Diabetes

Introduction

Ayurveda, an ancient system of medicine originating from India, provides a unique perspective on understanding and managing diabetes mellitus. According to Ayurveda, diabetes is classified as “Prameha,” a metabolic disorder that affects the body’s ability to utilize glucose. According to ancient texts, excessive consumption of ghee is believed to be the cause of prameha. The management of prameha involves identifying and addressing the underlying factors that lead to the disease, such as faulty dietary habits and a sedentary lifestyle causing obesity and insulin resistance. There are different types of prameha, including hereditary and acquired forms, which can be classified based on body mass index. While there is some debate within the Ayurvedic community about equating prameha with diabetes mellitus, Ayurveda provides valuable insights for managing chronic diseases like diabetes. The chapter also discusses the importance of urinalysis for diagnosis and prognosis. Overall, Ayurveda’s approach to prameha involves depleting therapies, specific medications, and a diet that helps lower fat and glucose levels. The description of Sahaja prameha and the role of genetic predisposition in the disease’s development highlights the scientific validity of Ayurveda.

Etiology of Prameha (Diabetes)

आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|

नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||

(Cha.Chi. 6/4)

  • Asyasukham – comfortable seat (luxury, sedentary life, lack of exercise and physical activity)
  • Svapnasukham – the comfort of sleep, deep sleep
  • Dadheeni – consumption of curd and its preparation
  • Gramya-oudaka-anupa mamsa – an animal that lives in water and swampy areas.
  • Payamsi – consumption of milk, its process and preparation
  • Navaanna panam – Food, drinks and dishes prepared from fresh grains etc.
  • Guda vaikruti – Jaggery, its products and dishes made from it
    Kapha krutscha Sarvam – These all foods and lifestyles increase Kapha which are causes of Prameha.

Pathogenesis of Prameha

मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|

करोति मेहान् समुदीर्णमुष्णैस्तानेव पित्तं परिदूष्य चापि||

क्षीणेषु दोषेष्ववकृष्य बस्तौ धातून् प्रमेहाननिलः करोति|

दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||

(Cha.Chi. 6/5-6)

Aggravated kapha vitiates the body’s medas, mamsa, and kleda in the basti (bladder and urinary system) caused by various kapha-dominated meha. In the same way, pitta makes things hot and makes these things appear and causes different kinds of meha that governs pitta. When the other two doshas are in a slightly reduced state, the aggravated vata attracts the physical elements (i.e. ojas, majja, and lasika) into the urinary tract and causes them to dominate the vata Pramehas. Different doshas enter the urinary tract in critical situations causing different types of meha to have their own potential.

कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|

मज्जा रसौजः पिशितं च दूष्याः प्रमेहिणां, विंशतिरेव मेहाः||

(Cha.Chi. 6/8)

  • Dosha : Kapha, Pitta, Vayu
  • Dushya : Meda, Rakta(Blood), Shukra(Semen), Ambu(Body Fluid), Vasa(fat), Lasika(Lymph), Majja, Rasa, ojas
    These are main the causes of Prameha which is of twenty types Prameha.
  • Strotas : Mutravaha, Medovaha
  • Adhishthan: Basti, Sarva Sharira
  • Agni : Dhatvagnimandhaya
  • Vyadhiswabhav : Chirkari( Cronic)

Classification of Diabetes(Prameha)

जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|

शुक्लं सशुक्रं शिशिरं शनैर्वा लालेव वा वालुकया युतं वा||

विद्यात् प्रमेहान् कफजान् दशैतान् क्षारोपमं कालमथापि नीलम्|

हारिद्रमाञ्जिष्ठमथापि रक्तमेतान् प्रमेहान् षडुशन्ति पित्तात्||

मज्जौजसा वा वसयाऽन्वितं वा लसीकया वा सततं विबद्धम्|

चतुर्विधं मूत्रयतीह वाताच्छेषेषु धातुष्वपकर्षितेषु||

  • 10 Types of Kaphaj Prameha:

