Heqi San, a traditional Chinese medicine (TCM) has been reported to regulate hormone levels in patients with metabolic disease, suggesting a potential clin

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, and its prevalence has been increasing all over the world, which is also the leading cause of end-stage renal failure. Hydroxysafflor yellow A (HSYA) is the main active chemical component of Carthamus tinctorius L., and it is commonly used in patients with cardiovascular and cerebrovascular diseases in China. The aim of this study was to investigate the renal protective effects and molecular mechanisms of HSYA on high-fat diet (HFD) and streptozotocin- (STZ-) induced DN in rats. The DN rats were treated with HSYA for eight weeks. We assessed creatinine (CR), urea nitrogen (UN), glomerular volume, podocyte number, renal inflammation, oxidative stress, and cells apoptosis markers after HSYA treatment. The number of apoptotic cells was measured by the TUNEL assay, and apoptosis-related proteins BAX, caspase-3, and BCL-2 in the renal tissue were analyzed by western blot. The treatment with HSYA significantly decreased fasting blood glucose, CR, UN, and blood lipid profile, including triglyceride and total and low-density lipoprotein cholesterol, even though it did not change the rats’ body weights. The western blot results indicated that HSYA reversed the upregulation of BAX and caspase-3 and significantly increased BCL-2 in renal tissue. Moreover, the levels of TNF-α and the inflammatory products, including free fatty acids (FFA) and lactic dehydrogenase (LDH) in the HSYA group, were significantly decreased. For the oxidative stress marker, the superoxide dismutase (SOD) markedly increased in the HSYA treatment group, while the malondialdehyde (MDA) in the serum and kidney tissue evidently decreased. In conclusion, HSYA treatment preserved kidney function in diabetic nephropathy in the HFD- and STZ-induced rats. The potential mechanism of renal protective effect of HSYA might be through inhibiting oxidative stress, reducing inflammatory reaction, and attenuating renal cell apoptosis. Our studies present a promising use for Hydroxysafflor yellow A in the treatment of type 2 diabetes mellitus.

Diabetic osteoporosis (DO) is a complication of diabetes. Zishen Jiangtang Pill (ZJP) is a Chinese herbal product which has been used in clinic to maintain blood glucose level and bone density for decades. However, the evidence about its mechanism on diabetes and osteoporosis is still unknown. The aim of this study is to investigate therapeutic effect of ZJP on DO in streptozotocin‐ (STZ‐) induced rats. Rats were randomly assigned to 4 groups: one control group (CON), one model group (MOD), and two ZJP treatment groups (1.5 and 3.0 g/kg/d). All rats were treated for 8 weeks. Results showed that ZJP decreased the blood glucose level during OGTT and prevented the changes of FBG and Fins. Similarly, ZJP inhibited the changes of BCa, P, TRACP‐5b, CTX‐1, BALP, and BGP and the reduction of BMD. In parallel, 1H‐NMR metabolomic studies showed that ZJP significantly altered the metabolic fingerprints of blood and urine level. These findings suggest that ZJP can effectively improve glucose metabolism, abnormal bone metabolism, and metabolic disorders in DO rats, which may be a useful alternative medicine for DO therapy.

Background: Prediabetes is a hypermetabolic syndrome with blood sugar levels falling between the normal and diabetes. People with prediabetes have a significantly increased chances of developing diabetes, cardiovascular and cerebrovascular diseases, tumors, dementia, and other diseases in the future when compared to the healthy population. However, prediabetes is mainly treated based on lifestyle intervention, currently without targeted drug treatment plan. Traditional Chinese medicine (TCM), which has a longstanding experience, has been shown in clinical studies to be effective for the treatment of diabetes and its related complications. Furthermore, different dosage forms such as decoction and granule have developed gradually in clinical application. Preliminary studies have found that Huoxue-Jangtang Decoction (HJD), with good hypoglycemic and lipid-regulating effects, is potentially one of the complementary and alternative treatments for prediabetes. Therefore, this project intends to perform a prospective clinical study to observe the clinical effectiveness of HJD on prediabetes and the consistency of the efficacy of formula granules and the elixation. Methods: This is a prospective, randomized, double-blind, and placebo-controlled clinical trial. A total of 183 participants are randomly assigned to HJD Formula Granules plus lifestyle intervention, HJD Elixation plus lifestyle intervention, and placebo plus lifestyle intervention. All subjects undergo 1 day of screening before participating in the study, followed by 84 days of drug intervention and observation. During and after treatment, the main outcome measures include fasting blood glucose and 2-hour postprandial blood glucose. Discussion: This research attempts to verify the clinical efficacy and possible mechanism of HJD in the treatment of prediabetes, and prove the consistency of HJD Formula Granules with HJD Elixation. This study also aims to provide a treatment that is both effective and safe for prediabetic patients. Trial registration: ClinicalTrials.gov Identifier: ChiCTR2200060813, Registered 12 June 2022.

Background: Diabetic neuropathy is one of the most common complications of diabetes, affecting about half of all people with the disease. Among these, 30%-50% experience nerve-related pain, characterized by abnormal sensations, burning, or stabbing pain, a condition known as painful diabetic neuropathy (PDN). PDN not only severely impairs quality of life but is also closely associated with sleep disturbances, depression or anxiety, and foot complications. Together, these problems substantially increase healthcare costs and place a considerable economic burden on both families and society. Methods: We systematically searched multiple databases from their inception to 1 November 2025 to identify randomized controlled trials evaluating pregabalin combined with duloxetine for the treatment of painful diabetic neuropathy. The methodological quality and risk of bias of the included trials were assessed using the Cochrane risk-of-bias tool (version 2.0). Statistical analyses were performed with RevMan 5.4. Results: Three randomized trials involving a total of 471 patients were included. In two studies that could be pooled, combination therapy produced significantly greater pain relief than monotherapy (MD=-1.82, 95%CI=-2.10, -1.54, P <0.00001). For secondary continuous outcomes reported in single studies, all results favored the combination, pain intensity on the visual analogue scale (VAS, MD=-1.42, 95%CI=-1.83, -1.01, P <0.00001), brief pain inventory-modified short form (BPI-MSF, MD=-1.46, 95%CI=-2.35, -0.57, P = 0.001), and neuropathic pain symptoms on the pain detect questionnaire (PDQ, MD=-3.00, 95%CI=-5.55, -0.45, P = 0.02). The proportion of patients achieving at least 50% pain reduction was also higher with the combination than with duloxetine 120 mg alone (RR = 1.81, 95%CI=1.17, 2.81, P = 0.008). In contrast, there were no significant differences between combination therapy and monotherapy in the overall risk of adverse events (RR = 1.10, 95%CI=0.84, 1.46, P = 0.48) or in key individual adverse effects, including somnolence (RR = 0.79, 95%CI=0.30, 2.08, P = 0.63) and nausea/vomiting (RR = 2.02, 95%CI=0.77, 5.27, P = 0.15). The certainty of evidence ranged from very low to low for most outcomes (GRADE). Conclusion: Low-certainty evidence suggests that pregabalin plus duloxetine may improve short-term pain scores compared with monotherapy in painful diabetic neuropathy. Safety outcomes remain uncertain due to few trials and imprecision. Systematic review registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD420251179997.

Obesity and autoimmune disorders represent a significant comorbidity burden, yet their shared genetic architecture is not fully understood. Elucidating the