Mulberry Twig Alkaloids Combined With Insulin Infusion: Effects on Blood Glucose Variability in Type 2 Diabetes

BACKGROUND Glycemic variability is increasingly recognized as an important contributor to the development of diabetes-related complications in patients with type 2 diabetes mellitus (T2DM). Continuous subcutaneous insulin infusion (CSII) is effective in improving glycemic control; however, fluctuations in blood glucose can persist. Mulberry twig alkaloids (MTA), a traditional Chinese medicine component with hypoglycemic properties, have shown potential benefits in regulating glucose metabolism. This study aimed to evaluate whether MTA combined with CSII could further improve glycemic variability and symptoms recognized by traditional Chinese medicine (TCM) in patients with T2DM. MATERIAL AND METHODS Sixty hospitalized patients with T2DM were randomly assigned to a control group (CSII alone, n=30) or an MTA group (MTA tablets plus CSII, n=30). Flash glucose monitoring was used to assess glycemic variability indicators, including mean blood glucose (MBG), standard deviation of blood glucose (SDBG), coefficient of variation (CV), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), time in range (TIR, 3.9-10 mmol/L), time above range (TAR), and time below range (TBR) over 14 days. TCM symptom scores were evaluated before and after treatment. RESULTS After 14 days, MODD, MAGE, TAR, and TBR were significantly lower in the MTA group compared with the control group (all P<0.05), while TIR was significantly higher (P<0.01). Additionally, the TCM symptom score was markedly reduced in the MTA group compared with the control group (P<0.05). CONCLUSIONS Our findings suggested that CSII combined with mulberry twig alkaloids can improve blood glucose variability and relive TCM symptoms in T2DM patients.