alcohol as this is very bad for the Yin fluids of the body. Excess alcohol on an empty stomach is especially cautioned against since it can lead to dangerously low blood sugar levels.
Foods which are good for prevention of Diabetes:
Because Chinese Medicine views Diabetes as three separate illnesses with different presentations it is difficult to give you precise advice about what you should eat since your condition is unique and would require a consultation (by the way, I offer consultations via Zoom meeting so if you would like to visit my virtual clinic for advice about food choices, supplements etc please contact me via email).
Because of this I will simply list foods that are commonly used in each of the three types of Diabetes that ought to be safe for anyone to eat:
Chinese Yam (Shan Yao): Chinese Yams are very good for digestion since they have considerable fiber, they also boost Yin which can thirst and make you more comfortable. Yam's have also been shown in studies on rats to potentially assist in controlling blood sugar.
Sea Weed (Hai Dai): note, do not eat salted Sea Weed, instead you should buy dried but otherwise unprocessed Sea Weed and boil it in soups. A 2018 study on rats found that Sea Weed may reduce markers of type two Diabetes such as high blood sugar and reduce inflammation,
Boiled Eggs: eggs are a good source of protein and boiling them removes any possibility of excess oil in cooking which may be an aggravating factor in diabetes due to potential risk of inflammation. They are also a handy protein snack if you have Diabetes and can help regulate your insulin levels throughout the day.
Carrots: carrots are a non starchy vegetable and can be very helpful for people with Diabetes since they are basically safe to eat, although you definitely should not juice them. Carrots are also high in Vitamin A, B6 and dietary fiber, all of which have some role in preventing Diabetes.
Of course there are many other foods you can eat to prevent Diabetes or avoid making it worse.
It is also extremely important to reduce or give up processed sugars entirely, avoid eating fried foods and other foods that cause inflammation, maintain healthy exercise and rest habits, and avoid high stress situations.
A difficult fact of life is that if an illness has become serious enough prevention is no longer sufficient to cure it, but even for people with relatively advanced Diabetes a combination of physician prescribed pharmaceutical medicine and healthy lifestyle choices can greatly improve health outcomes and prevent the illness from entering its terminal stages.
For people who are prediabetic or who might just be concerned about the risk as a result of having Diabetic family members, now is a great time to focus on maintaining your health through diet, exercise, rest, and a healthy attitude.
Many modern illnesses can be avoided altogether if you follow the right lifestyle early on, so I hope this article will encourage you to make steps toward taking command of your health through good eating and lifestyle!!