Ayurvedic way to treat the most common disease,DIABETES MELLITUS

MADHUMEHA- [DIABETES MELLITUS]

What is Diabetes Mellitus?

Diabetes mellitus is a clinical syndrome with disordered metabolism and inappropriate hyperglycaemia due to a deficiency of Insulin secretion. Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar levels that result from defects in insulin secretion, or action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose lead to spillage of glucose into the urine, hence the term sweet urine.

Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.

Types of Diabetes-

A-Type 1 Diabetes Mellitus- [Insulin-dependent diabetes mellitus]

It is due to pancreatic islet B cell destruction predominantly by an autoimmune process, and these patients are prone to ketoacidosis.

· Immune- medicated

· Idiopathic

B-Type 2 Diabetes Mellitus-[Non-Insulin-dependent diabetes mellitus]

It is due to more prevalent form and results from Insulin resistance with a defect in compensatory insulin secretion.

Sl.no.	Type	Ketosis	Islets cell Antibodies	HLA Association	Treatment
Type 1
A-	Immune- Medicated	Present	Present at onset	Positive	Low calorie healthy diet and pre prandial rapid acting Insulin, plus basal insulin replacement with intermediate- acting
B	Idiopathic	Present	Absent	Absent	Long -acting insulin
Type 2
A	Non obese	Absent	Absent	Negative	1-Eucaloric diet alone 2-Diet plus insulin or oral agent
B	Obese	Absent	Absent	Negative	1-Weight Reduction 2-Hypocaloric diet, plus oral agent or Insulin

PATHOLOGY-

Type 1 - It is a catabolic disorder in which circulating insulin is virtually absent, plasma glucagon is elevated and the pancreatic B cells fail to respond to all insulinogenic stimuli. Exogenous insulin is the fore required to reverse the catabolic state, prevent ketosis, and reduce hyperglycaemia.

TYPE 2- It is due to circulating endogenous insulin is sufficient to prevent ketoacidosis but is inadequate to prevent hyperglycaemia in the face of increased need owing to tissue insensitivity.

CLINICAL FINDINGS-

Features	Type 1 Diabetes	Type 2 Diabetes
Polyuria and thirst	+ +	+
Weakness’ or Fatigue	++	+
Polyphagia with weight loss	++	-
Recurrent blurred vision	+	++
Vulvovaginitis or pruritus	+	++
Peripheral neuropathy	+	++
Nocturnal enuresis	++	-
Often asymptomatic	-	++

C0MPLICATIONS OF DIABETES MELLITUS-

1-MICRO VASCULATURE Retinopathy, cataract Nephropathy Peripheral neuropathy Autonomic neuropathy Foot disease

2-MACRO VASCULATURE Coronary circulation Cerebral circulation Peripheral circulation

INVESTIGATIONS-

1-URINE TEST-

A. Glucose

B. Ketones

C. Protein

2. BLOOD TEST-

A-Glucose

B-Glycosylated haemoglobin blood lipid

3. ORAL GLUCOSE TOLERANCE TEST-(O.G.T.T)

A. 3rd day unrestricted carbohydrates

B. fasted over night

C. plasma glucose measured before 2 hrs after 75g glucose intake.

MANAGEMENT

There is very less management according to modern science for this malady except being on medicine for life long. The most common management is the Insulin regimen which is not very easy for every one. And this management requires constant checking of glucose level because sudden decrease in glucose level leads to hypoglycaemia which is far more fatal than hyperglycaemia.

A-Type 1

Traditional once or twice daily Insulin regimens are usually ineffective combination of rapidly acting insulin analogs and long acting insulin analogs allow for physiologic insulin replacement.

Regimen		Pre-Breakfast	Pre- Lunch	Pre- Dinner	At- Bedtime
Rapidly acting insulin analogy		5 units	4 units	6 units	-
Insulin detail		6-7 units			8-9 units
OR
Rapidly acting insulin analogue	5 units		4 units	6 units	-
Insulin glargine		-	-	-	15-16 units

70 kg Man of consuming approximately 75g carbohydrates at breakfast, 60g at lunch, and 90g at dinner.

B. Type 2

1. Obese Patient-

a. Weight reduction

b. Hypoglycaemic agents-Metformin,Thiazolidinediones,Sulfonylureas,Exenatide,Sitagliptin

2. Non obese Patient-

a. As like obese patient but not loose excess weight

b. If patient not have central obesity Insulin resistance LADA,MODY are given.

NORMAL GLUCOSE & FAT METABOLISM AND ROLE OF PANCREAS

AYURVEDIC CONCEPT

PRAMEHA

Is a disease in which urine of the patient is sweet like honey and quantitatively increased as well as of astringent, pale and rough quality. The whole body of madhumehi becomes sweet. In Ayurveda diabetes is categorized as prameha. Diabetes mellitus is known as madhumeha .This is one of the four VATAJ prameha.

