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Ayurvedic Treatment of Diabetes | Management of Diabetes Mellitus | Prevalence of Diabetes Mellitus

Updated: Dec 14, 2021

Ayurvedic System of Medicine clearly defines this disease and its line of treatment. Diabetes Mellitus is known to Indians from the Vedic period as Asrava (Prameha). Diabetes is known as Madhumeha in Ayurveda.

Ayurvedic System of Medicine clearly defines this disease and its line of treatment. Diabetes Mellitus is known to Indians from Vedic period as Asrava (Prameha). Diabetes is known as Madhumeha in Ayurveda.

According to Ayurveda, Prameha is classified into 4 major types, again subdivided into 21 divisions.

1. Kapha type (again divided into 10 types)

2. Pitta type (again divided into 6 types)

3. Vata type (divided into 4 types)

4. Juvenile diabetes for children (for unhealthy practices of parents and/or due to the sins of past-birth).

This study evaluates the efficacy of Classical and Traditional Ayurvedic line of treatment in the above different Diabetes types.


Madhumeha:-

  • Charak has included “Madhumeha” under vataja type of prameha.

  • Acharya Sushrut has used the term kshaudra to donate the same. In fact, Meha, Madhu & kshaudra are synonyms of Honey.

  • Ashtang Sangrah has defined “Madhumeha” as the disease where in the patient passes urine with sugar, which possesses of mainly madhura rasa along with kasaya rasa as Anurasa.

  • Vagbhatta has defined in different ways. “Madhumeha can be differentiated from Ikshu & Sheeta Meha on the basis of Hyperlipidaemia & Glucosuria”.

  • Madhumeha can be equated with modern Diabetes Mellitus, a combination of Greek & Latin term DIA- through + BAINEIN TO + MELLITUS- sweetened with Honey

  • Diabetes in the Greek word signified “Siphon”.


Ayurvedic Management of Diabetes Mellitus:-

Introduction:-

Madhumeha which has been correlated with Diabetes Mellitus has become a global problem in spite of advances in modern science. India has been projected by WHO as the country with the fastest-growing population of Diabetic patients. It is estimated that between 1995 – 2025 diabetic patients in India will increase by 195%. It is maharoga (major disease) because it affects the most part of the body and every cell of the human physiology. The ancient Indian physicians described not only the sweetness of urine as one of the major symptoms but also the relationship of the disease with disturbance of the 5 sheaths of the body – annamaya kosha{Food sheath}, pranamaya kosha{Energy sheath}, manomaya kosha{Mind Sheath}, vijnana maya kosha{Intalectual Sheath} and anandamaya kosha{Bliss Sheath}. Other classical texts also describes prameha. The word prameha derived from the root mih sechane meaning watering that means a dilution of everything in the body not only urine).


Prevailing Diabetes Mellitus:-

  • Aim of treatment,

  • Relief of “Hyperglycaemic symptoms”.

  • Correction of “Hyperglycaemic, ketonuria, & Hyperlipidemia ”.

  • Establishment & maintenance of desirable body weight.

  • Avoidness of acute complications.

  • To obtain the best possible control on DM & therefore prevent delay the onset of long-term complications.


Line of treatment:-

1) Diet

2) Exercise

3) Drug (a) Oral Hyperglycaemic agents,

(b) Insulin


Etiology:-

The main causes of Prameha (diabetes) are lack of exercise and improper food habits and food intake which imbalance of ushna, snigdha and guru properties of RP for example, fish, curd. Foods that increase kapha, medas and mootra are the etiological factors for prameha.

Classification:-

For the management of this disease – prameha can be listed in two categories:

1) Apatarpana utaja prameha describing the lean diabetic and

2) Santarpana utaja prameha relating the obese diabetic.

Etiological classification of diabetic patients:-

1) According to Acharya Sushrut:- (Shu. Chi. 11/3.)

a) Sahaja prameha (congenital) - Hereditary

b) Apatyanimittaja prameha (due to overeating and poor habits) – Acquired.

