The understanding of the pathogenesis of diabetic heart disease（DHD） in traditional Chinese medicine（TCM） is changing constantly. Through analyzing the historical origin and the modern achievements

it is considered that the pathological characteristics of "deficiency"

"heat" and "stasis" in diabetes mellitus are the basis for interpreting the pathogenesis of DHD. Deficiency of qi and yin

binding of phlegm and stasis and heart collateral obstruction are the basic pathogenesis

of which deficiency of qi and yin is the initiating factor for the formation of DHD; binding of phlegm and stasis is closely related to the development of the disease; and heart collateral obstruction is the manifestation. The classical pathogenesis theories

such as "yin fire"

"shaoyin（少阴） pivot"

"latent pathogen" and "turbid pathogen"

are of great significance to the prevention and treatment of DHD. From the TCM pathogenesis

certain scientific issues need to be further explored

including the moving-forward of threshold for DHD prevention

the establishment of individualized therapeutic effect evaluation methods

and the construction of a new research model to combine the disease and syndrome.