The Effect of Bloodletting Therapy on Lipid Metabolism and Glucose Control in Type 2 Diabetes: A Case Report

Trends in Immunotherapy

Article

The Effect of Bloodletting Therapy on Lipid Metabolism and Glucose Control in Type 2 Diabetes: A Case Report

Downloads

https://doi.org/10.54963/ti.v10i1.1416
Tserentogtokh Baasantogtokh, Seesregdorj Surenjid, Sainbileg Sonomtseren, Tsolmon Unurjargal, Wei-Ti Chen, Nominerdene Ulambayar, & Enkhtuya Vankhuu. (2026). The Effect of Bloodletting Therapy on Lipid Metabolism and Glucose Control in Type 2 Diabetes: A Case Report. Trends in Immunotherapy, 10(1), 95–101. https://doi.org/10.54963/ti.v10i1.1416
Volume 10, Issue 1 (March 2026): In Progress
Copyright (c) 2026 Tserentogtokh Baasantogtokh, Seesregdorj Surenjid, Sainbileg Sonomtseren, Tsolmon Unurjargal, Wei-Ti Chen, Nominerdene Ulambayar, Enkhtuya Vankhuu
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright

The authors shall retain the copyright of their work but allow the Publisher to publish, copy, distribute, and convey the work.

License

Trends in Immunotherapy (TI)  publishes accepted manuscripts under Creative Commons Attribution 4.0 International (CC BY 4.0). Authors who submit their papers for publication by TI agree to have the CC BY 4.0 license applied to their work, and that anyone is allowed to reuse the article or part of it free of charge for any purpose, including commercial use. As long as the author and original source are properly cited, anyone may copy, redistribute, reuse, and transform the content.

Authors

  • Tserentogtokh Baasantogtokh

    International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia
  • Seesregdorj Surenjid

    International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia
  • Sainbileg Sonomtseren

    School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia
  • Tsolmon Unurjargal

    School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia
  • Wei-Ti Chen

    Joe C. Wen School of Nursing, University of California, Los Angeles, CA 90095, USA
  • Nominerdene Ulambayar

    International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia
  • Enkhtuya Vankhuu

    International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia

Received: 17 July 2025; Revised: 10 September 2025; Accepted: 24 September 2025; Published: 23 January 2026

Type 2 diabetes mellitus (T2DM) is a pervasive chronic metabolic disorder characterized by insulin resistance and hyperglycemia. While conventional treatments exist, there is groqing interest in complementary and alternative therapies, particularyl for patients with poorly controlled disease. . Among these, bloodletting therapy of Traditional Mongolian medicine (TMM) has historical roots, yet it lacks robust scientific evaluation. This case report presents a 42-year-old male with uncontrolled T2DM and concomitant dyslipidemia, who demonstrated poor adherence to standard glucose-lowering medications. The therapeutic intervention involved a traditional Mongolian medicine protocol, commencing with a 5-day preparatpry regimen of an herbal blood-thinning decoction. This was followed by th bloodletting procedure itself, with no conventional anti-diabetic medications administered during the entire intervention period. This outcomes observed over 90-day follow-up were notably substantial. The patient’s metabolic parameters demonstrated framatic improvements: fasting glucose decreased from 13.89 to 5.77 mmol/L, and glycated hemoglobin (HbA1c) fell from 7.31% to 6.05%. Significant enhancements were also recorded in lipid metabolism, with cholesterol  and triglyceride levels dropping from 6.1 to 4.65 mmol/L and from 8.35 to 2.43 mmol/L), respectively. Furthermore, the patient exhibited considerable reductions in body mass index (from 35.7 to 29.5 kg/m²), and blood pressure (140/90 to 130/85 mmHg), no serious adverse events reported. In conclution, the combination of traditional Mongolian bloodletting and an herbal decoction was associated with clinically meaningful improvements in glycemic control, lipid profile, and overall metabolic balance in this refractory uncontrolled T2DM case. These promising findings suggest potential immunometabolic benefits; however, rigorous controlled studies are imperative to definitively confirm its efficacy, safety, and the underlying mechanisms of action.

Keywords:

Type 2 Diabetes Mellitus Bloodletting Therapy Mongolian Medicine Immunomodulation Case Report

