Endocrine/Metabolic
Diabetes management aims to prevent symptoms and long-term complications by maintaining near-normal glycemia while addressing cardiovascular, renal, eye, nerve, and foot risks. Western medicine defines diabetes biologically and relies on standardized diagnostics and evidence-based care pathways, including lifestyle, medications, and ongoing monitoring. Eastern and traditional systems such as Traditional Chinese Medicine (TCM) and Ayurveda conceptualize diabetes through pattern diagnoses (e.g., yin deficiency with heat; Madhumeha) and emphasize constitutional balance, diet, herbs, acupuncture, yoga, and mind–body practices. An integrative approach can combine the strengths of each: the proven risk reduction from Western protocols with patient-centered lifestyle, stress management, and culturally congruent dietary and herbal therapies when safe and appropriately monitored.
In Western care, diagnosis uses objective criteria: HbA1c ≥6.5%, fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), 2-hour OGTT glucose ≥200 mg/dL (11.1 mmol/L), or random glucose ≥200 mg/dL with classic symptoms. HbA1c guides longitudinal control and risk; targets are individualized (often <7% for most adults, tighter or looser based on comorbidities, hypoglycemia risk, and life expectancy). Management prioritizes medical nutrition therapy (Mediterranean/plant-forward patterns, carbohydrate quality/quantity, and energy deficits for weight loss), physical activity (≥150 minutes/week moderate intensity plus resistance training), sleep, and smoking cessation. Pharmacologic therapy is tailored to cardiorenal risk: metformin is common first-line unless contraindicated; GLP-1 receptor agonists and SGLT2 inhibitors provide cardiovascular and renal protection independent of metformin; dual GIP/GLP-1 agents and insulin are used when needed. Monitoring includes HbA1c every 3 months until stable, self-monitoring of blood glucose or continuous glucose monitoring (CGM), annual kidney (eGFR, albuminuria), eye, and
Moderate Evidence