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Therapy to Obese Type 2 Diabetes Mellitus: How Far Will We Go Down the Wrong Road?

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Abstract

Traditional glucose-lowering chemical agents, including various types of insulin and insulin secretagogues, insulin sensitizers, gliptins, etc., are based on diabetic pathogenesis of insulin resistance (IR) and islet insufficiency. Numerous evidence-based medical studies have shown that these traditional hypoglycemic chemical agents do not provide cardiovascular benefit to patients with type 2 diabetes mellitus (T2DM) and may even increase the risk of all-cause mortality. Based on research evidence published to date, these studies show that overload of energy could increase the incidence and prevalence of T2DM, and reduction in the heat load can significantly reduce the incidence of T2DM. Therefore, the essence of T2DM is heat overload, meaning heat overload is the etiology of obese T2DM. At the same time, results of numerous studies show that heat overloading is the cause of IR. IR and islet dysfunction are protective factors in intervening with heat overload. These drugs, which are based on the mechanisms of IR and islet insufficiency, increase caloric reserve and cause or worsen obesity, which is equivalent to exacerbating the basic etiology and the cardiovascular risk factor of T2DM. Thus, a reasonable strategy for prevention and treatment of obese T2DM appears to promote the negative balance of calories and the elimination of caloric reserves. Chinese herbal medicines can promote negative balance of heat in many aspects, which can bring new hope for prevention and treatment of T2DM.

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Authors and Affiliations

  1. Department of Endocrinology, People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350004, China

    Xian-pei Heng, Liang Li, Liu-qing Yang & Zi-ta Wang

  2. West China Medical Center of Sichuan Medical University (West China University of Medical Science), Chengdu, 610041, China

    Xiu-jun Li

  3. Academy of Integrative Medicine Fujian, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China

    Su-ping Huang

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  1. Xian-pei Heng
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Heng XP conducted the main research work and wrote the article; Li XJ served on advisory and reviewed the article; Li L, Yang LQ, Wang ZT and Huang SP helped for data and preliminary work.

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Correspondence to Xian-pei Heng.

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No potential conflicts of interest relevant to this article were reported.

Supported by the National Natural Science Foundation of China (No. 81473550, 81603508, 81873213), the Natural Science Foundation of Fujian Province (No. 2017J01213, 2016J0146), and the Innovation Fund of Medical Science of Fujian Province (No. 2017-CX-42), China

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Heng, Xp., Li, Xj., Li, L. et al. Therapy to Obese Type 2 Diabetes Mellitus: How Far Will We Go Down the Wrong Road?. Chin. J. Integr. Med. 26, 62–71 (2020). https://doi.org/10.1007/s11655-018-3053-8

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