Traditional glucose-lowering chemical agents

including various types of insulin and insulin secretagogues

insulin sensitizers

gliptins

etc.

are based on diabetic pathogenesis of insulin resistance (IR) and islet insufficiency. Numerous evidence-based medical studies have shown that these traditional hypoglycemic chemical agents do not provide cardiovascular benefit to patients with type 2 diabetes mellitus (T2DM) and may even increase the risk of all-cause mortality. Based on research evidence published to date

these studies show that overload of energy could increase the incidence and prevalence of T2DM

and reduction in the heat load can significantly reduce the incidence of T2DM. Therefore

the essence of T2DM is heat overload

meaning heat overload is the etiology of obese T2DM. At the same time

results of numerous studies show that heat overloading is the cause of IR. IR and islet dysfunction are protective factors in intervening with heat overload. These drugs

which are based on the mechanisms of IR and islet insufficiency

increase caloric reserve and cause or worsen obesity

which is equivalent to exacerbating the basic etiology and the cardiovascular risk factor of T2DM. Thus

a reasonable strategy for prevention and treatment of obese T2DM appears to promote the negative balance of calories and the elimination of caloric reserves. Chinese herbal medicines can promote negative balance of heat in many aspects

which can bring new hope for prevention and treatment of T2DM.