Diabetese and it's Managment by Ayurveda

 DIABETESE MELLITUS
Diabetes is ailment of modern era, which is creating havoc, and its prevalence is on rise with prompt pace, because of unhealthy foodhabits, lack of exercises and stress. Diabetes mellitus (DM) comprises a group of common metabolic disorder where hyperglycaemia is the chief symptom. It is also called protean [widespread] disease because it affects every system and organ in body. Pathologically different sort of DM prevails depending upon complex interaction of genetics, environmental factors, and life-style choices. Etiological, factors contributing to hyperglycaemia may include reduced insulin secretion, decreased glucose utilization, and increased glucose production.

THE KNOWLEDGE OF DM SYNDROME WAS EXISTED IN INDIA SINCE PRE HISTORIC AGE .ITS EARLIEST REFERENCE [1000 BC] IS FOUND IN MYTHOLOGICAL FORM WHERE IT IS SAID THAT THE ORIGIN OF DIABETESE TAKE PLACE BY EATING HAVISHYA [CHARAK SAMHITA NIDAN STHANA 11]. HAVISHYA IS A SPECIAL MIXTURE OF GRAINS OFFERED AS OBALATION AT THE TIME OF YAGYNA [FIRE RITUAL] AND THIS YAGYNA WAS ORGANISED BY DAKSHA PRAJAPATI
DM IN AYURVEDA IS DESCRIBED UNDER THE HEADING PRAMEHA AND CLINICAL PICTURE IS SIMMILAR TO MADHUMEHA [ONE TYPE OF 20 TYPE OF PRAMEHA].THE WORD PRAMEHA IS DERIVED FROM THE ROOT MIHA SECHANE MEANS WATERING, EXCESSIVE URINE PASSING [QUANTITY AND FREQUENCY]. THE WORD PRAMEHA MEANS PRABHUT AVIL MUTRATA MEANS EXCESSIVE AND TURBID URINATION THE AETIOLOGY, PATHOGENESIS symptoms [roopa and proova roopa] AND EVEN PRINCIPLES OF MANAGMENT DESCRIBED IN AYURVEDIC CLASSICS, GOT UTMOST PARELLANCE TO THOSE OF DM. AYURVEDA DESCRIBE DM AS MADHUMEHA ,WHICH MEANS URINE LIKE HONEY OR SWEET URINE ,SIMMILARLY DIABETES MELLITUS IS A LATIN WORD WHICH ALSO MEANS HONEY LIKE SWEET URINE
Classifications :

