Diabetes Mellitus: Wasting and Thirsting Disorder

Diabetes Mellitus:  Wasting and Thirsting Disorder

According to the American Diabetes Associations, a total of 23.6 million children and adults, that’s 7.8% of the population, have diabetes.  All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure for the common types outside of a pancreas transplant.  Insulin is a hormone, produced by the pancreas that enables cells to absorb glucose in order to turn it into energy.  Diabetes is caused when the pancreas does not produce enough insulin or when the body does not properly respond to insulin.

Symptoms

Type 1

• Frequent urination
• Unusual thirst
• Extreme hunger
• Unusual weight loss
• Extreme fatigue and Irritability

Type 2*

• Any of the type 1 symptoms
• Frequent infections
• Blurred vision
• Cuts/bruises that are slow to heal
• Tingling/numbness in the hands/feet
• Recurring skin, gum, or bladder infections

*Often people with type 2 diabetes have no symptoms.

Complications

Complications due to diabetes include acute health problems such as hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma if the disease is not controlled.  Long-term complications include cardiovascular disease, chronic renal failure, retinal damage, blindness, nerve damage, microvascular damage, which can cause erectile dysfunction and poor wound healing.  Poor healing of wounds, particularly in the feet, can lead to gangrene infection and possibly amputation.  Diabetes may also produce oral complications, digestive disorders, and complications in pregnancy.  Adequate treatment of diabetes and maintaining a healthy body weight and smoke free lifestyle improve the risk profile of most chronic complications.

Wasting and Thirsting Disorder

Discussion of diabetes under its traditional name, Wasting and Thirsting, appears in the earliest texts of Classical Chinese Medicine, including the Yellow Emperor’s Inner Classic (Neijing).  Thirst, hunger, and excessive urination are the three main symptoms connected to diabetes in the writings.  These symptoms are related to the Lung, Spleen, and Kidneys, respectively.  The wasting/thirsting imbalance is believed to be related to eating fatty or sweet foods in excess, to emotional disturbances and to a constitution that is yin deficient.

According to CCM, the transformative functions of the Spleen and Stomach are impaired by irregular eating habits that include over-consumption of fatty, greasy, pungent, and sweet food.  Hot drinks and alcoholic drinks have the same effect.  These substances accumulate and produce heat in the body.  All of these factors dehydrate leading to thirst and hunger.  This process is explained in Simple Questions:

“…fat causes interior heat while sweetness causes fullness in the middle burner. The qi therefore rises and overflows and the condition changes into that of thirsting and wasting.”

Long-term internal heat produces a cyclical imbalance.  Internal heat injures yin and consumes body fluids.  When fluids are consumed they are not available to nourish the Lung and Kidneys.  Yin deficiency leads to dry heat, dry heat to yin deficiency.

“The five inner yin organs are soft and weak and prone to symptoms of wasting heat.  When there is something soft and weak, there must be something hard and strong.  Frequent anger is hard and strong and the soft and weak are thereby easily injured.”

– The Spiritual Axis (Ling Shu)

TREATMENT ACCORDING TO THE THREE BURNERS: Lung, Spleen, and Kidneys

When working to understand the diabetic patient at Integrative Med Solutions, we pursue an analysis of symptoms to find which of the three burners is most affected by heat.  This way, treatment can be provided according to the area where yin is most deficient.  Relief is directed to the source of the problem.

Upper Burner………Lung

Middle Burner…………Spleen

Low Burners…….….Kidneys

The following are examples of manifestations and acupuncture treatment points aligned with the various symptoms of the three burners.

