Therapeutic values of Traditional Chinese medicine (TCM) in evolution of Type 1 Diabetes Mellitus with its Microvascular Complications in Adults

Introduction: Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease characterized by progressive β-cell destruction and a three-stage natural history. The American Diabetes Association (ADA) emphasizes early intervention in stages 1 and 2 to delay progression to overt diabetes (stage 3) and advocates comprehensive strategies to prevent microvascular complications (diabetic retinopathy, nephropathy, and neuropathy). Traditional Chinese Medicine (TCM) has been proposed as a complementary approach that may address key pathophysiological mechanisms, including autoimmunity, inflammation, oxidative stress, β-cell dysfunction, and vascular damage. Methods: This narrative review summarizes current Western evidence on T1DM pathophysiology, epidemiology, landmark intervention trials (e.g., TrialNet TN-10, DCCT/EDIC), and ADA guidelines, alongside TCM perspectives on etiology, pathogenesis, and treatment options, including herbal medicine, acupuncture, dietary therapy, and Qigong/Tuina. The literature was critically evaluated with a focus on evidence quality (preclinical, observational, RCTs, and meta-analyses). Results: TCM may have multiple effects by modulating the immune system, reducing inflammation, fighting oxidative stress, protecting β-cells, and enhancing microcirculation. Early preclinical and small clinical studies (mostly based on T2DM or animal models) suggest possible additional benefits, such as slowing β-cell loss in stages 1–2 and reducing microvascular damage in stage 3. Currently, there is a lack of high-quality T1DM-specific randomized controlled trials. Discussion: TCM provides a promising holistic, syndrome-differentiation approach as a complementary method in T1DM management. However, the lack of strong T1DM-specific evidence, standardization issues, and safety concerns require well-designed multicenter RCTs, mechanistic studies, and integrative models to confirm effectiveness, ensure safety, and support integration into global diabetes care.