The prevalence of diabetes mellitus in China has increased from <1% in 1980 to 13.7% in 2023, parallel to the adoption of a Western-style diet. Chinese medicine (CM) approaches diabetes differently through food therapy, which is more holistic than the reductionist focusing on the bioactive compounds found in modern nutritional science. Herein, we review the CM and modern nutritional approaches to diabetes of five regional Chinese cuisines: Sichuan, Cantonese, Shandong, Hunan, and Jiangsu. A literature review of PubMed, Web of Science, China National Knowledge Infrastructure, and other medicine-specific databases was conducted, including papers from 2014 to 2024 and foundational CM literature. The inclusion criteria were systematic reviews, clinical trials, population studies, and mechanistic studies of Chinese dietary patterns and diabetes outcomes. In several studies, CM food therapy demonstrated clinical outcomes comparable to those of Western dietary interventions, with the added advantage of fewer reported adverse effects. CM food therapy operates through five main mechanisms: glucose transport enhancement, glycogen metabolism improvement, glucagon-like peptide 1 secretion promotion, pancreatic islet protection, and intestinal flora modulation. Regional Chinese cuisine contains many bioactive compounds with established anti-diabetic effects. Sichuan capsaicin enhances insulin sensitivity by activating the AMP-activated protein kinase pathway. The fermented components of Hunan cuisine support gut microbiota; fresh food preparations of Cantonese cuisine are rich in antioxidants; and traditional dietary patterns are more protective against diabetes than Westernized dietary patterns. A combined approach of CM and Western medicine offers the best potential for managing diabetes, as the cuisine from each area has distinct therapeutic value. Blending age-old food therapy with contemporary nutrition provides a rational basis for clinical integration.

Generative artificial intelligence (AI), specifically large language models, such as DeepSeek, has accelerated the digital transformation of healthcare systems in both developing and developed countries. The use of AI in diagnostics, image processing and interpretation, treatment personalization, clinical documentation, and drug discovery is an example of the implementation of AI in Western medicine. The need for evidence-based studies and a standardized approach to scientific medicine aligns well with these applications. AI can leave a lasting impact on the Chinese medicine (CM) landscape by increasing expectations and presenting new challenges. The analogy between the CM-specific diagnostic methods and pattern differentiation, which is holistic, pattern-oriented, patient-centered, and clinical data analysis, is significant at multiple levels. These qualities pose challenges for AI usage in CM, which heavily relies on structured data and pattern recognition. Despite these adversities, AI can still be used in CM through data standardization, prediction formulation, and treatment planning, provided that the integration of this tool considers the primary principles of CM and adheres to ethical and regulatory considerations. This review examines the dichotomous approach to health and medicine in the contexts of AI and CM, highlighting the evolving potential, inherent limitations, and ethical and regulatory issues associated with the application of AI to CM. It provides a foundation for developing technologically progressive yet culturally and philosophically sensitive strategies that are in harmony with traditional clinical values.

In recent years, the gut microbiota has become an integral research topic in human health owing to its impact on digestion, immunity, metabolic processes, and mental health. The possibilities of microbiome treatment have increased interest in dietary approaches, with a special focus on the intake of fermented foods. This has revived some of the most profound and practical constructs derived from food therapy in Chinese medicine (CM), where food therapy, along with fermented options, actively preserves health and prevents disease. In CM, the spleen and stomach system refers to the postnatal foundation of the body, which controls the processes of chewing, nutrient assimilation, and energy production (qi). The balance between intestinal and overall health is the foundation of psychosomatic well-being and is of utmost importance. Fermented foods can boost the spleen, alleviate stagnant food syndrome, dispel excess fluids, enhance protective functions, and strengthen the immune system. This review aimed to integrate the conceptual and clinical paradigms of CM with those of Western medicine, focusing on the role of fermented foods in gut microbiota regulation. This article discusses prominent fermented foods in CM and their classical functions, alongside the currently available peer-reviewed literature (published within the last 7 years) on their impact on gut flora and other clinical outcomes. Mechanistic considerations regarding the production of probiotics and other active metabolites, such as short-chain fatty acids, and the modulation of the intestinal barrier are discussed. This review also examines multidisciplinary approaches to dietary customs worldwide and outlines the clinical applications of these findings in the context of chronic disease management and gastrointestinal health.