  1. Udaka Meha(Diabetes Insipidus): Pre-diabetes – hyperglycemia results in decreased water absorption and increased urine output.
  2. Ikshubalikarasa Meha(Alimentary Glycosuria): Diabetes occurs first when the liver cannot metabolize enough glucose due to resistance of the liver to insulin and therefore the presence of glucose in the urine.
  3. Sandra Meha(Phosphaturia) : 3 layers: a layer of chylomicrons, protein-rich middle layer, and outer layer with fibrin clots and cell sheets) The intermediate stage between pre-diabetes and diabetics begins with kidney damage.
  4. Sandraprasada Meha(Phosphaturia): Same as Sandra Meha
  5. Shukla Meha(Chyluria): The progressive level of type 2 diabetes mellitus and further disturbances of nephron function (proteinuria).
  6. Shukra Meha(Spermaturia): Diabetic autonomic neuropathy causes retrograde spermatogenesis.
  7. Sheet Meha(Polyurea with Glycosuria): The level of resource deficiency due to the presence of diabetic nephropathy by the amount of ammonia in the urine.
  8. Sikta Meha(Crystalluria): The presence of crystal in the urine.
  9. Shanai Meha(Frequency): The level of diabetes includes advanced nephropathy. Urinary production is frequent and decreased.
  10. Lala Meha(Albuminuria): The progressive level of type 2 diabetes mellitus can indicate the presence of albumin.
  • 6 Types of Pittaja Prameha:

  1. Kshara Meha(Alkaline Urine): Alkaline interactions cause an ammoniacal odor, and patients with diabetic ketoacidosis produce urine that may have a sweet or fruity odor
  2. Kala Meha(Haematuria): The patient passes black-colored urine.
  3. Neel Meha(Indicouria): The patient urinates with a sour taste and color like the feathers of a casa bird.
    Blue discharge indicates a urinary tract infection
  4. Lohit Meha(Frank Haematuria): The patient urinates with red color, salty taste, and smell like fish.
  5. Haridra Meha(Biliuria): yellow-colored urine due to dehydration.
  6. Manjishtha Meha(Haematuria): Massive hematuria due to urinary tract infection
  • 4 Types of Vataja Prameha:

  1. Vasa Meha(Lipiduria): Presence of lipids in the urine
  2. Majja Meha(Polyuria): Presence of bone marrow.
  3. Hasti Meha(Polyuria with Incontinence):  Diabetic ketoacidosis due to diabetes mellitus
  4. Madumeha(Diabetic Glycosuria): Same as Type – 1 Diabetes Mellitus

Prodromal Symptoms of Diabetes(Madhumeha Purvaroopa)

स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च|

हृन्नेत्रजिह्वाश्रवणोपदेहो घनाङ्गता केशनखातिवृद्धिः||

शीतप्रियत्वं गलतालुशोषो माधुर्यमास्ये करपाददाहः|

भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||

(Cha.Chi.6/13-14)

  • Sveda – excessive sweating
  • Angagandha – strong smell
  • Anga Shaithilya – lack of stability in the body
  • Anga Sada – weakness
  • Sayya sukherati – have comfort in bed
  • Svapna Sukherati – to have comfort in sleep
  • Asana Sukherati – to be comfortable and inactive
  • Hrudayopadeha – feeling as if the heart is heavy
  • Netropadeha – vision problems
  • Jihwopadeha – selling cover
  • Shravanopadeha – ear problem
  • Kesha Ativruddhi – great hair
  • Nakha Ativruddhi – thick nails
  • Sheeta Priyatvam – winter and season favorite food
  • Gala Talushosha – thirst on the palate
  • Asya Madhurya – sweet and delicious
  • Kara Pada Daha – burning sensation in feet and palms
  • Mutra Pipeeliha Abhisarana – Urine attracts ants
  • Madhura Mutrata – taste of urine
  • Shatpada Abhisarana na shareera – it is as if ants are crawling on the body

Symptoms of Diabetes(Madhumeha)

  • Prabhuta Mutrata( Polyuria)
  • Avila Mutrata(Turbid Urine)
  • Sharira Gauravata(Heaviness in Body)
  • Vibandh(Constipation)
  • Sharira Jadyata(Stiffness in Body)
  • Panduvarna Mutra(Yellowish Urine)
  • Mukh Madhurya Evam Sharira Madhurya( Sweetness in Mouth & Body)
  • Kshudha adhika(Excessive appetite)
  • Trishna adhika(Excessive thrist)
  • Daurbalya(Weakness)
  • Aalsya(Laziness)
  • Bhram(Fatigue)

