" Combating successfully against Diabetes with the power and potency of nature "

Diabetes Mellitus (Madhumeha)

Diabetes Mellitus (DM), commonly referred to as diabetes, describes a group of metabolic disorders in which there are high blood sugar levels for a longer period of time due to either the pancreas is producing inadequate amount of insulin or the body cells not responding properly to the insulin produced.The problem with diabetes mellitus is that it is very difficult to diagnose it in the early stages. However, Ayurvedic preventive strategies right from the beginning can easily prevent this disease and can also control it if the patient is already suffering. It is a medical condition in which there is an accumulation of glucose in the urine and blood of the patient. This condition is known as hyperglycaemia. The word diabetes has been derived from two words, diabetes (Greek) which means ‘siphon through’ and mellitus (Latin)which means ‘sweetened with honey’. Diabetes mellitus is a metabolic disorder, i.e. it is caused due to the malfunctioning of the pancreas, which is responsible for the production of the hormone insulin.

Pathogenesis

The beta cells of the islets of Langerhans in pancreatic gland are responsible for the secretion of the hormone insulin. Insulin is extremely essential for proper utilization of the carbohydrates in our body. If insulin is absent due to a metabolic disorder, or if it is not performing its functions properly, then these carbohydrates accumulate in the bloodstream in the form of glucose. The glucose then collects in the urine, which is in fact one of the primary characteristics diabetes mellitus is identified with. Hence, the disease can be described to be either a deficiency in the production of insulin by the pancreas or a dysfunction of the insulin produced by the pancreas.

Samprapthi (Pathogenesis)

मेदश्चमांसंचशरीरजंचक्लेदंकफोबस्तिगतंप्रदूष्य| करोतिमेहान्समुदीर्णमुष्णैस्तानेवपित्तंपरिदूष्यचापि||(च.चि.६/५) क्षीणेषुदोषेष्ववकृष्यबस्तौधातून्प्रमेहाननिलःकरोति| दोषोहिबस्तिंसमुपेत्यमूत्रंसन्दूष्यमेहाञ्जनयेद्यथास्वम्||(च.चि.६/६)

Due to etiological factors the is an increase in kapha, kapha reaches various dooshyas like rasa (plasma), rakta (blood) etc. As there is a shaithilyata (looseness) in the body and kapha being fluid predominant, spreads all over the body and gets vitiated, while spreading it also gets mixed with medas (fat – adipose tissue), mamsa (muscle) and kleda (body fluids). Body fluids which got vitiated draw them to the urinary bladder and produces prameha; similarly, the Pitta affects them, Vata also brings about vitiation in them and produces prameha.

Madhumeha (Prameha)

Ayurvedic remedies for Madhumeha (diabetes mellitus) are the oldest among all the available therapies, which includes in the prameha category. Pramehas are a list of urinary disorders, especially characterized by profuse urination with several abnormal qualities due to doshic imbalances.

The main causes of prameha are lack of exercise and improper food habits & an excess food intake which falls in the category of ushna, snigdha and guru, whichare the primal cause of this disease - Fish, curd are good examples. Foods that increase kapha, medhas and moothra are the etiological factors for prameha. The word Prameha is derived from, Pra – means excess, Meha – ksharane - passing of urine. So Prameha is passing excessive urine and turbid in color (‘prabhootha avila mootrata’).

Causes according to Ayurveda –

"आस्यसुखंस्वप्नसुखंदधीनिग्राम्योदकानूपरसाःपयांसि। नवान्नपानंगुडवैकृतंचप्रमेहहेतुःकफकृच्चसर्वम्।।"(च.चि.६/४)

Main causes –

Sleeping in day time, lack of exercise, Laziness, Sedentary habits, consumes food and drinks which are cold, unctuous, sweet and fatty items (Fat rich Diet)etc.

