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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2025; 16(11): 112171
Published online Nov 15, 2025. doi: 10.4239/wjd.v16.i11.112171
Published online Nov 15, 2025. doi: 10.4239/wjd.v16.i11.112171
Real-world evidence for herbal medicine benefit in 9728 type 2 diabetes patients-peridonotitis risk and ambulatory care utilization
Wen-Wei Lin, Wei-Jen Chen, Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 333325, Taiwan
Chieh-Tsung Yen, Department of Neurology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
Hanoch Livneh, Rehabilitation Counseling Program, Portland State University, Portland, OR 97207, United States
Hua-Lung Huang, Department of Rehabilitation, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
Ming-Chi Lu, School of Medicine, Tzu Chi University, Hualien 97050, Taiwan
Ming-Chi Lu, Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin Township, Chiayi 62247, Taiwan
Wei-Jen Chen, School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 97050, Taiwan
Wei-Jen Chen, Center of Sports Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
Tzung-Yi Tsai, Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
Tzung-Yi Tsai, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
Co-corresponding authors: Wei-Jen Chen and Tzung-Yi Tsai.
Author contributions: Lin WW, Livneh H, Yen CT, and Tsai TY were involved in the study design and drafted the manuscript; Huang HL, Chen WJ and Tsai TY contributed to data analysis and revised the manuscript; Lin WW, Livneh H, Yen CT, Huang HL, Chen WJ and Tsai TY contributed to the interpretation of data and provided comments on the final draft of the manuscript; Lu MC provided administrative support along with revision of the study; all authors gave final approval to the version to be published and agree to be accountable for all aspects of the work; Lin WW, Huang HL and Yen CT contributed equally to this work; Chen WJ and Tsai TY contributed equally to this work as co-corresponding authors.
Institutional review board statement: Given the anonymization of all personal identifiers in the database, the Institutional Review Board of Buddhist Dalin Tzu Chi Hospital confirmed that this study met the exemption criteria for full review (No. B10802014). This study was also conducted in accordance with the guidelines of the Helsinki Declaration.
Informed consent statement: As all analytical data used in this work were anonymized, the Institutional Review Board of Buddhist Dalin Tzu Chi Hospital confirmed that this study was exempt from full review along with the need for informed consent in this study.
Conflict-of-interest statement: The author(s) report no conflicts of interest in this work.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Due to legal restrictions imposed by the government of Taiwan in relation to the “Personal Information Protection Act”, data cannot be made publicly available. Requests to access the datasets should be directed to the NHI administration and the corresponding authors.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tzung-Yi Tsai, PhD, Assistant Professor, Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2 Minsheng Road, Chiayi 62247, Taiwan. dm732024@tzuchi.com.tw
Received: July 21, 2025
Revised: September 10, 2025
Accepted: October 20, 2025
Published online: November 15, 2025
Processing time: 117 Days and 23.4 Hours
Revised: September 10, 2025
Accepted: October 20, 2025
Published online: November 15, 2025
Processing time: 117 Days and 23.4 Hours
Core Tip
Core Tip: As periodontitis is a common and frequently occurring condition following type 2 diabetes (T2D) onset and insidiously triples cardiorenal mortality in individuals with diabetes, we conducted a population-based cohort study to gain deeper insight into the relationship between medicinal herb use and incident periodontitis. In this study, adding medicinal herbs to routine care for more than 2 years benefited T2D individuals by lowering periodontitis risk as much as 52%; moreover, this approach substantially reduced the subsequent use of periodontitis-related ambulatory services, underscoring the increasing importance of interdisciplinary healthcare.