How Mongolian Medicine Understands and Treats Diabetes: History, Theory, Methods, and Integration with Modern Medicine

Last updated: 2026-10-27

Diabetes is written in Mongolian as «чихрийн шижин», literally "sweet urine" — a name that came from a plain observation: the urine of affected people attracted ants. Steppe medicine recorded the cluster of excessive thirst, hunger, urination and weight loss for centuries, but old Mongolian physicians had no concept of insulin. They explained the same picture in another language: an imbalance of the three roots (Хий, Шар, Бадган), a weakened digestive fire, and a failure to transform the refined essence of food properly. Today, Mongolian medicine clinics in Inner Mongolia and in Mongolia classify this picture within their wasting-thirst category and work alongside endocrinology, which measures glucose and prescribes glucose-lowering drugs. This article follows three threads — history, theory, treatment — and then sets out a practical integration path with clear safety limits.

Important: this is health education, not medical advice. Mongolian medicine can be part of comprehensive diabetes care, but it cannot replace metformin, other glucose-lowering medicines or insulin. Reducing or stopping those medicines on your own can trigger a hyperglycaemic emergency.

1. History: from steppe empiricism to a defined disease pattern

Before the 13th century — accumulated experience. Nomadic life dealt with wounds, fractures and cold exposure, on a diet of meat, dairy and tea. There was no systematic theory of wasting-thirst yet, but the practice of regulating the body through food was already established — the root of Mongolian dietary therapy.
13th—14th century — Mongol Empire and Yuan era. The Mongol court absorbed both Chinese and Tibetan medicine. The Yuan court dietary treatise «Yinshan zhengyao» (饮膳正要, 1330) records the properties and taboos of dairy and meat products and includes food remedies for thirst-related symptoms: direct evidence of the meeting between steppe and Chinese medicine.
16th—17th century — theorisation. The Tibetan classic «Four Tantras» (Mongolian translation «Дөрвөн үндэс») spread widely across Mongolian regions. Monastery medical colleges (манба дацаг) trained physicians, and the framework of three roots, seven tissues and three wastes took shape, bringing chronic disease into the domain of pattern-based treatment.
18th century — foundation. Yeshe Balkhir (1704—1788) wrote «Амритын дөрвөн чуулган» (Four Tantras of Nectar), refining the three-roots doctrine and giving Mongolian medicine a theoretical system independent of Tibetan medicine. From then on the internal-medicine approach to chronic metabolic conditions driven by excess Badgan and weak digestive fire was essentially settled.
19th century — mature pharmacology. Jambaldorji (1792—1855) completed «Монгол эмийн зүй» (Mongolian Materia Medica), documenting more than 800 steppe medicinals with hand-drawn plates, while «Жорын далай» (Ocean of Formulas) gathered tens of thousands of prescriptions. Most formulas used in Mongolian clinics today trace their logic to these two works.
20th century to now — discipline and integration. Mongolian medicine entered universities and hospitals, and Mongolian internal medicine textbooks list diabetes as a distinct disease entity. Mongolian medicine and pharmacology were inscribed on the national intangible cultural heritage list of China in 2008. The Inner Mongolia International Mongolian Medicine Hospital in Hohhot runs Mongolian internal medicine and endocrine-related specialty clinics. Mongolia rebuilt traditional-medicine education from the 1990s, established a national centre for traditional medicine and opened traditional-integrative outpatient services in some general hospitals.

To be accurate: ancient Mongolian texts contain no disease name "diabetes". The modern clinical framework — wasting-thirst pattern, three-roots differentiation, constitutional treatment — is a re-reading of traditional theory informed by present-day understanding of diabetes. That is both its limitation and the reason it can hold a conversation with modern medicine.

2. Theory: how Mongolian medicine explains the picture

Physiology rests on the three roots: Хий (wind, governing movement and nerve activity; cold and mobile), Шар (bile, governing heat and metabolic transformation; hot), and Бадган (phlegm, governing stability and fluids; cold and heavy). When they cooperate, the seven tissue principles are nourished and the three wastes (sweat, urine, faeces) are eliminated.