2) The similar classification can be found in Bhela Samhita:-

1) Prakriti Prabhaavam

2) Narasya Swakritam

Constitutional classification:-

1) According to Charaka:- (Cha. Chi. 6/15.)

a) Sthula – Balvan(Obese)

b) Krista – Durbala(Asthenic)

Prognostic classification:-

Prameha can be classified into three groups based on Prognosis. (Cha. Chi. 6/56 & Cha. Chi. 6/7.)

1. Sadhya - curable

2. Yapya - Palliable

3. Asadhya – Incurable

  • Sadhya:- Patients who have been diagnosed very early in the onset of prameha Those who are sthoola[ obese] and the origin of their disease is in apathyaja [poor living habbits]

  • Yapya: Patients are categorized as having Pittaja prameha & certain types of kaphaja prameha. It is controllable with particular treatment.

  • Asadhya: It is the incurable prameha & inherited diabetes. Sahaja patients suffering from this variety are Krisha {lean}.

Dosha classification:-

Though prameha is a tridoshaja vyadhi, the relative predominance of any one dosha and dooshya enables Vataja, Pitaja and Kaphaja pramehas. These have further been classified into twenty sub-categories in all the three classics of Ayurveda. Kaphaja and Pittaja prameha have been sub-classified into ten types and six types respectively. These sixteen types have the physical characteristics of urine that are color, density, and volume depending upon the different gunas of Kapha and Pitta. Vataja prameha has been sub-classified into four types depending upon dhatu being excreted through urine.

The above 20 types are classified on the basis of color and physical characteristics of urine. They can also be correlated with systemic urological and nephrological conditions. The above theory is well described by all acharyas by general prodromal symptoms for all types of pramehas in which the sweetness of urine is a common and important symptom. In our practice, they are classified prameha according to dosha predominance like-

  1. Kapahja,

  2. Pittaja,

  3. Vataja,

  4. Kapha-pittaja,

  5. Kapha-vataja,

  6. Pitta-vataja, and

  7. Vata-pitta-kaphaja.

In these types sannipaata, kevala vataja, and some stages of Kapha-Vataja and Pitta-Pataja can be considered as IDDM, and others are considered as NIDDM.

Poorva Roopa:-

Prodromal Symptoms of prameha have been explained in detail by all the acharyas, especially in Brihatrayies.

They are as follows-

  1. Sweda Produced sweating

  2. Angagandham Foul smell of the body

  3. Anga shidhilatwam Looseness the body

  4. Sayyasna swapnasukhabhishangitwam Feeling of lethargy

  5. Hridayopadeham Feeling of something coated or heaviness of Hridaya

  6. Netropadeham Feeling of something coated on eyes

  7. Jhwopadeham Sensation of a coated tongue

  8. Shravanopadeham Feeling of coating on ears

  9. Anga ghanatwam Heaviness of body parts

  10. Keshathivridhi Excessive growth of hairs

  11. Nakhathivridhi Excessive growth of Nails

  12. Sheet priyatwam Affinity towards cold

  13. Gala shosham Dryness of throat

  14. Thalu shosham Dryness of palate

  15. Asya madhuryam Sweet taste in the mouth

  16. Karadaham Burning sensation of palms

  17. Pada daham Burning sensation of soles

  18. Mootra madhuryam Sweetness of urine

General Features:-

The characteristic features of all types of prameha are PRABHOOTA and AAVILA MOOTRATHA & MEDO DUSHTI LAKSHANAS - {excessive urination & turbidity in urine and symptoms of vitiated medodhatu.

Prameha upadravas {Complications of prameha}:-

Doshas are involved in pathogenesis of the disease. This may further complicate the problem and must be considered in the management of the original disease, which is called upadrava. An individual suffering from prameha usually seeks to doctor’s help when the complications have developed. Fatigue, excessive thirst, and excessive urination are some of the symptoms for which the diseased person approaches physicians. Acharya Sushruta has described prameha complications according to dosha predominance. Briha Thrayees have described prameha pidaka as a major complication of prameha. Acharya Sushruta has mentioned “Malabandhata” (constipation) as a commonly observed complication as the body of the diseased person is loaded with media hence they do not respond to common purgatives in usual doses. Modern Physiological theories attribute this complication to the involvement of the autonomous nervous system.

The following symptoms under each category of kaphaja, pittaja, and vataja describe the d