Diabetes is a collection of disorders characterized by increased blood glucose levels/ hyperglycemia due to the body’s inability to produce enough insulin to regulate high glucose levels. There are two types of diabetes – Type 1: often occurs in children or adolescents, due to incapability of body to produce insulin and Type 2: occurring as a result of the body’s inability to respond suitably to insulin or insulin resistance. While Type 2 diabetes is more prevalent than Type 1, it is mostly (though not always) diagnosed after the age of 40.

There are several symptoms or Poorva Roopas (prodromal symptoms) to watch out for in Ayurveda that helps in early diagnosis or prevention of diabetes. These include:

Sweda – Excessive sweating
Anga gandham – Excessive body odor
Anga shithilathwam – Looseness of body
Sayyasna swapna sukhabhishangithwam – Feeling of lethargy
Hridayopadeham – Heaviness of heart
Netropadeham – Coated eye
Jhwopadeham – Excessive coating on tongue
Shravanopadeham – Feeling of coating on ears
Anga ghanathwam – Heaviness of body parts
Keshathivridhi – Excessive growth of hair
Nakhathivridhi – Excessive growth of nails
Sheetha priyathwam – Attraction towards cold
Gala Talu shosham – Dryness of throat and palate
Asya madhuryam – Sweet taste in mouth
Kara Pada daham – Burning sensation of palms and soles
Moothra madhuryam – Sweetness of urine

Ayurveda recognizes Diabetes as Prameha, a condition characterized by excessive outflow of urine. Ayurveda recognizes two types of Prameha patients: Sthula Prameha and Krisha Prameha. Sthula Prameha refers to diabetes caused due to obesity or disorders for the stout while Krisha Prameha refers to disorders for the lean. While not all who are obese are diabetic, about 90 per cent of diabetic patients are obese or over weight.
Obesity and Diabetes

Santarpana Uttaja Janya Prameha or diabetes due to over weight is a growing concern, caused due to sedentary lifestyle, excessive sleeping, excessive use of milk and milk products, meat soup, pork or red meat, seafood as well as excessive intake of sweets, fatty and fried items.

Obesity is a state of increased body weight, due to adipose tissue accumulation, that is of sufficient magnitude to produce adverse health effects. People who are overweight or obese have an added pressure on their body to utilize insulin that is produced by body to suitably control blood sugar levels and hence are more likely to develop diabetes. Excess weight is a well-known risk factor for type 2 diabetes.

Understanding the mechanism of obesity associated insulin resistance is very complex. The influence of type 2 diabetes risk in not only determined by overweight but also depends on where the fat gets accumulated. Central or visceral obesity is associated with a much higher risk for several disorders and diseases, including diabetes, hypertension, hypertriglyceridemia, decreased high-density lipoprotein (HDL) cholesterol, proteinuria, osteoarthritis, pancreatitis, gallstones, fatty change in the liver, hypoventilation syndrome, cardiovascular diseases, etc. Hence it is important to keep a check on one’s body weight to avoid further complications.

Diabetes and obesity both are basically metabolic disorders and can be very well managed by Ayurveda treatment. According to Ayurveda the line of treatment of prameha/ diabetes is strictly on individual’s constitution. The prakrithi (body constitution) of the patient, Dosha predominance of disease, Strength of the patient, tissues involved in disease, mental condition, life style and dietary habits etc all these are considered while treating the individual.

In Type 2 Diabetes, obese diabetic patient with optimum body strength having intense increase of doshas, Purification of the body by Panchakarma treatment is advocated. This depends on dosha predominance. If there is increase in Kapha dosha then Vamana or emesis and in case of increase in Pitta dosha, Virechana or purgation is advised.

Well qualified Ayurveda physician will diagnose the patients’ metabolism and agni and prescribe medicines accordingly.