The chain of explanation runs roughly as follows:

Triggers: long-term overconsumption of rich, sweet and greasy food and alcohol, physical inactivity, exposure to cold, and emotional disturbance that agitates Хий.
First link — weakened digestive fire. The transformative heat (governed by Шар) falls short, so the essence of food is not properly converted; immature nutritive essence and metabolic turbidity accumulate.
Second link — Badgan and Шар combine. Excess Badgan makes the body heavy and metabolism sluggish; turbidity enters blood, muscle and fat, obstructing further transformation. The classical image is "nutritive essence escaping with the urine" — the traditional explanation of sweet urine.
Third link — Хий leaves its place. Once fluids are consumed, Хий becomes erratic: thirst with large intake of water, wasting, fatigue, insomnia, burning sensations in the hands and feet, restlessness.

Clinically three patterns are described, often mixed: Шар-dominant (marked hunger, bitter taste, heat intolerance, irritability), Хий-dominant (dry mouth with heavy drinking, prominent weight loss, insomnia, numbness), and Badgan-dominant (heaviness and drowsiness, poor appetite with bloating, puffiness, slow metabolism).

For orientation — as analogy, not equivalence: Chinese medicine groups the same manifestations into the three wasting-thirst patterns (upper: thirst, middle: hunger, lower: urination), while modern medicine explains them through insulin resistance, declining β-cell function and metabolic syndrome. The three vocabularies describe one long-term metabolic process, each with strengths: modern medicine quantifies risk and blocks damage; Mongolian medicine adjusts diet, daily rhythm, constitution and emotion as a whole.

3. Assessment: how a Mongolian physician evaluates the patient

Interview: diet composition (sugar, alcohol, meat, dairy tea), season and workload in pastoral life, daily rhythm, sleep and emotions, family history.
Urine observation: volume, colour, foam and smell. Historically, whether ants were attracted to the urine served as a clue to sweetness — a genuinely valuable observation before laboratory tests existed. Today it must be replaced by glucose and HbA1c measurements.
Tongue and pulse: a thick greasy or pale swollen coating suggests Badgan and damp turbidity; a thin rapid empty pulse suggests Хий and fluid depletion.
Constitution and season: the same glucose level is managed differently in a Badgan-type and a Хий-type patient, following the principle of adapting to time, place and person.

In a modern Mongolian-medicine clinic this assessment is paired with fasting and 2-hour post-meal glucose, HbA1c (a 2—3 month average), kidney function and urinary albumin, lipids, eye examination and foot examination. Mongolian diagnostics add a view of how the body is coping; they do not replace laboratory numbers.

4. Treatment: food, conduct, medicine, external therapy

Mongolian medicine traditionally steps up in order — diet first, then daily conduct, then medicines, and external therapy last. Applied to diabetes:

4.1 Dietary therapy&amp;amp;nbsp;

Cut or strongly restrict sugar and sweets, alcohol, greasy and fried food, and cold drinks.
Stop adding sugar to salted milk tea; keep dairy products within a sensible total calorie budget.
Portion-control roasted grain foods such as хайсан будаа (炒米): they raise blood glucose quickly and are the most overlooked carbohydrate source in a nomadic diet. Here modern nutrition and the Mongolian rule of "moderate rich food" reach the same conclusion.
Increase lean meat, fish, vegetables and coarse fibre; eat at set times and amounts; avoid late heavy dinners.

4.2 Conduct and daily rhythm (амьдралын хэв маяг)

Regular sleep and rest; staying up late agitates Хий.
Consistent activity — walking, riding, daily labour — which does not conflict with the modern target of 150 minutes of moderate exercise per week.
Weight and waist control; stop smoking and drinking.
Emotional stability: anxiety and anger are seen as disturbing Хий and worsening thirst and insomnia.

4.3 Herbal and formula medicine (эмчилгээ)

Mongolian pharmacology relies on compound formulas, commonly as pills (гарал), powders (тоосон) and decoctions, composed according to which of the three roots is out of balance and adjusted for season and constitution. For this group of conditions the therapeutic direction usually concerns clearing Шар heat, supporting digestive fire, generating fluids to relieve dryness, and securing fluids from loss, while addressing accompanying bloating, constipation or loose stools and insomnia.

