Prediabetes

Prediabetes refers to a progression from normal blood glucose regulation to impaired glucose regulation (IGR), in which blood glucose levels are elevated but do not yet meet the diagnostic criteria for diabetes. It includes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), which may occur separately or together. In traditional Chinese medicine (TCM), prediabetes falls within categories such as “spleen dan” (pi dan).

TCM Pattern Identification and Medication Reference

|Common Symptoms

Clinical description:

Abdominal obesity, epigastric and abdominal fullness and distension, frequent belching and flatus, with relief of fullness after belching or passing gas; large-volume stools; pale-red tongue, enlarged tongue body, thick white coating, and a wiry, slippery pulse.

In plain language:

  • More fat around the waist and abdomen, with a larger belly (abdominal obesity).
  • The upper abdomen and belly often feel full, bloated, and uncomfortable, as if under pressure.
  • Frequent belching and passing gas, with noticeable relief of bloating afterward.
  • Stools are larger in volume than usual.
  • The tongue is pale red and enlarged, with a thick white coating.
  • The pulse feels taut and smooth, like a drawn string with beads rolling beneath the fingers.

|Treatment Approach

Clinical description:

Move qi and relieve stagnation.

In plain language:

  • Help the digestive system function more smoothly and ease the feeling of blockage.
  • Ease discomfort such as bloating, belching, and frequent gas, and support digestion and bowel movements.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Yueju Pill

|Common Symptoms

Clinical description:

Lean build, fatigue and lack of strength, dry mouth and thirst (worse at night), heat in the palms, soles, and chest, spontaneous sweating, night sweats, shortness of breath, reluctance to speak, palpitations, and insomnia.

In plain language:

  • A thin build and a slight, frail appearance.
  • Feeling tired and weak easily; everyday activities quickly become tiring.
  • Noticeable dry mouth and thirst, especially at night.
  • Heat in the palms, soles, and chest, accompanied by restlessness.
  • Sweating spontaneously, even without heat or exertion, and with difficulty stopping.
  • Sweating during sleep; after waking, the sweating stops and the body feels cool.
  • Short, labored breathing and little desire to talk.
  • A fluttering or unsettled heartbeat, sometimes with a pounding sensation.
  • Difficulty falling asleep, waking easily, and restless sleep throughout the night.

|Treatment Approach

Clinical description:

Tonify qi and nourish yin.

In plain language:

  • Support the body’s energy and stamina, helping reduce feelings of weakness and fatigue.
  • Moisten and replenish the body, helping ease dryness and support the mouth, throat, and skin.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Fatigue and weakness, dry mouth and increased thirst, numbness in the limbs, dusky tongue with sublingual blood stasis, and a wiry, fine pulse.

In plain language:

  • Feeling tired and weak easily; everyday activities quickly become tiring.
  • Noticeable dry mouth and an increased desire to drink water.
  • Numbness in the limbs, with reduced sensation or dexterity.
  • The tongue looks dusky, and dark vessels or spots may be visible beneath it.
  • The pulse feels taut and fine, like a tightened string, with relatively little strength.

|Treatment Approach

Clinical description:

Tonify qi and nourish yin, invigorate blood, and unblock the collaterals.

In plain language:

  • Support energy and stamina while replenishing moisture in the body.
  • Support smoother blood flow and circulation, and ease numbness and pain.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Dry, bitter mouth; red tongue with little moisture; thin, white, dry coating or scant coating; and a weak, fine, rapid pulse.

In plain language:

  • Dry mouth with a bitter taste.
  • The tongue looks red and dry, with little moisture.
  • The coating is thin, white, and dry, or there is very little coating.
  • The pulse feels weak, fine, and fast; the resting heart rate is about 90–130 beats per minute.

|Treatment Approach

Clinical description:

Nourish yin and clear heat.

In plain language:

  • Moisten the body and ease dryness.
  • Help ease internal “heat” and feverish sensations, including dry mouth, restlessness, and heat in the hands and feet.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Frequent urination; cloudy, paste-like urine; soreness and weakness in the lower back and knees; dizziness and tinnitus; heat in the palms, soles, and chest; low-grade fever with flushed cheeks; dry mouth and throat; vivid dreams and nocturnal emissions; red tongue with scant coating; and a fine, rapid pulse.