DM is classified on the basis of the pathogenic process that leads to hyperglycaemia, not on the basis of, earlier criteria like type of therapy or age of onset. The two broad categories of DM are type 1 and type 2 Type 1A DM results from autoimmune beta cell destruction, which leads to insulin deficiency. Individuals with type 1B DM lack immunologic markers indicative of an autoimmune destructive process of the beta cells However, they develop insulin deficiency by unknown pathology and they are usually ketosis prone Type 2 DM is characterized by variable degrees of insulin resistance, impaired insulin secretion, and increased glucose production. Distinct genetic and metabolic defects in insulin action and/or secretion give rise to the common phenotype of hyperglycemias in type 2 DM
Two features of the current classification of DM are different from previous classifications. First, the terms insulin-dependent diabetes mellitus (IDDM) and noninsulin-dependent diabetes mellitus (NIDDM) are obsolete. Since many individuals with type 2 DM eventually require insulin treatment for control of glycaemia, the use of the term NIDDM generated considerable confusion. A second difference is that age is not a criterion in the classification system. Although type 1 DM most commonly develops before the age of 30, an autoimmune beta cell destructive process can develop at any age. It is estimated that between 5 and 10% of individuals who develop DM after age of 30 have type 1A DM. Likewise, type 2 DM more typically develops with increasing age, but it also occurs in children, particularly in obese adolescents
According to Ayurvedic classifications DM is classified in sahaja prameha and Apthyanimitthaja which can be correlated with type 1 and type 2 DM
Similarly on the basis of management DM is classified in to two broad categories
1 Lean Diabetic
2 obese Diabetic
IN Ancient text book of surgery Sushruta samhita ,it is described [Chikitsa adhyaya 11:3 ] that Sahaja prameha [congenital DM] is of krisha constitution [lean or asthenic constitution] and those of Apathya nimitthija pramehi [due to unhealthy or incorrect eating and living styles] is of sthula constitution [obese constitution] ,which can be correlated with type 1 and type 2 DM
In Ayurveda DM is described under the head Prameha and; Madhumeha [DM] is one of its 20 subtypes, it is also mentioned that all subtypes if not properly treated and cared eventually terminates in Madhumeha [DM] {Charak samhita Ni 4:3}
As a matter of facts all subtypes of prameha are classified according to the nature and other physical properties of urine and all of them are not similar to DM, and can be kept under different metabolic, Nephrological and other systemic ailments , Madhumeha has got parrellance with DM Syndrome
According to prognosis [sadyaasadhyata] Charak had classified Prameha in three categories
1 Sadhya or curable: this includes Kaphaja Prameha [predominance of Kapha humour], usually due to improper life style and dietary habits, and patient is usually sthula [obese]
2 Yapya or Palliable : this includes Pittaja Prameha [predominance of pitta humour],
3 Asadhya [incurable]: This includes Vattaja Prameha [Predominance of Vata humour] ,patient is usually asthenic or lean
Charak also said that : the congenital case of Prameha or one inheriting the disease from his Diabetic Parents is incurable because of genetic factor [Type 1 DM], whatever diseases are familial are said to be incurable [ch chi :6:57]
AetioPathogenesis of Madhumeha [DM]
The madhumeha can be categorised in to two broad types according to description in classical text of Ayurveda
1 Avrita vaatjanya Madhumeha [Primary DM]
2 Dhatu kshyajanya Madhumeha[secondary DM]
Primary madhumeha [DM] : it is vaataj in nature and seemed to be fulminant from advent and can be compared with type 1 DM and advent is usually early [juvenile],usually patient is lean from the advent of ailment
Secondary madhumeha [DM] results from the complication of all subtypes of 20 prameha and can be compared with type 2 DM
Aetiology : includes excessive intake of Navanna[newly harvested Paddy ]which is rich in carbohydrates ,Gudavikriti[ jaggery and sugar products] Payamsi,Dahini[ milk and curds] ,Gramya Anupa rasa[ meat and flesh of aquatic and land animals ]which is rich in trans fats and lipids
Other factors includes Asaya sukham [lack of exercise and sedentary life style] savapna sukham[ excessive sleeping habits] . These improper life style and dietary habits eventually leads in madhumeha ,especially to those who are prone [have family history of DM]
Clinical Features:

A : Poorva rupa [Prodromal symptoms ]
These are the symptoms which occur prior to manifestation of disease if in this stage we recognise the disease process by these symptoms, than it can be prevented by taking proper care of our routine and diet regimen, these proopa rupa or pre occurring prodromal symptoms are as under and they have been dealt with great details by three principle texts of Ayurveda [VRAHAT TRYAHI], because of the utmost importance in prevention of such a deadly ailment which clings to life forever : excessive sleep ,Fatigue, Apathy, lack of pleasure ,excessive growth of nails and hairs ,sweet taste in mouth, dryness of palate and throat ,thirst, attraction towards cold objects, greasiness and numbness , burning sensations over hand and feet ,honey like urine[turbid and sweet ] as for as modern medical view is concerned they also support this by saying all ,type 2 DM is preceded by a state called impaired glucose tolerance [IGT] for long period and by taking proper preventive measures like diet control and exercise can prevent or delays DM
Symptoms and criterion for Diagnosis: The chief symptoms of DM syndrome according to Ayurveda and modern medicines are given under; although most patients with type 2 diabetes mellitus are asymptomatic for years.