It must be stated plainly: which formula and which dose can only be decided by a licensed Mongolian physician after an in-person examination. This article deliberately recommends no formula names or doses, because individualised pattern differentiation is the core of the practice. Likewise, any claim that a Mongolian remedy "replaces glucose-lowering drugs" or "cures diabetes in a few courses" should be treated as a warning sign. Some Mongolian medicines are multi-ingredient or mineral-based formulas, so liver and kidney function need monitoring during long-term use.

4.4 Traditional external therapies

External treatment mainly improves symptoms, circulation and quality of life — notably the numbness, pain, cold sensation and insomnia of diabetic peripheral neuropathy:

Manual therapy and massage (барианы эмчилгээ): releases neck, shoulder and back tension and improves limb circulation.
Cupping (хоолой тавих): dispels cold and moves qi, used for cold-damp pain and muscle strain.
Moxibustion (утлага): warms and disperses cold, used for cold-deficiency constitutions and chronic pain.
Medicated and mineral springs baths (эмийн банн): for joint and skin symptoms, with strictly controlled temperature and duration.
Needling (зүүний эмчилгээ): for pain, insomnia and some neurological symptoms.
Bloodletting (цус гаргах): an invasive procedure restricted to heat patterns and to be performed only in qualified facilities under aseptic conditions.

Special caution for people with diabetes: where protective sensation is reduced, moxibustion, cupping and hot baths easily cause burns and skin injury, and diabetic skin wounds heal poorly with a real risk of infection and gangrene. Temperature and duration must be controlled by the physician in person; do not perform hot baths, moxibustion or cupping at home. Never apply external therapy to an area with ulceration, infection or severe arterial disease. Bloodletting and needling require strict asepsis, and patients on anticoagulants must disclose this beforehand.

5. Combining Mongolian medicine with modern medicine

A workable combination is not either/or but division of labour by layer: modern medicine owns targets and damage control, Mongolian medicine supports whole-person regulation and symptom relief.

Layer	Modern medicine	What Mongolian medicine can add	Integration cautions
Lifestyle	Medical nutrition therapy, 150 minutes of moderate activity weekly, weight and waist management	Dietary and conduct therapy: moderate rich, sweet and alcoholic food, regular meals and sleep, emotional care	Goals align; merge them into one practical schedule and avoid extreme dieting on both sides at once
Monitoring	Fasting and post-meal glucose, HbA1c every 3 months, continuous glucose monitoring when needed	Tongue, urine and pulse assessment plus constitution and seasonal review	Mongolian assessment cannot replace a glucometer. Never reduce medication because you feel well
Glucose-lowering drugs	Metformin as the base, then other oral agents, GLP-1 receptor agonists or insulin per guidelines	Compound formulas as an adjunct for digestion, sleep, fatigue and accompanying symptoms	Disclose every medicine you take to both physicians; formulas must not substitute for glucose-lowering drugs; watch for additive hypoglycaemia
Chronic complications	Retina screening, urinary albumin, foot and vascular assessment, blood pressure and lipid control	External therapy for numbness, pain and sleep; constitutional care for stamina	Ulcer, infection, sudden vision loss or chest pain are modern medical emergencies — go at once; no external therapy on the affected site
Adherence and follow-up	Structured recall, education, psychological support	A constitutional and seasonal explanation that many pastoral patients accept readily, helping them stay the course	Set shared review points every 4—8 weeks and judge the plan by glucose data, not by feeling

Practical checklist for combined care:

Prepare one complete file: laboratory results from the last 3—6 months including HbA1c, a list with packaging of everything you take (supplements and Mongolian or Chinese herbal medicines included), previous records and imaging discs.
Start with endocrinology to confirm diagnosis, type and the backbone of treatment, then see Mongolian internal medicine for constitutional and symptom care — or choose a hospital with a joint Mongolian medicine and endocrine clinic.
Put Mongolian medicines on the medication list so both physicians see them, and ask whether they may add to the glucose-lowering effect.
Test more often when a new element is introduced: over the first 1—2 weeks, add fasting and post-meal readings and keep a log.
Re-evaluate every 4—8 weeks using HbA1c, weight and symptom change to decide whether to continue, adjust or stop the Mongolian part.
Never stop glucose-lowering drugs or insulin on your own; avoid homemade pills, medicated wines or mineral medicines of unclear origin or labelling.