In plain language:

  • Frequent urination, with a noticeable increase in trips to the bathroom during the day and at night.
  • The urine looks very cloudy and thick, as if mixed with oil.
  • The lower back and knees feel sore, weak, and heavy.
  • Dizziness or blurred vision, along with frequent ringing in the ears.
  • Heat in the palms, soles, and chest, with restlessness.
  • A persistent low-grade fever and flushed cheeks.
  • Dry mouth and throat, with a desire to drink more water.
  • Frequent vivid dreams; men may experience involuntary nocturnal emissions.
  • The tongue looks red and has very little or no coating.
  • The pulse feels fine and fast. When measured at rest while seated with light pressure, the pulse is weak and fine, with a rate of about 90 beats per minute or more (more than four beats per breath); this differs from a pulse that is only fine but not fast, or only fast but not fine.

|Treatment Approach

Clinical description:

Nourish yin and tonify the kidneys.

In plain language:

  • Moisten the body and ease dryness.
  • Support the body’s underlying vitality and stamina, while also addressing sleep- and reproductive-related functions.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Liuwei Dihuang Wan

References

  1. Tong Xiaolin. Standards for the Prevention and Treatment of Diabetes with Traditional Chinese Medicine (Draft) [M]. Beijing: Science Press, 2014: 7.
  2. Pan Changyu. Joslin’s Diabetes Mellitus [M]. 14th ed. Beijing: People’s Medical Publishing House, 2007: 149–150, 344.
  3. Xu Manyin. Diabetology [M]. 2nd ed. Shanghai: Shanghai Scientific & Technical Publishers, 2010: 93–96.
  4. Endocrinology Branch of the Chinese Medical Association. Expert Consensus on the Prevention of Type 2 Diabetes in Chinese Adults [J]. Chinese Journal of Endocrinology and Metabolism, 2014, 30(4): 277–283.
  5. Diabetes Society of the Chinese Medical Association. Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2013 edition) [J]. Chinese Journal of Diabetes, 2014, 22(8): 2–42.
  6. Li G, Zhang P, Wang J, Gregg EW, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study [J]. Lancet, 2008, 371(9626): 1783–9.
  7. An Liangyi, Wei Haitao, Zhang Xiangzhen, et al. Clinical Study of Oral Yueju Pill for “Preventive Treatment of Disease” in Patients with Prediabetes [J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2015(4): 429–431.
  8. Lian F, Li G, Chen X, et al. Chinese Herbal Medicine Tianqi Reduces Progression From Impaired Glucose Tolerance to Diabetes: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial [J]. J Clin Endocrinol Metab, 2014, 99(2): 648–655.
  9. He Bing. Clinical Observation of Jiangtang Pill for Prediabetes (Qi and Yin Deficiency Pattern) [D]. Yunnan College of Traditional Chinese Medicine, 2015.
  10. Chen Chao. Effects of Shenqi Jiangtang Capsules on Blood Glucose and Lipid Levels in Patients with Impaired Glucose Tolerance [J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2005, 14(13): 1681–1683.
  11. Zhang Chunxiang, Zuo Wenbiao, Wang Shi. Interventional Study of Tangmaikang in Older Adults with Impaired Glucose Tolerance [J]. Journal of Xuzhou Medical College, 2007, 27(4): 250–253.
  12. Yang Lihua, Lü Weibin. Clinical Observation of Yangyin Jiangtang Tablets in 60 Patients with Prediabetes [J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica, 2014, 35(7): 49–50.
  13. Cheng Jinhan. A Randomized, Parallel-Controlled Study of Liuwei Dihuang Wan and Lifestyle Intervention for Impaired Glucose Tolerance [J]. Journal of Practical Traditional Chinese Internal Medicine, 2014, 28(11): 31–34.
  14. Wang Hui, Liang Xiaoping, Yu Xiaoming, et al. Observational Study of Liuwei Dihuang Wan for IGT [J]. Liaoning Journal of Traditional Chinese Medicine, 2002, 29(12): 758–759.