alternative medicine
Concept of Ayurvedic Dietetics and Yoga
therapy in the management of Diabetes
Mellitus
Kirankumar V. Mutnali, Sanjeev S. Tonni, Amrutha Kalyani
Health is a simple word with
a complex meaning. For few it is
a mere freedom from a disease,
a goal to be achieved, to some
it is the normal functioning of
body and to some it’s a business.
But to be precise, Health is
“Life”. In the present scenario,
man is under the clutches of
various challenging diseases due
to his improper lifestyle and
dietary regimen. Diseases like
hypertension, diabetes, obesity are
among such challenging diseases
which not only need cure but
complete elimination from the
society. At present, due to the
increasing incidence, Diabetes has
throned itself as the “king of
diseases”; and India is at the verge
of being crowned as the “World
Capital of Diabetes”. Every year
7th April is observed as World
Health Day to commemorate the
inception of WHO; with each
year being assigned a health
theme. The theme for the year
2016 stood as “Halt the Rise –
Beat Diabetes”. The theme itself
highlights the need of embracing
prevention in managing Diabetes.
From 2016, the Ministry of
AYUSH, has decided to celebrate
the DhanwantariJayanthi(Inceptor
of Ayurveda) as the National
Ayurveda Day and its theme in
Dr. Kirankumar V. Mutnali, Reader,
Dept. of PG Studies in Kayachikitsa,
Dr. Sanjeev S. Tonni, Reader / HOD,
Dept. of PG Studies in Swasthavritta,
Dr. Amrutha Kalyani, PG Scholar,
Dept. of PG Studies in Swasthavritta,
KLE University’s Shri. B.M. Kankanawadi
Ayurveda Mahavidyalaya, PG Studies and
Medical Research Centre, Shahapur, Belagavi.
Karnataka. India.
Specially Contributed to "The Antiseptic"
Vol. 114 No. 7 & P : 40 - 42
40
2016 was “Prevention and Control
of Diabetes”
Ayurveda – the “Science of life”,
firmly believes in the concept of
prevention. Diabetes is mentioned
in Ayurveda as Prameha, occurring
due to the derangement of three
basic psycho - physiological factors
of the body (Vata, Pitta, Kapha)
and bodily tissues like meda
(Fat). Prameha is characterised
by frequent urination, occurs due
to various factors which affect all
the entities framing health. It’s a
disease occurring due to practise
of unhealthy dietary regimen,
lifestyle, genetic predisposition
and disturbed psychosocial state.
By this we infer that, Prameha
is not a single organ targeted
disease but is of multiorgan. The
ancient texts describe each cause
in detail and each of them stands
valid till date.
Causative factors:
1. Unhealthy dietary regimens:
Excess consumption of high
calorific food and drinks, viz.
those of oily, sweet, heavy for
digestion, highly viscous, colder
potency and more of soothing
kind precipitate the risk of
acquiring Prameha. Consuming
incompatible foods, stale food,
excess of food, untimely food
intake serve as the welcoming
causes for Prameha.
2. Unhealthy Lifestyle: Practice
of sedentary lifestyle like
excess of sleep, prolonged rest,
inclination to have comfort
in every action like sitting,
sleeping instigate buildup of
THE ANTISEPTIC
kapha and meda (Fat) and serve
as the prime causes of Prameha.
3. Genetic predisposition:
Ayurveda states that like other
genetic diseases, Prameha
too manifests due to the
pathologies at the genetic level
(Beejadosha). Derangement in
the properties of sperm and
ovum at the time of conception,
adoption of unhealthy lifestyle
and practices during pregnancy
and lactation cause Prameha
since the birth of a child.
4. Psychosocial factors: Mind,
is both the cause and cure
to a disease. Factors like
constant grief, anger, anxiety
and other such stress factors
bring imbalance in the mind
resulting in Prameha.
Pathogenesis of Prameha:
Though the disease develops by
derangement in all thedosha; it is
predominantly due to the vitiation
of Kaphadosha and Medadhatu.
These entities have properties
similar to the properties of high
calorific diet. Adoption of any
form of above said causes, adds
on to Kapha and meda leading to
Obesityand Prameha.
Types of Prameha:
Ayurvedic texts like Charaka
Samhita and Sushruta Samhita,
mention different types of
Prameha, with basic types being
SahajaPrameha or JatahPrameha
(Juvenile/Hereditary) and Apa
thyanimittajaPrameha(Maturity
Onset Diabetes Mellitus/Acquired
Variety). These can be correlated
to Type I and Type II DM of
Vol. 114 • July 2017