1- Polyuria: increased urinary output and increased frequency; in Ayurveda this symptom is termed as prabhootavila mootrata [increased output and frequency of turbid urine]
2- Polydipsia: Excessive and frequent thirst in Ayurveda it is termed as Trishna
3-Unexplained weight loss
These three symptoms are called cardinal symptoms of DM, apart from this, following symptoms are also described in Ayurvedic text as valuable for diagnosing DM
4-Maduratwa in mootra [sweet urine]
5-Pani-Pada Daha: Bunning sensation over feet and palms and Lower extremity paresthesias- pins and needle sensation; other most common symptoms encountered are
Lethargy
Fatigue
Nocturia
Erectile dysfunction
Few cases of DM remains undiagnosed and accidentally at time of routine checkups come to notice The revised criteria for the diagnosis of DM emphasize the FPG as a reliable and convenient test for diagnosing DM in asymptomatic individuals. A random plasma glucose concentration (200 mg/dl) accompanied by classic symptoms of DM (polyuria, polydipsia, weight loss) is sufficient for the diagnosis of DM ;Fasting plasma glucose of >125 mg/dl and Two hour post glucose load (75g), plasma glucose levels 200 mg/dl, and confirmed by repeat test is sufficient criterion to confirm the diagnosis
Treatment: The basic principle or Chikitsa sutra according to Ayurvedic point of view is Shodhana [purification] and Shamana [suppression]
1-shodhana or purification is generally done in obese diabetic with adequate body strength and requires expertise in assessment of vitiated doshas and therapy to be applied ,mismanagement would lead to more harm than any good hence in general practice shaman Chikitsa is prevalent and popular
Shaman Chikitsa:[pacificatory management]
The herbs used in the management of DM syndrome are bitter ,astringent ,and pungent in Rasa [taste] all herbs having these taste is having some anti diabetic quality ;while treating DM herbs are used either single or with combination with other herbs or mineral [yoga or composite formulae]
Single drugs [herbs]:
1- Karvellaka or karela, Bitter gourd [Momoradia charantia ] also known as bitter melon, is one herb that has proven beneficial in the treatment of diabetes. Karavella has a long history of use as an herb for diabetes in Asia, Africa and Latin America. The plant extract was referred to the as vegetable insulin. Various studies have demonstrated the potent antioxidant activity of karavella. Treatment With karavella resulted in a significant increase in various antioxidant enzyme levels in the liver and kidney of diabetic rats. The extract of karavella exerted rapid protective effects against lipid per oxidation by scavenging free radicals, thereby reducing the risk of diabetic complications. Other studies have demonstrated the blood glucose lowering activity of karavella. The effect of karavella on fasting and post-prandial (two hours after food) blood glucose levels was studied in 100 cases of moderate non-insulin dependent diabetic subjects. Drinking of an aqueous homogenised suspension of the vegetable pulp led to significant reduction of both fasting and postprandial serum glucose levels. This hypoglycaemic action was observed in 86 (86%) cases3. The active components in karavella are thought to be an alkaloid memordicine, glycosides charantin and vicine, and polypeptide-p. (Polypeptide-p is a Insulin like protein Karvellaka also reduces increased lipids specially cholesterol
2- Meshshringi [Gymnema sylvestre] also called Gudmar,and madhunashini ;it controls hyperglycemia and carbohydrate metabolism in in liver and in skeletal muscles . It causes complete obliteration of sweet perception by tongue due to excessive copper content in leaf. The active hypoglycaemic agent is gymnemic acid and two crude saponins ,gymnemosides-a and gymsemoside
3-Bimbi [coccinia indica] also called Durike bel or kunduru ;the root of this herbs contain hypoglycaemic principle ,and fruit contains a bitter glycoside containing cuceubirocin B . The expressed juice of tuberous root stem and leaves is used to control glucose in DM
4-Nimba [Azadirachta indica] also called Neem ,Leaves and bark of this plant is used in DM ,it is very good detoxifier ,Liver stimulant ,and lowers the glycosuria ,it also good for to keep vessels healthy and thus prevent diabetic vasculopathies
Similarly different composite drug combination is also described in Ayurvedic texts ,a few of them are
Abhyadi kashyam
Nyogradhi churna
Nishaamalki kashyam
Asana bilvadi kashyam
Chandra prabha vati
Pramehantak Rasa
Vasant kusumakar rasa
Author of this paper has developed a composite herbal drug combination and found it very much effective in proper management of Type -2 DM

Amrit clinic panch karma yoga and cancer sansthan

Amrit clinic panch karma yoga and cancer sansthan: "specialized clinic for Ayurvedic treatment for Vitiligo [Leuckoderma]  psoriasis Liver cirrhosis ,hepatitis B , Gastrointestinal disorder Diabetes Arthr..."

