Exploring the Onset of Type 2 Diabetes Mellitus Based on the Theory of Liver-Spleen Harmonization

Abstract

Type 2 Diabetes Mellitus (T2DM) is a clinical syndrome characterized primarily by chronic hyperglycemia, resulting from the combined effects of multiple factors. In traditional Chinese medicine (TCM), it falls under the category of “Xiaoke disease.” The syndrome differentiation and treatment of Xiaoke disease often follow the “three types of Xiao” approach. Guided by the holistic concept of TCM, treatment transcends single-organ strategies by integrating both the holistic and differential perspectives of TCM, emphasizing coordination among multiple organs—particularly liver and spleen harmonization—to achieve unity between local and systemic regulation. This paper explores the pathogenesis of T2DM from multiple angles, including inflammatory responses, glucose and lipid metabolism, gut microbiota, bile acid metabolism, and pancreatic fat deposition, to elucidate the roles of the liver and spleen in the onset of T2DM. It provides a theoretical basis for the prevention and treatment of early-stage T2DM through liver-spleen harmonization. Aligned with the TCM principle of “preventive treatment of disease,” this approach advocates for early detection and effective intervention of abnormal blood glucose levels. By soothing the liver and relieving stagnation, tonifying qi and strengthening the spleen, the harmony between wood and earth is restored, and blood glucose naturally stabilizes. This strategy holds significant value in improving patients’ quality of life and delaying the progression of early-stage T2DM.