Physical and mental causes:

  1. Asyashuka-eating as per one’s will.
  2. Svapnasukham – addiction to the pleasure of sedentary habits and sleep.
  3. Kapha krut cha sarvam – All foods and lifestyle activities which increases Kapha.
  4. Sahaja (inherited factor).
  5. Chinta (stress).
  6. Shoka (grief).
  7. Bhaya (fear).
  8. Deergha roga (long standing illness).
  9. Alasya (sedentary life).

Food and drinks as Causative Factors:

  1. Dadheeni – Excessive consumption of Curds and its preparations.
  2. Gramya udaka aanupa rasa – soup of meat of domesticated and aquatic animals and animals from marshy land.
  3. Payas- excess intake of milk and its products preparations.
  4. Navaanna panam – Food, drinks and dishes prepared from freshly harvested grains etc.
  5. Guda vaikruti – Guda(Jaggery), its derivatives and dishes made out of it.
  6. Ikshurasa (sugar cane).
  7. Madhura Ahara (sweet substances).
  8. Pishta Ahara (carbohydrate rich food).
  9. Adyashana (repeated food intake).
  10. Adhikashana (excess food intake).
  11. Ahitashana (unwholesome diet).
  12. Guru ahara (heavy food).
  13. Samashana (improper diet).

In Ayurveda we can find the described of early symptoms of the disease. They are accumulation of dirt on the teeth (mouth, eyes, nose, and ears), a feeling of burning sensation in the palms and soles, stickiness of the skin all over the body, thirst and a sweet taste in the mouth etc., and moothra madhuryam (sweetness of urine).

People with diabetes frequently experience certain symptoms, these include:

  1. Being very thirsty.
  2. Frequent urination
  3. Weight loss
  4. Increased hunger
  5. Blurry vision
  6. Irritability
  7. Tingling or numbness in the hands or feet
  8. Frequent skin, bladder or gum infections
  9. Wounds that don't heal
  10. Extreme unexplained fatigue

Prabhootha mutrata (Poly uria), Avila mutrata (Turbid Urine) and Medo dushti lakshanas are the main symptoms of prameha.

1. Specific Ayurvedic symptoms -
  • Tartar in teeth
  • Burning sensation of hands and feet
  • Excess glossy/ oily skin Excessive thirst
  • Feeling sweetness in mouth Excessive urination
  • Turbid urination
  • Urine having colour of honey Excess perspiration
  • Bad body odour
  • Flaccidity of muscles
  • Desire for sedentary life
  • Desire for cold food & environment
  • Dryness of palate & throat
2. Main symptoms (Modern science) –

    The classic symptoms of untreated diabetes are loss of weight, polyuria, polydipsia and polyphagia.

  • Polyuria (Excessive Urine)
  • Polyphagia(Excessive Hunger)
  • Polydipsia (Excessive Thirst)
  • Exhaustion/Tiredness
  • Body ache
  • Giddiness
  • Polyneuritis (Numbness / Tingling)
  • Visual disturbance
  • Hridroga-cardiac disorder.
  • Loulya-urge to have food.
  • Anidra-loss of sleep.
  • Stambha-stiffness of the body.
  • Kampa-shivering.
  • Shoola-body ache.
  • Baddha purishata-constipation.
  • Udavarta-regurgitation.
  • Shosha-emaciation.
  • Kasa-cough.
  • Shwasa- dyspnea.

"स्निग्धस्ययोगाविविधाःप्रयोज्याःकल्पोपदिष्टामलशोधनाय |ऊर्ध्वंतथाऽधश्चमलेऽपनीतेमेहेषुसन्तर्पणमेवकार्यम्||"(च.चि.६/१६)
"गुल्मःक्षयोमेहनबस्तिशूलंमूत्रग्रहश्चाप्यपतर्पणेन|प्रमेहिणःस्युः, परितर्पणानिकार्याणितस्यप्रसमीक्ष्यवह्निम्||"(च.चि.६/१७)

According to Ayurveda the line of treatment forprameha strictly depends on individual’s constitution. It is based on an entire change in the lifestyle of the person, along with medication and diet, the patient is also advised to lead a healthy & active life. Even mental aspects of the disease are stressed upon. The principles of treatment in a diabetic patient may be classified as under

There are two types of diabetics:

1. In Sthulya (for obese patients) - The treatment must be mainly based on proper utilization of excess fat i.e. he should be given:

a) Shodhana - purification process

b) Apatarpana - reduction in patient’s body weight

  • Fasting.
  • Diet control.
  • Cleansing therapies – vamana – (induction of emesis) virecana (induction of purgation) basti (applicatin of medicine through the anal route – in specific conditions).
  • Physical exercises.

