Chinese herbal medicine is generally considered safe. If used properly, it can treat type 2 diabetes, which is supported by long-term clinical practice. However, all drugs have certain risks, and Chinese herbal medicine is no exception. The adverse reactions of Traditional Chinese Medicine for Diabetes may be due to incorrect prescription, excessive dosage, improper preparation, wrong substitution, incorporation of western medicine, inherent toxicity or pollutants.

However, there is a lack of universally referenced scientific evidence to evaluate the safety of this intervention measure, and there is also insufficient data related to adverse reactions of traditional Chinese medicine.

In addition, the chemical composition of Chinese herbal medicine is more complex than that of Western medicine, with each formula typically containing several herbs, and each herb typically contains multiple potential active ingredients.

Overall completeness and applicability of evidence

In all the included studies, there are three main intervention methods for type 2 diabetes: drug treatment, Chinese herbal medicine and lifestyle (diet and exercise) control. In this review, all these treatments were included in the analysis. The results indicate that the combination of Chinese herbal medicine and other interventions (dietary control, exercise therapy, and medication) is more effective than medication, but there are major limitations (selection bias in patient recruitment). Most clinical trials are not well designed, and due to limited information reported in the study, the overall quality of the study is difficult to determine.

Overall, the quality of evidence is not satisfactory, and the risk of bias is still unclear due to insufficient available information in most of the included studies. Most participants come from the Chinese population and are recruited from traditional Chinese medicine hospitals, which may affect the applicability of intervention measures to other populations. This is the main source of prejudice.