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TCM interventions have been shown to enhance glucose, lipid, and oxidative stress profiles while favorably modulating gut microbiota ( 2.1.24 Modulation of glucose metabolic factors and related pathways Murrayae Folium et Cacumen extracts, rich in flavonoids, improve metabolic markers by optimizing glucose and lipid metabolism, reducing oxidative stress, and mitigating inflammation ( Panax notoginsenoside R1 (NG-R1), derived from Panax notoginseng, activates key pathways such as PI3K/AKT, Wnt/-catenin, and NRF2-HO-1, which reduce inflammation, apoptosis, and oxidative damage, and help protect podocytes and retinal tissue from hyperglycemia-related injury ( 2.1.2.5 Insights from modern metabolomics Recent metabolomics studies have highlighted the bioactive constituents and mechanistic pathways of classical TCM prescriptions, such as Ge-Gen-Jiao-Tai-Wan (GGJTW) and Huanglian Decoction, which are associated with key processes like bile acid production, branched-chain amino acid metabolism, and anti-inflammatory actions ( 2.1.3 TCM Interventions for diabetic complications 2.1.3.1 TCM-based approaches for cardiovascular protection and diabetic osteoporosis The degeneration of vascular structures and their cellular components is a notable feature in older individuals with diabetes ( Both herbs, along with Phellodendri chinensis cortex, influence key pathways like NLRP3, ASC, caspase, GSDMD, and Nrf2-Keap1, which promote bone health and reduce inflammation

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J Rheumatol (2007) 34(11):214453

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