TYPES OF DIABETES -

Kaphaja prameha	Pittaja prameha	Vataja prameha
Udakameha	Ksharameha	Vasameha
Ikshuwalikameha	Kalameha	Majjameha
Sandrameha	Neelameha	Hastimeha
Shuklameha	Lohitameha	Madhumeha
Sandraprasadmeha	Manjishthameha
Shukrameha	Haridrameha
Shitameha
Siktameha
Shanairmeha
Alalmeha

CAUSES-

The Root Causes of Diabetes

According to Ayurveda, the following are the general types of imbalances at the source of most chronic conditions, including diabetes:

1. Toxins accumulating in tissues and blocking circulation.
2. Poor nutrition.
3. Poor digestion.
4. Imbalance of the nervous system.
5. Accumulation of physical and mental stress.
6. Lowering of natural resistance and immunity.
7. Disruption of natural biological rhythms.

The common modern medical approach that matches drugs to symptoms does not completely address many of these factors. As a result, modern medicine often cannot fully remove the disorder and the condition becomes chronic. Chronic means that the condition persists over time even with the best modern medical treatment.

.

SYMPTOMS-

· Increased urination frequency excessive thirst ,

· burning sensation of palm and soles increased hunger,

· sweet taste in mouth ,

· unhealed or delayed healing wounds which might lead to amputation of limbs,

· skin infection,

· fatigue, general body weakness .

· The ignorance about blood sugar level can be lead to long- term complications like heart attack, strokes ,blindness, nerve damage, amputation of limbs, impotence and pruritus (itching)

DIET-

According to Ayurveda diet is most important factor responsible for unhealthy body and doshas imbalance. Ayurveda says all disease start with abdominal disturbance. Thus managing diet is the first step of treatment for a diabetes patient .The diabetes diet is a normal balanced diet with few modifications and proper timing between breakfast, lunch and dinner. Avoid diet and life style with increased KAPHA doshas such as sugar ,fruits which contain high percentage of sugar content , carbohydrates , fats, potatoes ,rice ,dairy product. Alcohol and smoking, day time sleep are a strict no. Natural vegetables ,low caloric ,low fat- Alkaline diet, roasted rice and wheat are useful and should include <TIKTA RASA> item in diet.

HERBS-

.

JAMUN

The seed is rich in protein and carbohydrates. It also contains traces of calcium. These are, therefore, widely used as cattle feed, a medicine against diabetes and antidote in a kind of soft-food poisoning. Diabetic patients can take Jamun fruit regularly during the season of its availability for a temporary relief from the said malady. The Jamun bark also acts as tonic, astringent and anti-periodic too.

HALDI

Turmeric is thought to have many medicinal properties and is used as antiseptic for cuts, burns and bruises. It is also used as an antibacterial agent. It also has anti inflammatory properties.

BHUMI AMALAKI

It is bitter, astringent, cold, anti-inflammatory, hepato protective and useful in liver disorders, cough, asthma, jaundice, spleen disorders and diabetes.

AMALAKI

Amla is the best source for Vitamin C. It also has anti oxidant and detoxification properties. It is well known for treating skin disorders and hair problems. It is a strong rejuvenative.

FENUGREEK

It is bitter so used in diabetes. It is widely used as milk producing agent. And is believed that it also lowers triglycerides and serum cholesterol.

MADHUCA

It is astringent and tonic and is nutritive. Useful in bronchitis, diabetes, bleeding gums, rheumatism,

Pilles etc.

HOME CURE FOR DIABETES-

v Bitter gourd seed powder with water, twice daily.

v Juice of bitter gourd daily in empty stomach.

v Jamun or dried powder of its seed with water.

v Fresh juice of Amla in empty stomach is useful for diabetes patient.

v Amlaki powder and haldi (Turmeric powder) with honey twice daily.

v Fenugreek, white pepper and turmeric powder with a glass of milk,twice daily.

v Used STERIA leaves instead of sugar or any sweet enters it give the sweet taste, as well as it helps to reduce sugar.

v Chew 4-6 neem leaves every day in the morning empty stomach.

v Put one cup of water in a cup or bowl at night and drink it in morning.

THERAPEUTIC REMEDIES-

v AROGYAVARDHINI RAS

v VASANTA KUSUMAKAR RAS

v YASHAD BHASMA

v CHANDRA PRABHA VATI

v TRIPHALA WITH AMALAKI JUICE

v GUDMAR GHANVATI

v SHILAJITADI VATI

v JAMBASAVA

YOGA AND EXERCISE-

According to Ayurveda’s concept healthy diet and regular exercise is important to balance the body doshas and yoga is the science which helps to attain higher level of physical, mental and spiritual balance.

v PRANAYAMA

v PASCHIMOTTAASANA

v HALASANA

v MANDUKASANA

v Morning walk is useful in diabetes

This is a summary of the basic management of diabetes mellitus, but the main management is to lead an active life without stress. Controlled diet is very beneficial along with Meditation helps in competing with this chronic disease. Ayurvedic management checks the sudden fall of glucose levels without increasing the glucose level. In short it maintains the proper glucose levels in the blood. Thus helps the patient to lead a good life.

WITH BLESSINGS FROM GOD DHANWANTARI.

Dr.Vinod Kumar

Email: drvinodkm@gmail.com

C/O DHARMA AYURVEDA SOCIETY.

BAMS, BHARTI VIDYAPEETH, PUNE.

PGDEMS, UK

......Click Here to Read More!