Abstract
Regulatory T cells (Tregs) are essential for immune tolerance, and their dysfunction is implicated in diabetes mellitus (DM) and its complications. This review examines the role of Tregs in type 1 and type 2 diabetes (T1DM, T2DM) and the potential of traditional Chinese medicine (TCM) in modulating Treg responses. Tregs contribute to β-cell autoimmunity in T1DM, inflammation and insulin resistance in T2DM, and complications such as nephropathy and vasculopathy. Recent studies show that TCM-derived compounds, including polysaccharides, flavonoids, and alkaloids, enhance Treg function, restore Treg/Th17 balance, and improve immune homeostasis. Tregs are a key link between immune regulation and metabolic dysfunction. TCM offers promising strategies for Treg-targeted immunomodulation, supporting integrative approaches to the prevention and treatment of DM and related immune disorders.