Traditional Chinese medicine use and risk of type 2 diabetes mellitus among patients with prediabetes: a population-based cohort study.

Background: Prediabetes was a reversible process in the development of type 2 diabetes mellitus (T2DM). Traditional Chinese medicine (TCM) was used to regulate blood glucose for thousands of years. However, there was a lack of real-world evidence on the long-term impact of TCM in prediabetic populations. This study aimed to evaluate the association between the use of TCM and T2DM incidence among individuals with prediabetes.

Methods: A long-term population-based cohort study of participants with prediabetes was conducted using the Yinzhou Regional Health Care Database (YRHCD). A cox model with propensity score (PS) matching was applied to estimate the hazard ratio (HR) of the association between the use of TCM and T2DM. Various subgroup analyses and multiple sensitivity analyses were also performed to demonstrate the robustness of results.

Results: A total of 14,164 patients with prediabetes were included from the YRHCD between 2009 and 2024, among whom 12,252 participants were TCM users and 1912 initiated western medications (WM). In the primary analysis, the incidence of T2DM was 33.95 and 94.85 per 1000 person-years in users of TCM and WM, respectively. TCM use was associated with a significantly lower risk of developing T2DM (HR 0.32 [95%CI 0.27, 0.38]) after controlling confounding using PS matching. The results were generally consistent in various subgroup analyses and sensitivity analyses.

Conclusion: Use of TCM was associated with a decreased T2DM incidence in patients with prediabetes in the study region.