Snehanam – is oil therapy or oleation therapy using medicated ghee/ oils. This is administered as per the patients’ body requirement and given in increasing dose every morning on an empty stomach. Medicated ghee is given till the body attains Sneha Snigdha Lakshna – until dryness from the body has gone. A particular diet that is easily digestible is suggested. There may be slight giddiness or hot sensation in the body during the intake which is natural as the body will be digesting the ghee and correcting the metabolism.

Shodhana – Purification or detoxification treatment. After snehana, purification treatment is advised. Unlike in normal detoxification treatment swedana (fomentation therapy) is contra-indicated in Prameha as Swedathi Pravruthi or profuse sweating is one of the main symptoms of prameha. Moreover Swedana induces Kleda (wetness) which is a causing factor for this disease. Shodhana is given in case of increase in Kapha dosha and Virechana for increase in Pitta dosha. Drugs are chosen according to the individual’s body and disease strength. Appropriate diet given by the physician must be followed during and after the procedure.

Shamana – Palliative treatment or internal medication. After the detoxification, herbs are used in the management of Prameha which are bitter, astringent and pungent in taste. These include Eugenia Jambolana (Jamun beej churna), Gymnema Sylvestre (Gudmar patra churna), Pterocarpus Marsupium (Vijaysar churna), Ficus Bengalensis (Nyagrodha twaka churna), Shilajitu, Fenugreek seeds powder (Methi seeds churna), Emblica Officinalis (Amla), Curcuma longa (Haridra), Kirat tikata (Chirayata). Chandraprabha Vati, Trivanga Bhasma, Nisha Amalaki Churna, Vasantha Kusumakara Rasa, Madhumardhana Churna, Nyagrodadi Kashayam are some of the commonly prescribed drugs.

Apart from medication diet also plays a major role in controlling obesity and diabetes. Yava (Barley), Godhooma (Wheat), Bajra, Mudga (Green gram), Nimba (Azadirachta Indica), Karavella (Momordica charanti), Patola (Trichosanthas Anguina), Rasona (Garlic), Udmbara (Ficus racemosa), Jambu (Black berry), Syzygium, Cumin, Tala phala (Borassus flabellifer), Kharjura (Phoenix sylvestris), Kamala (Nelumbo nucifera) and Utpala (Nymphoea Stellata) are some of the recommended foods.

Stress and Diabetes

Stress, especially for those who have a family history of diabetes or those who are diabetic, is sign of concern. Our body responds to physical or emotional stress by preparing itself to take a “fight-or-flight” action. During this time, the adrenaline levels, growth hormone and glucocorticoids also called as stress hormones, increase and release the stored glucose into the bloodstream.

Typically the body responds to the increased glucose level by increasing the insulin level. However if the person is diabetic, the fight-or-flight response does not work effectively as the increased body glucose cannot be utilized by the cells due to improper insulin production – eventually leading to increased blood sugar levels. Prolonged stress can repeatedly increase the blood sugar levels making it impossible for the body to have a control on diabetes.

Anger (krodha), grief (shoka), and anxiety (udvega), depression (vishaada) are different forms of stress and among the most common etiological factors of Pittaja and Vataja Prameha.

Uncontrolled blood glucose levels can lead to many health complications such as blindness, kidney problems, and nerve damage resulting in foot numbness and gangrene among others. Cardiovascular problems such as heart attack and even stroke may follow.

Some simple steps to manage diabetes by keeping their stress under control include:

• Slow down and relax – One must make time to stop and smell the roses. There is no point in rushing through life at the cost of one’s health. A relaxed state of mind is a happy and healthier state of mind.
• Exercise or Yoga will keep you fit both physically and mentally. Physical stress can be combated by doing at least minimal body exercise.
• Meditation with Pranayama can help balance blood sugar levels and is also a great way to de-stress mentally and physically.
• Abhyanga body massage with medicated oils is a wonderful way to combat stress.
• Shirodhara with medicated butter milk will not only relax you but also helps reduce your blood sugar levels.

Whatever your concerns, always consult with an Ayurveda physician first and manage your diabetes the holistic way.