VITILIGO (Safed Daag)
Hello I am Dr Naithani, I have completed my graduation B.A.M.S (Bachelor of Ayurvedic Medicines and Surgery) from Haridwar Gurukul Kangri. I have completed my M.D. in Lucknow University and I am practising in Lucknow and working with different pharmaceutical company as technical adviser and promoter. I have also worked as Lecturer, Reader & Professor in different Ayurvedic College. This is some information about Vitiligo (Safed Daag):

This is a non-infectious disorder of skin; where white lesions (Patches) are formed. Vitiligo is caused by stoppage of melanin (Colour pigment) formation by melanin producing cell, melanocyte; as a result depigmented macules are formed.
These macules may vary in size and shape and can be located in any part of body even on mucus membrane of lips and genitals
The common areas affected are face; hand; feet; axillae; groins; trunk.
The areas which are subjected to friction and trauma are usually involved; and anywhere in skin white depigmented Scar is formed Vitiligo can also be precipitated due to these causative factors:
1. Persistant pressure of string of underwear or in a person who wear tight string of under wear
2. Use of plastic slippers (over dorsa of feet)Plastic Bindi and Rubber gloves
3. Use of rubber brassieres
In Ayurveda all the skin ailments are usually described under the head “Kusth”
Vitiligo in Ayurveda classical text is described as “Svitra” or “SHVETA KUSTH” while classifying Kusth in its 18 main types; Ancient Ayurvedic Erudite had omitted Vitiligo due to its non infectious nature
The lesion of Vitiligo is painless and remains sensory unlike leprosy.
Except the cosmetic defect Vitiligo is an absolutely harmless disease.
TREATMENT
There is a common myth about the Vitiligo that it cannot be cured but contrary to this; remarkable repigmentation can be achieved in every patient and its spread can be arrested; provided that patient follows dietary restrictions and take appropriate treatment for prescribed duration.
A proper assessment of known causative factor of Vitiligo; such as plastic slippers; gloves; and other plastic materials; pressure or traumas is very mandatory and if any such factor instruct patient to discard them.
The Ayurvedic concept regarding the treatment of Vitiligo is comprehensive
Both Sodhan (Purifications) and Saman Chikitsa is being advocated for the treatment
Sodhan is chiefly performed with liquid extract of Kakoudambur (FICUS HISPIDA) with sugar lump.
Saman Chikitsa is mainly composed of:
A. KASTHA AUSHADHI (Herbal drugs )
B. RAS AUSHADHI (Herbo- mineral drugs)
A. In group of Kastha Aushadhi there are mainly 2 types of drugs:
1. Photo Sensitizing Drugs
2. Blood purifiers

1) Photo sensitizing drugs: It includes Psoralea corylifolia (Bavachi) Ammi Majus (Aatri lal) Semicarpus anacardium (Marking nut) and Ficus hispida (Kakoudambur).These Drugs are used locally as well as systemically with sun exposure.
Sun exposure is usually advised after 3 hours of oral administration; and 45 minutes of local application of the medicines at least for 10 minutes. These drugs are given once a day during daytime only; because without sun exposure these drugs cannot initiate repigmentation.
2) Blood Purifiers : As Svitra (Vitiligo) is a disease of Rakta Vikrati(Auto immune disorder)Therefore blood purifying drugs like Curcuma longa ; Eclipta alba ;Tinospora Cordifolia ; Hemidascus indicus ; Acacia catechu ;Acaranthes aspera are used to redress the blood morbidity.
B. Ras Aushadhi (Herbo-mineral drugs): It includes chiefly Ras Manikya, Taal Sindur, Sameer Pannag Ras, and Talkeshwar Ras. These drugs act like an Immuno Supressant and usually used in those patient where spread of disease is very fast to arrest the spread of disease.
TAMRA Bhasm; KASHISH Bhasm; are also used to initiate repigmentation.
After initiation of repigmentation; treatment must be continued till the desired complete repigmentation of all the lesions is achieved. But some stubborn lesions especially of mucosal surface of palms and fingers tips; sometimes respond very poorly or incomplete.
These residual repigmented area can be subjected to camouflage .For this Paste made from Mehndi (Henna) leaves is applied to affected area or lotion made from root of Plumbago Zeylenica in absolute alcohol is painted over skin. This impart natural colour which last for two or four days.
Dr.Shailendra Kumar Naithani
M.D. (Ayurveda)
Amrit Clinic
Meena Bakery Chauraha, C-Block,
Rajajipuram, Lucknow,
India.
Mob: 9415158412
Email: drnaithani@gmail.com
Web page : http://ayurvedadivine.com/