2. In krusha (For Lean patients) - The treatment should be mainly based on the line of increasing stamina and vitality by way of tonics (brumhana), diet, drugs etc., and the patient should never be given excessive Langhana or Apatarpana i.e. he should not be starved.

The role of ahara and vihara are equally or even more important in diabetes to control blood sugar level as well as to prevent complications of this disease.

  1. Cereals: Yava (Hordeum vulgare - Barley) is the best, different preparations of food, prepared from Barley can be given e.g. Mantha, Odana, Appopa, bread, Roti etc. Wheatcan also be given. Rice: - Ayurveda prescribed old rice (purana shali), as one of the cereals, which can be prescribed to the diabetic patients.
  2. Pulses: Mudga (Vignaradiata Greengram), Chanaka (Cicer arietinum Linn. – Bengal gram), Kulattha (Dolichos biflorus) , Adhaki (Cajanus cajan - Pigeon pea) etc, can be taken.
  3. Vegetables: All types of bitter vegetables (Tikta shaka) e.g.Karela (Momordica charantia - Bitter gourd), Methi (Trigonella foenum-graecum - Fenugreek), Patola (Vietnamese luffa, Vietnamese gourd, or Chinese okra), Rasona (Allium sativum Linn. - garlic), Udumbara (Ficus racemosa - Cluster Fig Tree, Indian Fig Treeor Goolar (Gular) Fig), etc. can be given.
  4. Fruits: Jambu (Syzygium cuini - Black berry), Amalaki (Phyllanthus emblica - Nepalese/Indian gooseberry,or Dhatrik (in Maithili) or amla), Kapitta (Limonia acidissima - Wood Apple, Elephant Apple, Monkey Fruit or Curd Fruit ) , Tala phala (Borassus flabellifer - theAsian Palmyra palm, Toddy palm, Sugar palm, or Cambodian palm), Kharjura (Phoenix sylvestris –Date Sugar Palm ), Kamala (Nelumbo nucifera Indian lotus, sacred lotus, bean of India, or simply lotus,), Utpala (Nymphoea Stellata) etc., can be given.
  5. Seeds: Kamala, Utpala seeds can be given.
  6. Oils: Mustard oil (Sarshapa taila) is the best.

But according to Ayurveda one should start with light diet (laghu ahara) and then gradually increase the quantity of food. It is a rule that one should keep complete attention on the condition of Agni i.e. digestion. Diabetes being a disease of deranged metabolism, special attention should be paid on the conditions of digestion and metabolism.

Exercise –

Hard exercises are prescribed for diabetics and obese patients. This is meant for proper utilization of the fat and for proper consumption of the glucose in the body. Exercises are very necessary.

