Positive Health Online

Diabetes Mellitus is a lifestyle driven metabolic disorder that impacts nearly 4 million people in the UK alone. There are two forms of Diabetes - Type I and Type II.  Currently autoimmunity is the major factor in the development of type 1, whilst type 2 is often triggered by lifestyle factors including excessive caloric intake and inadequate caloric expenditure. Obesity and weight gain are important determinants of insulin resistance in type 2 Diabetes. Globally, the condition is fast becoming a pandemic, with prevalence of diabetes rising from 108 million in 1980 to 463 million in 2019, with a predicted 700 million likely to be diagnosed by 2045. In large, this rise constitutes a lot of type 2 diabetes cases and can be attributed to our modern lifestyle practices and the unhealthy habits that come with it – poor diet, too much refined convenience foods and not enough movement. All of which contribute to the development of diabetes.

In Ayurveda, Diabetes can be interpreted under the broad clinical entity described as ‘Prameha’, which is classified on the basis of aetiology, clinic pathology, body constitution and prognosis. Because Prameha is a multi-systemic disease caused by the imbalance of Tridosha, initially mediated through Kapha which affects the urinary system tissue, it can manifest as polyuria (excessive or an abnormally large production or passage of urine) and polydipsia (excessive thirst), alongside others symptoms including lassitude (lack of energy), nausea, weight  loss,  fungal  infection  and  blurred  vision,  all  of  which  result  from  the hyperglycaemia itself. 

Prameha is classified in to three based on tridoshas (three body humours) i.e. vata, pitta and kapha. Some etiological factors are identified for separate doshik varieties.

• Kapha Prameha is caused by fresh cereals, dairy and sugar products, meat and reduced physical activities;
• Paittika Prameha is caused by spicy food, hot environments, physical exertion, anger and the intake of contradictory food articles;
• Vatika Prameha is caused by low calorie diet, skipping of meals, excessive physical activity, suppression of manifested urges including stress.

The different doshik varieties of Diabetes should be kept in mind before designing any Ayurvedic programme because the line of treatment of each type varies. Diabetes is a chronic disease that requires long-term medical attention to limit the development of its devastating complications and to manage them when they do occur.  Though there are many synthetic drugs used for the treatment of diabetes in modern medicine, these come with numerous side effects and complications. By contrast, treatment modalities in Ayurveda are focused on tackling the causative factors and correcting the metabolism at the multi systemic level, as opposed to treating the symptoms and merely focusing on hyperglycaemia, thereby preventing emerging complications.

Ayurveda is a life science and advises the most natural method of treatment in all ailments. In the case of a diabetic patient, the most important causes of the condition are sedentary lifestyle and junk food.  By following the Ayurveda regime, patients will be able to combat these issues and return to a more ‘natural’ state of being unknowingly, helping to relieve the disease.

When it comes to the regime, every patient will have a bespoke treatment plan created for them, customised to their specific condition. Ayurvedic drug and diet is very useful in type II Diabetics and has allowed many to be able to stop taking insulin related medicines. Many types of herbal decoctions, powders, arishtas (medicated fermented products) and single drugs are used as shaman in Prameha. Depending on the chronic level of the patient, it may be that they require nourishment through micronutrients and in these cases, mineral drugs help to compensate such conditions.

Shodana chikitsa (cleansing of the system or detoxification) through Panchakarma, Shamana cikitsa (pacifying the disease), Rasayana (rejuvenating the body) and Satwavajaya (refers to meditation and mental hygiene) helps to yield better glycaemic control.

Rasayanas can offer a new and promising approach in the long-term management of diabetes, because of its multifaceted action. Many of the herbs used in Ayurveda, have proven efficacy in the regeneration of β-cells and overcoming insulin resistance, some of them also possess antioxidant activity. Such distinguishing factors makes it unique compared to treatment modalities in modern medicine where a single treatment is prescribed in all types of Diabetes aiming to decrease hyperglycaemia only.   

Many people only become aware that they have diabetes when they develop one of its potentially life-threatening complications.  Around 3.2 million deaths every year are attributed to complications of diabetes. Heart disease is the leading cause of diabetic related death. The risk of stroke is 2-4 times higher among people with Diabetes, whilst diabetes causes 12,000 to 14,000 cases of blindness per year. It is also a major contributor to kidney disease and causes nerve damage to extremities, sometimes leading to amputation.

Given the severity of these results, a “do or die” approach should be followed for preventing the onset of Diabetes or its complications.  Disease specific dietary measure is a unique concept of Ayurveda. Food is the first and most important form of medicine.  This is the reason why Ayurveda science specifically prescribes special diets for Prameha patient.

The patient is advised to avoid the specific causative factors mentioned in different doshik varieties. For example, in Paittika Prameha, reducing spicy food and hot environments etc is more important than the restriction of sweets. The same is true in case of Vatika Prameha too.

WHO reports (1997) showed that between 20%-50% of people with type II diabetes can control their blood glucose levels by dietary modification alone, thereby preventing or delaying the onset of Diabetes. With this in mind, a diet with a low glycemic index, rich in fibre content and resistant to starch is advised as it increases the viscosity of meal bolus and delays the absorption, so there will be no sudden fluctuations of blood sugar.  The enzymes responsible for carbohydrate hydrolysis are excluded by the fibre components in food thereby slowing down the rate of hydrolysis, impersonating resistant starch metabolism. A low-fat diet with a dietary fibre intake of more than 30g a day was shown to represent an effective preventive approach. This will justify the apathyahara (unwholesome food) mentioned in Ayurvedic classics such as black gram baked in steam, corn flour mixed with milk sugar and ghee, paste of pulses fried in oil prepared from barley, meat of animals from desert like regions roasted on a rod or well dried in the sun and honey water.

The practice of regular exercise like a bare footed long walk without an umbrella (to absorb sunlight), Udwarthana (mild massage with dry herbal powder), adhering to an ascetic way of life (disciplined and hard life) etc. is beneficial.

Regular physical exercise improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life.

Increased exposure to some sunlight helps to boost the availability of Vitamin D in diabetic patients, which helps in improved pancreatic B cell function. Furthermore, vitamin D plays an important part in the regulation of calcium which helps to control the release of insulin.  

Walking barefoot allows the patient to “ground” with the Earth. This grounding has one of the most potent antioxidant effects, reducing inflammation, stress and sleep disturbance.

Alongside this, specific yogasana, pranayama (breathing practices), dyana (meditation) etc are clinically proven to support in various stages of Prameha. Yoga improves all sorts of metabolism in the body, reducing stress and increasing circulation which helps to prevent complications like nephropathy and neuropathy. Diabetics should perform different types of yoga. In fact, a recent study found that pranayama and yoga-asana showed a significant improvement in the P300 latency and the amplitude of N200, which improves cognitive brain functions in those suffering from Diabetes.

It is the dynamic fusion of diet and exercise, alongside Ayurvedic medicine that provides a much-needed method to tackle this growing epidemic. As more and more patients are diagnosed, Ayurveda offers a solution to think differently and go beyond the Western medical approach to provide true relief.