About Author And His Reaserch Clinic

About physician :

Dr Shailendra kumar naithani an Ayurvedic doctor from Lucknow [india] completed his Graduation > BAMS < from gurukul kangri हरिद्वार[Kanpur university] and Post graduation MD [physiology] from state Ayurvedic college Lucknow[Lucknow university ] and also worked as guest lecturer at same Ayurvedic college ,and as lecturer Rajeev Lochan Ayurvedic college, and at SGM Ayurvedic college Ghazipur . Hailing from a typical Brahmin family of uttarakhand, he has been doing active research in the field of healing for the past 20 years – primarily related to raising energy from the lower centre of the body to the higher centre [kundalini awakening]by tantric method of laya yoga and developed paranormal power of healing by mantra, a sort of distant healing by divine sound vibrations . He is one among the few ayurvedic physicians around the world who practice pulse reading and panchakarma treatment and help of astrological remedies by healing gems , a complete holistic approach in eradicating ailments by roots, he also know reiki and pranic healing

Incorporating the philosophy and the gist of Ayurveda with the root idea of Tantra and Yoga, the final result is not just cure, but a sea change – a path to enlightenment and bliss. The results have been amazing – an enlightened mind in a sound body.

The detailed bio data of Dr Shailendra Naithani is as under

Curriculum Vitae

DR.SHAILENDRA KUMAR NAITHANI

F : 3265 RAJA JI PURAM

Lucknow-17

Contact numbur- +91-9415158412

PERSONAL INFORMATION:

Father’s name : Sri Vishvanath Prasad Naithani

Date of Birth : 01-07-1967

Nationality : Indian

Sex : Male

Marital Status : Married

Languages Known : Hindi, Sanskrit and English

ACADEMIC QUALIFICATION:

High School : 1981 U.P. Board

Intermediate : 1983 U.P. Board

Graduation {BSc} : 1985 Lucknow University

PROFESSIONAL QUALIFICATION:

Graduation B.A.M.S. 1986-1990 Kanpur University State Ayurvedic

College Gurukul

Kangdi Haridwar

P.G. M.D. 1995 Lucknow University State Ayurvedic

(Physiology) College, Lucknow

WORK EXPERIENCE:

1. Research work: Worked as a Research officer during the period 1997 to 2000 at well known Kanpur based Pharmaceutical Company Hind Chemical.

PTO

2. Worked as a lecturer at Rajeev Lochan Ayurvedic Chikitsa Mahavidyalaya during the period 09-04-2003 to 28-02-2006

3. Worked as lecturer at SGM Ayurvedic College Ghazipur in physiology department during the period 01-04-2006 to 09-11-2008

4. Working as Associate professor at Dayanand Ayurvedic Medical College and Hospital Siwan (Bihar) from 31-11-2008 to till now

More over Dr Naithani is engaged in formulating herbal formulae of Ayurvedic drugs for different pharmaceuticals company on work to work contract basis, and also taking training seminars of medical representative of different herbal pharmaceuticals companies on work to work contract basis

DECLARATION:

I hereby declare that all the particulars furnished above are true to the best of my knowledge and belief.

Date: 10:12:2009

Place: Lucknow (Dr.Shailendra Kumar Naithani)

About clinic : Amrit clinic Panch-karma, Yoga and Cancer centre was established in the year 1998 , at Raja ji puram area of District Lucknow of state Uttarpradesh [INDIA] . From the beginning we are giving Ayurvedic treatment services, as well as astrological aspects of ailments and astrological remedies for ailment. We focus on patients with chronic intractable ailments where routine medicine is only palliative. we are dealing all chronic and lingering ailments which become resistant to modern medicines , like hepatic ailments such as cirrhosis’s liver ,Hepatitis -B ,Hepatitis-c ,drug induced Hepatitis , Fatty infiltration of Liver ; other chronic ailments of Gastro-intestinal system like IBS ,Peptic ulcers, riflux –oesophagitis; chronic skin disease like psoriasis, Vitiligo, dermatitis; osteo arthritis, Rheumatoid Arthritis, gout ;metabolic disorders like obesity ,diabetes.

Apart from this rejuvenation therapy consisting of Ayurvedic Rasayans , and Aphrodisiac herbal treatment is also available