Discussion
T2D, thirst, fatigue, abnormal sweating, diabetic, hypoglycemic, Diabetes, polyuria, dry mouth, diabetes
DIABETES, HEAT, DRY MOUTH, PATHOGENESIS, DIABETES
The control of T2D has become a global challenge. For the management of diabetes, there are various oral hypoglycemic drugs (OHDs) that are available worldwide, which is major management for most T2D patients. Of all the OHAs to treat T2D, metformin is the first-line oral hypoglycemic agent for the treatment of T2D recommended by the American Diabetes Association (In TCM theory, the pathogenesis of T2D is closely related to Pi (spleen) deficiency. Pi (spleen) deficiency usually leads to clinical symptoms such as fatigue, thirst, and abnormal sweating. Jinlida granules is a herbal formula developed according to the Chinese understanding of the pathogenesis theory of diabetes, Pi (spleen) deficiency. It reduces blood glucose and improves clinical symptoms by nourishing Pi (spleen) and regulating the body fluid of diabetic patients (From the current evidence of the trials, both Jinlida and metformin reduced the level of blood glucose, and the curative effect of Jinlida add-on metformin was superior to metformin monotherapy (In the aspect of improving clinical symptoms, Jinlida granules have an improvement effect on all symptoms, especially the five symptoms: increased eating with rapid hunger, polyuria, dry mouth, spontaneous sweating, and vexing heat in the chest, palms, and soles. Among them, the disappearance rate of spontaneous sweating symptoms was statistically significant after 4 weeks of treatment. It shows that spontaneous sweating is the most effective symptom of Jinlida granules. At weeks 4 and 12, the night sweat symptom in the treatment and control groups showed significant differences. At week 8, the night sweat symptom showed an insignificant difference. The curative effect was improved in a spiral pattern, indicating that the effect of Jinlida granules was mild and stable. In addition, we analyzed the correlation between HbA1c and the improvement of clinical symptoms, and there was no significant difference. Therefore, the effect of Jinlida on improving clinical symptoms is considered to be independent of regulating blood glucose.There were also some limitations in the present study. First, subjectivity in assessing subjective symptoms is a notable confounding factor. Second, due to the long follow-up interval, the patient’s symptoms may not be able to get timely feedback. Third, the 12-week intervention period is short, and the long-term benefits of Jinlida granules in improving clinical symptoms are unclear. Future research should focus on developing more effective strategies to evaluate subjective clinical symptoms and longer follow-up times to evaluate the improvement of T2D clinical symptoms.