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REVIEW article

Front. Nutr.

Sec. Nutrition and Metabolism

This article is part of the Research TopicNatural Products: A Microecological Perspective for Treating Diabetes and its ComplicationsView all 6 articles

Emerging roles of Traditional Chinese Medicine in the Treatment of Diabetic Gastroparesis

Provisionally accepted
Hong  ZhangHong Zhang1*Qianhui  YouQianhui You2Xiaohong  FengXiaohong Feng1Zhengran  QinZhengran Qin1
  • 1First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
  • 2Shanghai University of Traditional Chinese Medicine, Shanghai, China

The final, formatted version of the article will be published soon.

Diabetic gastroparesis (DGP), a prevalent manifestation of diabetic autonomic neuropathy, is characterized by impaired gastrointestinal motility and delayed emptying. The pathogenesis of DGP is multifactorial, with chronic hyperglycemia serving as a key contributor through its induction of oxidative stress, inflammatory responses, immune dysregulation, and gut microbiota imbalance. These pathological processes collectively induce injury to interstitial cells of Cajal (ICCs) and gastric smooth muscle cells (GSMCs), accompanied by neuromuscular dysfunction, ultimately resulting in gastroparesis and its associated clinical symptoms. In the management of DGP, traditional Chinese medicine (TCM) offers distinct advantages, including demonstrated efficacy, favorable safety profiles, personalized treatment approaches, excellent patient tolerance, diverse dosage forms, and multi-target therapeutic effects. While the precise mechanisms remain to be fully elucidated, emerging evidence suggests that TCM may exert its beneficial effects through the protection of ICCs and GSMCs, modulation of brain-gut peptide dysregulation and neuropathy, regulation of inflammatory and immune responses, attenuation of oxidative stress, and restoration of gut microbiota homeostasis. Notably, current evidence supporting TCM for DGP leans on preclinical data with a focus on positive outcomes, whereas clinical evidence is sparse and largely limited to Chinese cohorts, reflecting the need for more clinical data and multi-cohort studies. This review comprehensively summarizes recent advances in understanding the mechanisms underlying TCM-mediated prevention and treatment of DGP, intending to provide a scientific foundation for expanding the clinical application of TCM in DGP management.

Keywords: Traditional Chinese Medicine, Diabetic gastroparesis, Therapeutic agent, Interstitial Cells of Cajal, Oxidative Stress, Gut microbiota homeostasis

Received: 06 Aug 2025; Accepted: 31 Oct 2025.

Copyright: © 2025 Zhang, You, Feng and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hong Zhang, 15168281297@126.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.