Diabetes
Diabetes mellitus (DM) is defined as a heterogeneous metabolic disorder characterized by a common feature of chronic hyperglycemia with disturbance of carbohydrate, fat and protein metabolism. Ayurvedic texts identify two main manifestations of diabetes: Prameha and Madhumeha. The word Prameha is composed of two sub words Pra and Meha, Pra means excess and Meha means to emit urine frequently. Prameha is a syndrome which includes all those clinical conditions which are characterized by increased quantity of urine associated with or without the increased frequency of micturition. It includes conditions resembling diabetes mellitus, where excessive urine output is a prominent feature.According to Ayurveda, diabetes is seen as a disruption in the balance of Agni within the gastrointestinal tract due to various causes such as genetics, lifestyle choices, and unhealthy eating habits.
Classification of diabetes
1. TYPE I -Insulin Dependent Diabetes Mellitus- Caused due to Pancreatic Beta cell destruction that leads to insulin deficiency.
2. TYPE II- Non-Insulin Dependent Diabetes Mellitus- Caused due to Progressive loss of Beta Cell insulin secretion with Insulin resistance.
3. Gestational Diabetes
As per ayurveda Prameha is categorized as
Hetu bheda (Etiological factors) : Sahaja-Hereditary or familial and Apatyanimitta -lifestyle
Doshaja (Pathological) : Vitiation of three humors (Vata, pitta, kapha). Twenty types of prameha are mentioned under this category
Dehaprakrti (Constitutional) : Sthula (Obese) and krisa (Lean)
Premonitary symptoms of Prameha
· Matting of hairs
· Sweet taste in mouth
· Numbness and burning sensation in hands and feet
· Dryness of mouth, palate, throat
· Thirst
· Lethargy
· Accumulation of waste products on teeth, palate, tongue, ears, nose etc
· Attraction of ants towards the body and urine
· Abnormalities in the urine
· Bad body odour
· Excessive sleep
· Drowsiness
Causes of Prameha
Ahara (Food)
•Guru Ahara (heavy foods)
•Snigdha Ahara (fatty foods)
•Madhura (Sweet)
•Nava Anna (new grains)
• Nava Madya (fresh wines)
•Payamsi (Milk and milk products)
.Gudavikrti (Jaggery and its products)
Vihara (Lifestyle)
•Ati Nidra (excessive sleep)
•Asyasukham (sedentary habits)
•Avyayama (lack of exercise)
Manas Karana (Mental factors)
Achintana (lack of mental exercise)
Management of Prameha
If the patient is physically strong and suffers with Apathyanimittaja (acquired) Prameha, Samshodhana (biopurification) is considered the ideal option. For physically weak patients, Samshamana (pacification of the Doshas) is recommended. Samshamana is also utilized after biopurification in those patients who undergo Samshodhana. Balanced nutrition, appropriate physical exercise, and administration of herbal supplements will help to manage Prameha.
Patients with Prameha must eat a diet that pacifies the disease. The best foods to eat are those that are not sweet, not too oily, have the ability to mitigate Kapha and Meda, and are nourishing. Foods and drinks that are sweet in taste, such as dairy products, Ikshu (sugar cane), sugar products, foods with Guru (heavy) quality and Sheeta (cold) quality (such as ice cream), Madya (alcoholic beverages and wines), and so on should be avoided since they further provoke Kapha and Meda. In the diet, first and foremost importance should be given to Yava (barley). Research shows the consumption of barley kernels and products made from barley flour enriched with b-glucan improves glucose tolerance, reduces insulin responses, and lowers inflammatory markers. Vegetables that mitigate Prameha include bitter gourd ,Patola (Trichosanthes anguina), Tikta Shaka (green leafy vegetables) as a main component of the diet for patients with Prameha. Judicious administration of legumes and grains such as Kodrava (kodo millet), Mudga (green gram, moong dal), Kulatha (horse gram), Adhaki Beeja (pigeon pea). Spices with antidiabetic effects include cinnamon, Jeeraka (Cuminum cyminum Linn., cumin), Dhanyaka (coriander), Shunthi (ginger), Methika (fenugreek), and Rasona (garlic).
Ayurveda does not prohibit meat in the diet of Prameha patients; however, frying of the meat is not recommended. Harina (venison) and Shashaka (rabbit) are the recommended meats for Prameha patients. The meat of domesticated animals is not recommended, and this correlates with current research findings. A systematic review and meta-analysis of studies on red and processed meats concluded that the consumption of processed meats is associated with a higher incidence of coronary heart disease and diabetes mellitus.
Ayurveda emphasizes the importance of regular exercise, including brisk walking, jogging, sports, wrestling, fencing, horseback riding, and so on. Patients are advised to avoid laziness and a sedentary lifestyle. It is essential to perform exercise such as walking or jogging to burn extra calories in the body. Meditation, Pranayama (breathing exercises), and Asanas (yoga exercises) are beneficial in developing and maintaining a healthy lifestyle. Research has shown that a comprehensive lifestyle education program that includes these practices reduces risk factors for diabetes mellitus.
For the treatment of Prameha, there are more than 100 medicinal plants Ayurveda utilizes, singly or more often in combination. Selection of the herbal treatment is based on the stage and type of disease, as well as disturbances in the psychophysiologic constitution of the patient. Research has shown that many of these herbs have an antidiabetic effect as well as a beneficial effect on the lipid profile. Ayurveda also addresses the management of psychologic factors that contribute to the development of Prameha.
The prudent application of diet, lifestyle adjustments, and psychological considerations can aid in averting the advancement and complications associated with Prameha.