① Yin deficiency in the body and weakness of the five internal organs. Yin deficiency of body and weakness of five internal organs are the internal factors of diabetes. Yin deficiency of the body refers to the lack of vaginal fluid and some components in vaginal fluid, especially kidney and spleen deficiency, which plays a decisive role in the pathogenesis of diabetes.

② Poor diet and obesity. Long-term gluttony, mellow wine and thick taste will damage the spleen and stomach, the spleen and stomach will lose their function, accumulate heat and eliminate the body fluid, consume yin and hurt the body fluid, and are prone to diabetes. At present, people have realized that obesity is an important factor in the occurrence of type 2 diabetes. In recent years, a large number of epidemiological investigation data at home and abroad show that with the development of economy and the improvement of living standards, the incidence of obesity and diabetes is gradually increasing due to long-term intake of high-calorie diet, or multiple meals, and the reduction of physical activity. This is completely consistent with the understanding of Chinese medicine.

③ Mental stimulation and emotional disorder. Long-term mental overstimulation, emotional discomfort, or depression and anger hurting the liver, liver qi is not vented, qi stagnation turns into fire, burning lung, stomach, yin and body fluid, and burning kidney yin; Or overthinking, stagnation of heart-qi, stagnation of heart-fire, excessive heart-fire, loss of heart and spleen essence and blood, and burning of stomach and kidney yin can all lead to diabetes.

(4) Exogenous six evils, poisonous and evil invasion. Exogenous six evils, dryness, fire, wind, heat, poison and evil invade the paste (pancreas), affecting the viscera and causing diabetes. For example, according to the different causes, Qin Jingming divided diabetes into exogenous diseases (dry fire, damp heat) and internal injuries (accumulated heat, essence deficiency). Three elimination of exogenous pathogens refers to diabetes caused by exogenous pathogens and toxic pathogens.

⑤ Long-term use of Dan medicine will eliminate dryness and damage body fluid. In ancient China, since the Sui and Tang Dynasties, people often took Dan medicine refined from mineral drugs for strengthening yang or preserving health and longevity, resulting in internal heat, yin deficiency and body fluid deficiency and diabetes. In many ancient medical books, there are records of taking Dan medicine to quench thirst. Western medicine believes that some chemical poisons, such as alloxan, streptozotocin, pioglitazone and some drugs, such as oral steroid contraceptives and adrenocortical hormones, can cause diabetes.

6. Long-term drinking leads to overwork. China's medical books in past dynasties emphasized that alcoholism and overwork were related to diabetes. It is believed that long-term alcoholism will damage the spleen and stomach and accumulate heat and body fluid. Or excessive indulgence, overwork, kidney essence loss, endogenous deficiency fire, yin injury and body fluid can all cause diabetes.

(2) Pathogenesis

Based on the ancient and modern literature of traditional Chinese medicine, the clinical data of diabetes from onset to death are analyzed, and the pathogenesis characteristics of diabetes in the long course of disease can be summarized as follows.

① At the initial stage of the lesion, yin and body fluid were deficient, with excessive dryness and heat. When discussing the pathogenesis of diabetes mellitus, Chinese medical literature in past dynasties mostly takes yin deficiency and dryness-heat as the basis. In the early stage of diabetes, the basic pathogenesis is yin and body fluid deficiency, excessive dryness and heat, yin deficiency as the basis and dryness and heat as the standard. The more severe the dryness and heat, the more yin deficiency and body fluid loss, the more yin deficiency and body fluid loss, and the more intense the dryness and heat. The two influence each other and are mutually causal. Although the lesion site of diabetes is related to the five internal organs, it is mainly in the lung, spleen (stomach) and kidney.

② The course of the disease is prolonged, both qi and yin are damaged, and the vein is blocked. If the early stage of diabetes is not treated properly in time, the course of the disease will be prolonged, and the yin will consume gas, and the heat will hurt the yin and consume gas, resulting in deficiency of both qi and yin. At the same time, it will cause dysfunction of viscera, impaired metabolism of body fluid, blocked blood circulation, endogenous phlegm and blood stasis, and the whole body will be blocked, and the corresponding viscera and organs will lose the nourishment of qi and blood, resulting in many complications.

③ In the late stage of the disease, Yin and Yang are damaged and both are deficient. Yin and Yang of human beings are mutually rooted and interdependent.

The root of diabetes is yin deficiency. If the course of disease is prolonged, yin will damage yang, or due to improper treatment, bitter cold will damage yang, which will eventually lead to deficiency of both yin and yang.

In addition, a small number of diabetic patients have sudden onset and serious illness. It quickly leads to extreme exhaustion of yin and body fluid, yin failing to converge yang, deficiency yang floating outside, red face and irritability, headache and vomiting, dry skin, sunken eye sockets, red lips and dry tongue, deep breathing and rotten apples. If not rescued in time, the true yin will be exhausted, and the yin will die and the yang will be unconscious.