Ayurveda also recommends –
  • Regular Yoga, meditation and Pranayama to prevent or treat stress.
  • Regular exercise – to keep up good metabolism rates.
  • Regular oil massage – to treat muscle and joint aches and pains.
  • Regular eye exercises, eye check-up and Ayurvedic eye therapies such as tarpana treatment, to prevent and treat retinopathy.
  • Foot massage with neem based oils such as Nimbadi Tailam, to prevent and treat non healing wounds and ulcers.
  • Avoid sleeping during daytime.
  • Avoid smoking.
Anti-diabetic Herbs and Foods of Ayurveda –
  1. Jambhul (Eugenia jambolana): The jambhul fruit is regarded as a specific medicine in traditional ayurvedic medicine because of its specific action on the pancreas. The fruit, the seeds, and the whole fruit juice are all useful in the treatment of diabetes. The seeds contain jamboline, which controls the excessive conversion of starch to sugar. For internal usage, dry the seeds, powder them, and take 3 grams, twice daily with water or butter milk.
  2. Bitter Gourd/bitter melon (Momordica charantia): The fruit and seeds of this plant contain most active blood sugar-lowering components. This contains an active principle called charantin. For better therapeutic benefits, extract juice from four to five karelas every morning and take empty stomach. You can take the seed powder either directly or in the form of a decoction. The bitter gourd is regarded as the best remedy for diabetes. Drinking at least one tablespoon of bitter gourd juice daily will reduce blood sugar levels in your blood and urine.
  3. Bel (Aegle marmelos): Though this plant is famous for its fruit, here we are interested in its leaves. They are scientifically proven to be antidiabetic. Drink fresh juice of leaves daily along with pinch of black pepper. This will take care of your excess body sugar.
  4. Fenugreek (Trigonella foenum graecum): The medicinal qualities or fenugreek seeds are described in ayurvedic literature. In recent studies, it has been reported that the decoction of fenugreek seeds suppressed the urinary excretion of sugar and relieved symptoms of diabetes. It contains trigonelline, and an alkaloid known to reduce blood sugar levels.
  5. Turmeric: Ayurveda recommends turmeric as an exclusive remedy for diabetes. It is more effective if taken with an equal amount of amla powder.
  6. Neem: Neem is an age-old remedy and does not require a trip to stores. It is easily available anywhere. Leaves made to juice or paste can be taken internally to lower blood sugar.
  7. Drinking a glass of water with 10 tulsi leaves, 10 neem leaves and 10 belpatras early morning on an empty stomach helps in keeping sugar levels under control.
  8. Put one cup of water into a copper vessel at night, and drink the water in the morning.

In short for diabetics, exercise serves the purposes of (1) Utilizing the fat and (2) Metabolizing sugar fat and carbohydrates, and also proteins. In the present day civilization one should regularly play some out- door games, do some productive work, or the best is different type yogic exercises. Yoga improves all sorts of metabolism in the body. So diabetics should perform different types of yoga. Yoga will definitely help diabetes mellitus. Yoga now-a-days has attracted the attention of Western people.

Drugs -

As regards drugs, there are so many drugs and formularies but the main drugs are either bitter (Tikta) or astringent (kashaya) in taste. They improve the fat and carbohydrate metabolism. Some of the medicines are given below:

The drug of choice is (1) Shilajatu (2) -Guggulu and (3) Haritaki (myrobalan) and Amalaki.

Single formulations -
  1. Guduchi satva (Tinospora cardifolia)
  2. Amalaki Churna (Phyllanthus emblica)
Compound preparations
  1. Chandraprabha vati - 500 mg twice a day with water/milk
  2. Vasant kusumakara R
  3. Vrihat vangeswara Ras
  4. Vangabhasma + parad bhasma + Ras-sindoor
  5. Mauktika kamadugha
  6. Praval bhasma
  7. Suvarnamalini vasant ras
  8. Arogyavardhini
  9. Tarakeshwara Ras
  10. Trivanga bhasma
  11. Apurvamalini vasanta
  12. Shiva Gutika - regulates proper metabolism of glucose in the body.
Medicated Ghee

Triphala Ghrit

Kwatha (decoction)

Phaltrikadi Kwatha

The dose and duration of therapy, pathya– apathy (wholesome and unwholesome) may be conveniently decided by the physician on case to case basis on Ayurvedic parameters.

Ayurveda does not regard diabetes mellitus as a disease that can be treated by mere medicine or by a dietary regimen. Though it is a yapya (not totally curable / difficult to cure) disease, the prolonged use of the above treatment procedure will not only generate the person free from Diabetes Mellitus but protect to live a long life (deergha jeevanam), healthy (sukhayu) and will be useful to the society (hitayu).