References

  1. Zheng, Y.; Ley, S.H.; Hu, F.B. Global Aetiology and Epidemiology of Type 2 Diabetes Mellitus and Its Complications. Nat. Rev. Endocrinol. 2018, 14, 88–98.
  2. Petersen, K.F.; Dufour, S.; Mehal, W.Z.; et al. Glucagon Promotes Increased Hepatic Mitochondrial Oxidation and Pyruvate Carboxylase Flux in Humans with Fatty Liver Disease. Cell Metab. 2024, 36, 2359–2366.
  3. Louie, J.Z.; Shiffman, D.; Rowland, C.M.; et al. Predictors of Lack of Glycemic Control in Persons with Type 2 Diabetes. Clin. Diabetes Endocrinol. 2024, 10, 2.
  4. Dayan, A.; Erkhembayar, R.; Luvsandavaajav, O.; et al. Prevalence of Type 2 Diabetes in Mongolia: Results from Population-Based Survey Compared with 1999 Study. Diabetes Metab. Syndr. Obes. 2023, 16, 1833–1846.
  5. Chimed-Ochir, O.; Delgermaa, V.; Takahashi, K.; et al. Mongolia Health Situation: Based on the Global Burden of Disease Study 2019. BMC Public Health 2022, 22, 5.
  6. Association, A.D. Economic Costs of Diabetes in the US in 2017. Diabetes Care 2018, 41, 917–928.
  7. Misheel, G.; Gantugs, Y. Result of the Study of Cost Estimates for Individuals with Type 2 Diabetes. J. Health Sci. 2024, 3, 140–144. (in Mongolian)
  8. Blériot, C.; Dalmas, E.; Ginhoux, F.; et al. Inflammatory and Immune Etiology of Type 2 Diabetes. Trends Immunol. 2023, 44, 101–109.
  9. Chavakis, T.; Alexaki, V.I.; Ferrante Jr, A.W. Macrophage Function in Adipose Tissue Homeostasis and Metabolic Inflammation. Nat. Immunol. 2023, 24, 757–766.
  10. Mahmoud, M.; Abdel-Rasheed, M. Influence of Type 2 Diabetes and Obesity on Adipose Mesenchymal Stem/Stromal Cell Immunoregulation. Cell Tissue Res. 2023, 394, 33–53.
  11. Fei, Q.; Huang, J.; He, Y.; et al. Immunometabolic Interactions in Obesity: Implications for Therapeutic Strategies. Biomedicines 2025, 13, 1429.
  12. Guo, Q.; Jin, Y.; Chen, X.; et al. NF-κB in Biology and Targeted Therapy: New Insights and Translational Implications. Signal Transduct. Target. Ther. 2024, 9, 53.
  13. Hou, G.; Dong, Y.; Jiang, Y.; et al. Immune Inflammation and Metabolic Interactions in the Pathogenesis of Diabetic Nephropathy. Front. Endocrinol. 2025, 16, 1602594.
  14. Lainé, F.; Ruivard, M.; Loustaud-Ratti, V.; et al. Metabolic and Hepatic Effects of Bloodletting in Dysmetabolic Iron Overload Syndrome: A Randomized Controlled Study in 274 Patients. Hepatology 2017, 65, 465–474.
  15. Casanova-Esteban, P.; Guiral, N.; Andrés, E.; et al. Effect of Phlebotomy on Lipid Metabolism in Subjects with Hereditary Hemochromatosis. Metabolism 2011, 60, 830–834.
  16. Fernández-Real, J.M.; Peñarroja, G.; Castro, A.; et al. Blood Letting in High-Ferritin Type 2 Diabetes: Effects on Insulin Sensitivity and β-Cell Function. Diabetes 2002, 51, 1000–1004.
  17. Gyamtso, D.S. Blue Beryl (Blue Sapphire); Inner Mongolia People’s Press Committee: Hohhot, China, 1990; pp. 1–80. (in Mongolian)
  18. Tserendagva, D.; Tumurbaatar, N.; Ambaga, M.; et al. Essence and Waste Product Secretion Pattern, Impure Blood, Blood Secretion Decoction (Tang) and Their Correlation; Munkhiin Useg.: Ulaanbaatar, Mongolia, 2019. (in Mongolian)
  19. MOH. Clinical Practice Guidelines for Bloodletting Treatment, in Order of Health Minister A/152; Ministry of Health: Ulaanbaatar, Mongolia, 2021. (in Mongolian)
  20. Miller, B.R.; Nguyen, H.; Hu, C.J.H.; et al. New and Emerging Drugs and Targets for Type 2 Diabetes: Reviewing the Evidence. Am. Health Drug Benefits 2014, 7, 452.
  21. Akbari, M.; Hassan-Zadeh, V. IL-6 Signalling Pathways and the Development of Type 2 Diabetes. Inflammopharmacology 2018, 26, 685–698.
  22. Tilg, H.; Moschen, A.R. Inflammatory Mechanisms in the Regulation of Insulin Resistance. Mol. Med. 2008, 14, 222–231.
  23. Marku, A.; Galli, A.; Marciani, P.; et al. Iron Metabolism in Pancreatic Beta-Cell Function and Dysfunction. Cells 2021, 10, 2841.
  24. Backe, M.B.; Moen, I.W.; Ellervik, C.; et al. Iron Regulation of Pancreatic Beta-Cell Functions and Oxidative Stress. Annu. Rev. Nutr. 2016, 36, 241–273.
  25. Chen, Y.; Lei, K.; Liu, Y.; et al. Metabolic Dysfunction-Associated Steatotic Liver Disease: From a Very Low-Density Lipoprotein Perspective. Biomolecules 2025, 15, 990.
  26. Clyne, A.M. Endothelial Response to Glucose: Dysfunction, Metabolism, and Transport. Biochem. Soc. Trans. 2021, 49, 313–325.
  27. Dijkstra, A.; Lenters-Westra, E.; de Kort, W.; et al. Whole Blood Donation Affects the Interpretation of Hemoglobin A1c. PLoS One 2017, 12, e0170802.
  28. Greenstone, G. The History of Bloodletting. BC Med. J. 2010, 52, 12–14.
  29. Bai, L.; Fu, M. Traditional Mongolian Medicine: Past, Present, and Future. Chin. Herb. Med. 2022, 14, 343–344.
  30. Dulan; Bagenna; Wang, H.; et al. Famous Traditional Mongolian Medicine Xieriga-4 (Turmeric-4) Decoction: A Review. Chin. Herb. Med. 2022, 14, 385–391.