Traditional Chinese medicine in diabetes management: a comprehensive review of mechanisms and therapeutic potential

Background Diabetes mellitus is a chronic metabolic disorder frequently associated with severe complications. Traditional Chinese Medicine (TCM) offers potential therapeutic benefits through multi-targeted mechanisms. Objective This study explores the pharmacological actions, clinical applications, and therapeutic potential of TCM herbs, extracts, and prescriptions in managing diabetes-related complications. Methods A comprehensive review of studies from multiple databases was conducted, focusing on experimental evidence, signaling pathways, and clinical trials evaluating TCM interventions for diabetes and its complications. Results TCM demonstrates significant potential in modulating insulin secretion, improving glucose metabolism, and attenuating oxidative stress. Specific formulations and bioactive compounds regulate pathways including PI3K/Akt, Nrf2/HO-1, and VEGF, contributing to better glycemic control and reduced complications such as diabetic retinopathy, cardiomyopathy, osteoporosis, and peripheral neuropathy. Several randomized controlled trials report enhanced clinical outcomes when TCM formulations are used alone or in combination with conventional therapy. Conclusion TCM offers a promising complementary strategy for diabetes management and its associated complications. Further large-scale clinical trials are needed to validate efficacy and ensure safety.