Abstract
Evidence for long-term use of Chinese herbal medicine (CHM) as an adjuvant treatment in patients with type 2 diabetes (T2D) remains limited. This study aimed to assess the frequency of use, utilization patterns, and therapeutic effects of adjuvant CHM for ischemic heart disease (IHD) in patients with T2D in Taiwan. We identified 4620 IHD patients with T2D. After matching for age, gender, and insulin use, 988 subjects each were allocated to a CHM group and a non-CHM group. There were no differences in baseline characteristics except for comorbidities. The CHM group contained more cases with chronic obstructive pulmonary disease, hepatitis, ulcer disease, and hyperlipidemia. The cumulative survival probability was higher in CHM users than in matched non-CHM users aged 60 years or older (P < .0001, log rank test) regardless of gender (P = .0046 for men, P = .0010 for women, log rank test). Among the top 12 CHM combinations, Shu-Jing-Huo-Xue-Tang and Shao-Yao-Gan-Cao-Tang (13.6%) were the most common. This dual combination improved antiapoptotic activity in H2O2-exposed H9C2 cells by enhancing phosphorylation of glycogen synthase kinase-3β and p38 mitogen-activated protein kinase and could increase the survival of myocardial cells. Our study suggests that adjuvant CHM therapy may increase the survival probability and provides a comprehensive list for future investigations of the safety and efficacy of CHM for IHD patients with T2D.
Highlights
Type 2 diabetes (T2D) is a disorder of glucose metabolism that affects more than 6% of the population worldwide [1]
The cumulative probability of survival was higher in Chinese herbal medicine (CHM) users than in matched non-CHM users
Treatment with H2O2 decreased the phosphorylation of p38 MAPK to 41.9% (Figure 6C), which was only recovered by Shu-Jing-Huo-Xue-Tang and Shao-Yao-Gan-Cao-Tang (51.1%, p = 0.0014). This population-based study shows that treatment with the most commonly used dual CHM combinations has additive benefits in improving survival in patients diagnosed with ischemic heart disease (IHD) after a diagnosis of type 2 diabetes (T2D) and on regular insulin therapy
Summary
Type 2 diabetes (T2D) is a disorder of glucose metabolism that affects more than 6% of the population worldwide [1]. T2D is regarded as glycemia resulting from impaired β-cell function, decreased insulin sensitivity in tissues, and increased glucose levels in the blood [5]. Diabetic complications including cardiovascular disease, retinopathy, nephropathy, neuropathy, and peripheral circulatory disorders are believed to be responsible for the symptoms, signs, ill-defined secondary conditions, and mortality observed in these patients [6], [7]. Cardiovascular disease is the major cause of morbidity and mortality in patients with diabetes. Cardiovascular mortality among T2D patients has been increasing [6], suggesting that there are still unknown factors that contribute to the excess cardiovascular risk in these patients
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