State of the evidence: research on Mongolian formulas for glucose metabolism is dominated by animal studies and small clinical observations; large randomised controlled trials do not support replacing standard glucose-lowering therapy with Mongolian medicine. The realistic value in diabetes care lies in structured diet and lifestyle adjustment, symptom and quality-of-life improvement, and better adherence to long-term follow-up. The sound position is: guideline-based glucose treatment as the backbone, Mongolian care as support, with glucose data always deciding.

6. Safety limits: seek modern medical care immediately when

You have diabetes but are stopping or sharply reducing glucose-lowering drugs or insulin, or abandoning standard treatment after claims of a cure.
Recurrent hypoglycaemia: palpitations, sweating, trembling, hunger, confusion. Weekly or nocturnal episodes need prompt regimen review — take extra care while adding Mongolian medicines.
Hyperglycaemic emergency signs: severe thirst and polyuria with vomiting, abdominal pain, deep rapid breathing, fruity breath, drowsiness or confusion (ketoacidosis or hyperosmolar state) — emergency department now.
Foot problems: any wound, blister, ulcer, colour change or blackening should be seen in a modern medical clinic within 24 hours.
Sudden vision decline, field loss or floaters — possible retinal bleeding; urgent eye assessment.
Chest pain, breathlessness on exertion, one-sided weakness — possible cardiovascular or cerebrovascular event; call emergency services.
Pregnancy or breastfeeding, children and adolescents, type 1 diabetes, serious liver or kidney impairment: no self-directed Mongolian medication or external therapy; adjunctive care only under specialist supervision.
You take anticoagulant or antiplatelet drugs — tell the physician before bloodletting or needling.

7. Practical route for Mongolian patients coming to China

Where: institutions such as the Inner Mongolia International Mongolian Medicine Hospital in Hohhot run Mongolian internal medicine and endocrine-related outpatient services that combine Mongolian pattern diagnosis with modern laboratory work. If disease is advanced or complications exist, book an endocrinology appointment as well.
Before travelling: bring originals of recent laboratory and imaging reports (translated into Chinese or English if possible), your medication list, passport and visa documents. Visa steps and required documents are covered in our medical travel guide.
Language: Mongolian diagnosis depends heavily on precise description of diet, daily habits and symptoms, so a Mongolian—Chinese speaking escort is strongly advised; imprecise description weakens pattern differentiation. See consultation and escort services.
Time needed: the first visit usually combines laboratory tests with Mongolian assessment and most tests finish the same day; external therapies such as medicated bath, massage, cupping or moxibustion run over several sessions, so plan for 7—14 days. Public price structure is on fee standards.
Prepare a written summary: how many times you urinate at night, weight change over months, and every medicine you currently take. This shortens consultation markedly.
After returning home: give your local physician the treatment plan, laboratory results and medication list for continued monitoring. Do not maintain long-term self-medication with Mongolian products bought online.

References and further reading

Classics of Mongolian medicine: «Амритын дөрвөн чуулган» (Four Tantras of Nectar, Yeshe Balkhir, 18th century), «Монгол эмийн зүй» (Mongolian Materia Medica, Jambaldorji, 19th century), «Жорын далай» (Ocean of Formulas), and the Mongolian translation of the Tibetan «Дөрвөн үндэс» (Four Tantras).
«Yinshan zhengyao» (饮膳正要, 1330) by Hu Sihui, Yuan dynasty court dietician — the emblematic text where steppe food wisdom meets Chinese dietary therapy.
Chinese Diabetes Society guidelines for the prevention and treatment of type 2 diabetes (recent edition) — the authority on diagnostic thresholds, drug pathways and complication screening.
WHO Traditional Medicine Strategy — principles for integrating traditional medicine into modern health systems, including evidence and safety requirements.
On this site: disease library, fee standards, medical travel guide.

Disclaimer: this article is health education and travel-reference information. It is not individualised medical advice and cannot replace in-person examination, testing and prescription by a licensed physician. Any change to medication, external therapy or your glucose-lowering regimen should be made under joint guidance from an endocrinologist and a licensed Mongolian physician.