Upper Burner Manifestation

• Excessive thirst
• Dry throat/mouth
• Night sweats
• Emaciation
• Flushed cheeks
• Wiry, rapid pulse
• Red tongue with thin, dry, yellow coating or no coating
• Hoarse voice

Upper Burner Acupuncture Treatment to Strengthen and Tonify the Lung

• Feishu BL-13
  • Clears heat
  • Tonifies Lung yin
• Chize LU-5
  • Clears heat
  • Alleviates cough
  • Regulates the water passages
• Gaohuangshu BL-43
  • Nourishes blood and yin
  • Tonifies Lung, Spleen, Stomach, and Kidneys
  • Cools hear
  • Treats night sweating
• Yuji LU-10
  • Clears Lung heat
  • Beneits the throat
• Lianquan REN-23
  • Stimulates the production of body fluids
  • Chicken-claw method used
• Zusanli ST-36
  • Assists Feish BL-13 in strengthening the Lung
• Taixi KID-3
  • Tonifies the Kidneys
  • Nourishes yin
  • Supports the Lung

Middle Burner Manifestation

• Excessive hunger
• Halitosis
• Dry lips
• Painful swelling/bleeding gums
• Preference for cold drinks
• Constipation
• Rapid, full pulse
• Red tongue with thick yellow coating and red ulcerous tip

Middle Burner Acupuncture Treatment to Clear Stomach Dryness and Heat

• Zusanli ST-36 
  • Clears stomach dryness
  • Benefits stomach Yin
  • Classically indicated for “heat in the middle warmer with propensity to hunger”
• Neiting ST-44 
  • Clears stomach heat
• Sanyinjiao SP-6 
  • Benefits the stomach
  • Tonifies yin and body fluids
• Neiguan P-6 
  • Regulates the middle burner
  • Clears heat
• Zhongwan REN-12 
  • Harmonizes the middle burner
  • Tonifies the stomach
• Pishu BL-20 and Weishu BL-21 
  • Benefit the Spleen and Stomach
  • Classically indicated for remaining thin despite large food intake
• Weiguanxiashu (M-BW-12) 
  • Clears heat
  • Generates fluis
• Taixi KID-3
  • Tonifies the Kidneys
  • Nourished yin
  • Supports the yin of the whole body

Lower Burner Manifestation

• Excessive urination
• Lower lumbar pain
• Weak legs
• Constipation
• Blurred vision
• Dizziness
• Malar flush
• Memory problems
• Afternoon fever
• Thin, rapid pulse
• Red tongue with scanty coating 

Lower Burner Acupuncture Treatment for Lower Wasting to Strengthen Exhausted Kidneys

• Guanyuan REN-4 
  • Benefits essence
  • Tonifies and nourishes the Kidneys
  • Benefits the Bladder
• Qihai REN-6 
  • Tonifies the Kidney
• Taixi KID-3 
  • Tonifies Kidneys
  • Nourished yin
• Rangu KID-2 
  • Clears deficiency heat
  • Regulates the Kidneys
• Sanyinjiao SP-6 
  • Benefits the Kidneys
  • Nourishes yin
• Shenshu BL-23 
  • Tonifies the Kidney qi
  • Nourished yin and essence
  • Treats excessive urination
• Jingmen GB-25
  • Combines with its back-shu point Shunshu BU-23
  • Tonifies Kidneys
  • Benefits the water passages
  • Controls Urination

Tumeric Tip!

In a study using diabetic rats, the active principal of turmeric, curcumin, significantly reduced blood sugar, Hb, and glycosylated hemoglobin levels.  Supplementation with turmeric or curcumin also reduces the oxidative stress encountered by diabetics.  On top of these benefits turmeric also significantly lowers SDH, which catalyzes the changes of sorbitol to fructose.

Sources:
“Chinese Medicine Diabetes Report” Los Angeles Chinese Learning Center
“Efficacy of turmeric on blood sugar and polyol pathway in diabetic albino rats,. Arun N, Nalini N.
The Treatment of Diabetes Mellitus With Chinese Medicine: A Textbook & Clinical Manual By Bob Flaws, Lynn M. Kuchinski, Robert Casañas
American Diabetes Association. www.diabetes.org