Five Element Acupuncture and Diabetes

Diabetes is a chronic endocrine disease characterized by a disorder of carbohydrate metabolism with high blood glucose levels caused by various factors. The etiology is not fully understood, but it is currently believed to be associated with genetics, autoimmune disorders, viral infections, and excessive production of glucagon. The pathophysiology is caused by absolute or relative insulin deficiency leading to disruptions in glucose, lipid, and protein metabolism, which can result in chronic complications affecting multiple organs such as the eyes, kidneys, nerves, heart, and blood vessels. The main symptoms and signs include polyphagia, polydipsia, polyuria, weight loss, high blood glucose levels, and glycosuria, with severe cases resulting in ketoacidosis and hyperosmolar coma.

The onset of the disease is slow, and early or mild cases may have no obvious symptoms and are sometimes discovered during urine or blood tests. The typical symptoms mainly include polyuria, thirst, polydipsia, increased appetite, weight loss, and renal fatigue. Laboratory tests such as fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and urine glucose test can help make a definitive diagnosis. Based on the symptoms and signs, the clinical classification ranges from mild, moderate to severe.

The etiology of diabetes is not yet fully understood in modern medicine. Insulin is the only hormone in the body that lowers blood glucose levels, but there are eight hormones that can raise blood glucose levels. The level of blood glucose is the result of the combined effects of multiple hormones, including insulin. However, modern medical research has focused only on insulin, insulin receptors, and insulin's "target" organs, while ignoring the effects of hormones that increase blood glucose levels, the contradictory relationship between insulin and hormones that increase blood glucose levels, and the overall relationship between the pancreas and organs throughout the body. Such theoretical research will inevitably lead to trade-offs in clinical treatment.

Traditional Chinese medicine has a history of two thousand years in understanding this disease, which was formerly known as "Xiaoke" or "Xiaoyan". It is believed that excessive emotions, mental exhaustion, stagnation of Qi, excessive Heart fire, and depletion of Yin fluids in the Lungs and Stomach can lead to Xiaoke; excessive consumption of fatty and sweet foods, alcohol, and spicy foods, as well as accumulation of heat and dryness in the Spleen and Stomach can also lead to Xiaoke; excessive indulgence and depletion of Kidney essence, leading to a deficiency of Yin and excess of fire, can also cause Xiaoke. Therefore, the pathogenesis of this disease can be summarized into two major aspects: dryness and heat, with Yin deficiency as the root cause and heat as the manifestation. These two aspects have a causal relationship with each other. The pathological changes can involve the Lungs, Stomach, Spleen, and Kidneys, covering the upper, middle, and lower jiaos. In the upper jiao, Lung heat damaging Yin is the main factor, with symptoms such as thirst, polydipsia, and frequent urination; in the middle jiao, Stomach heat is the main factor, with symptoms such as excessive eating, good appetite, emaciation, and dry stools; in the lower jiao, Kidney Yin deficiency is the main factor, with symptoms such as frequent urination, turbid urine like paste, and dry mouth and tongue.

From the perspective of the Five Elements theory, the main issue in this disease is the overall dysfunction of the Zang-fu organs. First, there is a dysfunction in the transformation and transportation of Earth element in the Middle Jiao, which affects the Metal element in the Lung and Large Intestine, leading to dysfunction in their function of descending and transmitting; second, there is a deficiency of Water element in the Kidneys due to the dysfunction of the Metal element, leading to leakage of Jing and Qi. The insufficient Kidney Water cannot nourish the Heart Fire, which burns the Lung Metal, leading to further deficiency. With the weakened Metal unable to control the Wood and Fire of the Heart and Liver, the dysfunction of the Zang-fu organs becomes more widespread.

The Five-Element acupuncture is based on the theory of Five Elements to balance the Zang-fu organs as the principle of treatment, replenishing deficiencies and reducing excesses. For example, a patient named Huang Tai had diabetes and ate ten meals a day, finishing all the food in the house but still feeling hungry. According to the theory of Five Elements in traditional Chinese medicine, this was caused by a dysfunction in the transformation and transportation of Earth element in the Middle Jiao, leading to excessive Stomach heat. Acupuncture points on the Lung and Large Intestine meridians were used for purging, and points on the Liver and Gallbladder meridians were used for tonification, combining tonification and purging to naturally regulate Stomach heat. After a week, Huang Tai felt no hunger, ate normally, and his urine sugar turned negative. This shows that the dysfunction of the Zang-fu organs is the root cause of this disease, as stated in the Yellow Emperor's Inner Classic: "Treating a disease must seek its root."