Complications of Diabetes

1.Hridroga (heart disease)
2. Daha (Burning at feet)
3. Anidra (lack of sleep)
4. Stambha (Stiffness of the body)
5. Kandu (Itching)
6. Shoola (body pain)
7. Vibandh(Constipation)
8. Udavarta (regurgitation)
9. Vidradhi(Abscess)
10. Kasa (cough)
11. Shwasa (dyspnea)

Ayurvedic treatment for Diabetes

Based on the physical constitution or body type (prakriti), or human health condition, ancient Ayurvedic
recommended two different types of treatment for people with diabetes.

1. Apatarpana (malnutrition) and Samshodhana (cleansing):

This treatment is given if you are overweight mostly Kapha body type patients. In this, the antidiabetic medicine plant is given an important factor for the nutritional deficiency of fat and elimination of toxins through Vyayama (different exercises), Langhan therapy (Fasting), Panchakarma treatment (five-fold treatment is vomiting, purgation, oil enema, decoction enema and instillation of nasal drops).

2. Santarpana (replenishment) and Brumhana (improvement of the body):

This is prescribed if you suffer from chronic diseases, less constipation, Vata or Pitta patients, and obesity due to depletion of essential nutrients. This treatment helps to deliver faster Nutrients and micronutrients are acceptable to rebuild the body and help strengthen the immune system without increasing the distribution of blood sugar and fatty tissue. This prevents further damage and ensures a better-fit treatment and repair.

Ayurvedic Medicine

  • Vasantkusumakar Rasa
  • Brihatbangeswar Rasa
  • Tribanga Bhasma
  • Chandraprabha Vati
  • Triphala Churanam
  • Shilajitvadi Vati
  • Phaltrikadi Kashayam
  • Lodhrasava
  • Pramehagaja kesari Rasa
  • Pramehahara Kashayam

Yoga and Meditation

Regular practice of yoga asanas, pranayama (breathing exercises), and meditation can be beneficial for diabetes management. Yoga postures like forward bends, twists, and gentle inversions help stimulate the pancreas and improve insulin sensitivity. Pranayama techniques like Kapalabhati (skull-shining breath) and Nadi Shodhana (alternate nostril breathing) can help reduce stress and balance the nervous system. Meditation and mindfulness practices can promote overall well-being and reduce emotional stress related to diabetes.

Diet

Ayurveda emphasizes an individualized approach to diet based on a person’s dosha (body constitution) and specific imbalances. Generally, a diabetes-friendly Ayurvedic diet focuses on whole, unprocessed foods. It includes high-fiber foods like whole grains (such as barley, millet, and brown rice), fresh vegetables (bitter gourd, spinach, bitter melon), low-sugar fruits (such as Indian gooseberry, pomegranate), and lean proteins (such as lentils, tofu, and lean meats in moderation). It is important to avoid sugary and processed foods, refined carbohydrates, and excessive consumption of sweet fruits.

Lifestyle Modifications

Ayurveda emphasizes the importance of a healthy lifestyle in managing diabetes. Here are some key lifestyle recommendations:

  • Maintain a regular sleep schedule and aim for adequate sleep.
  • Engage in regular physical activity or exercise, such as walking, yoga, or swimming, to support metabolism and insulin sensitivity.
  • Manage stress through relaxation techniques like deep breathing exercises, meditation, and gentle stretching.
  • Avoid tobacco and excessive alcohol consumption, as they can worsen diabetes symptoms and complications.

By Dr.Dimpal Baldha

I'm DR. Dimple Baldha, an Ayurvedic doctor and I have treated more than a thousand patients in my couple of years of experience in this field. This has given me a lot of insights and positive areas to work with people from different parts of the world managing arthritis issues, Dietary changes, healthy lifestyles, and metabolic disorders. I have good knowledge of Ayurvedic medicine, Panchkarma treatment, Healthy lifestyle and yoga. I have treated so many diseases like spondylitis, psoriasis, allergies and bronchial asthma. Talks about #health, #ayurveda, #wellness, #healthylifestyle

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