The disease is closely related to the advance of age, obesity, reduction of physical labor and the habit of taking food of high caloric, high fat and high protein. Its basic physiopathologic changes are caused by the absolute or relative insufficiency of insulin secretion, leading to metabolic disturbance of carbohydrate, protein, fat, water and electrolyte, and even the acid-base imbalance in severe cases.

According to its clinical manifestations, diabetes is categorized in TCM as "xiao ke" or "xiao dan", both of which mean diabetes. It is attributed to yin-deficiency diathesis, improper diet, emotional disorders, overstrain and excessive sexual activities. The main pathogenesis lies in consumption of yin fluid leading to endogenous dryness-heat in the body, with yin deficiency as the principal aspect and dryness-heat as the secondary aspect, and often with the presence of blood stasis and phlegm retention. If prolonged yin deficiency impairs yang, this will result in deficiency of both yin and yang as well as deficiency of both qi and yin.