contemporary medical science
respectively. Other classification is
based on the physique of the patient
like KrushaPramehi (asthenic/
thin type) and SthulaPramehi
(over nourished/obese type)
relating to SahajaPrameha
and ApatyanimittajaPrameha
respectively.
Sahaja Prameha:
It occurs either due to the union
of defective sperm and ovum at the
time of conception, improper diet
and lifestyle practises opted by
mother during pregnancy leading
to the defective intrauterine
environment or improper diet
and lifestyle practises opted by
mother during lactation which
trigger genetic predisposition.
Excess intake of high calorific
diet may cause juvenile onset
of Prameha in children who are
genetically susceptible to it.
Apatyanimittaja Prameha:
The unhealthy dietary, lifestyle
and psychologic factors precipitate
the manifestation of the disease.
Prameha is also classified on
the basis of doshic predominance
as vataja, pittaja and kaphaja and
further these having 4, 6 and 8
subtypes respectively.
Prodromal Symptoms of Prameha:
They are the symptoms
observed prior to the complete
manifestation of the disease. For
Prameha they include excessive
sweating, body odour, laziness,
inclination towards rest, formation
of excess wastes in eyes, ears,
teeth, oral cavity, excess growth
of hair and nails, matting of hair,
burning sensation in feet and palms,
sweet taste in mouth, attraction of
insects towards body and urine.
It presents many conditions of
oral cavity especially on the
gums and the periodontal tissues,
like, gingivitis, cavities and oral
candidiasis. Other symptoms like
Vol. 114 • July 2017
the body odour occur due to the
bacterial growth and thirst due to
excess of disturbed metabolism.
Few of these features represent Pre
diabetic stage or noticed during
impaired glucose levels.
Diagnosis:
Prameha can be diagnosed on
the basis of its symptoms viz.,
excess urination (polyuria), thrist
(polydypsia), increased appetite
(polyphagia), lethargy etc. Careful
observation of the symptoms helps
to diagnose the disease. Tests like
fasting blood sugar, post prandial
blood sugar, random blood
sugar, Glycocylatedhemoglobin
(HbA1c), Glucose Tolerance
Test (GTT) help to confirm the
condition more precisely and its
prognosis.
Prognosis:
Madhumeha, variety
ofvatajaprameha (Type I DM) is
incurable, because the cause of
the disease is lack of Insulin
hormone from the pancreas or
insensitivity towards insulin by
the body tissues and the strength
of the person being compromised.
While KaphajaPrameha is easy to
cure and PittajaPrameha is Yapya
(controllable by diet and lifestyle
modification). Both Kaphaja and
Pittaja variety of Prameha can be
correlated to Type II variety of
Diabetes mellitus.
Complications (Upadravas) of
Prameha:
Lack of control over the disease
at the initial stage, progresses the
disease to an irreversible state and
also there occur emergence of
other diseases. Few complications
of Prameha are Kushtha (skin
diseases), Pramehapidaka(diabetic
carbuncles), abcess, sthoulya
(obesity), shopha (generalised
oedema), Mutrakricchra (urinary
disorders), weakness, indigestion,
diarrhoea.
THE ANTISEPTIC
alternative medicine
Management of Prameha:
Ayurveda mentions avoidance
of causative factors of the disease
as the first line of treatment of
any disease. It stressess more
on the preventive aspect of
the disease than the curative.
Samshodhana(biopurifaction)
therapy is adopted if the patient
is physically strong and suffers
from ApathyanimittajaPrameha,
on the contrary, to a weak patient
Samshamana(palliative therapy) is
advisible. Management of Prameha
mimics that of obesity wherein
Apatarpanachikitsa (balanced diet
with calorie restriction) is adopted
to minimize the vitiation of kapha
and meda.
Dietary management:
Food is one of the three
basic pillars which govern life.
A text in Ayurveda quotes that
a disease gets cured by just
following appropriate Pathya
(wholesome diet); but even 100
medicines fail to cure a disease
in the absence of pathya. A good
planned diet brings equilibrium
among the body humours and
tissues. The science mentions
various food principles at the stage
of preparation, processing and
consumption, which are important
both in prevention and cure of
the disease.
SthulaPramehi should consume
Apatarpakaahara(balanced diet
with caloric restriction), avoid
food and drinks that are kapha and
meda promoting. Yava (barley)
is quoted as the best diet to be
adopted by a pramehi. Many
researches have proven that use
of barley and preparations made
using barley flour improve glucose
tolerance, reduce insulin responses
and lowers the inflammmatory
markers. Use of barley in the form
of Apupa (cake), foods prepared by
soaking the barley seeds in the in
Triphala decoction (herbal mixture
41
 alternative medicine

of Teminaliachebuala, Terminalia in relishing the food and aids disease.

bellerica and Phyllanthusemblica), digestion. Quantum of the food to Psycho social management:
because triphala is proved be consumed should be decided on
to be antidiabetic and the basis of appetite. Foods heavy Practice of meditation,
antioxidant. Studies have proven for digestion should be consumed pranayama, deep and quick
Amalakim(Indian gooseberry) to to the half of the satiety level and relaxation techniques would
those of light to be consumed to help to calm the mind; thereby
be antidiabetic, hypolipidemic
the full of individual’s satiety. curing the disease and its
and antioxidant. Seeds of Venu
complications. Various brain
(bamboo) and Godhuma (wheat) Consumed quantum of food tonics like Shankhapushpi
stand as substitutes to use of should not restrict an individual’s (Convoluluspluricaulis), Brahmi
barley with triphaladecoction. activities like standing, walking (Bacopamonneirri), Vacha
Various spices and condiments like etc. Food should be consumed counter act the stress induced
turmeric, jeera, dhaniya, ginger, only on experiencing the urge neuroendocerine changes and
methi, garlic and cinnamon are of hunger. Prior and overeating render good availability of
proven to be antidiabetic and leads to various gastrointestinal insulin for metabolism. Herbs like
thereby, use of these in routine, discomforts. Post meals one should Meshashrigi (Gymnemasylvestra),
halts the progress and cures the practise walking for 100 steps and Guduchi(Tinosporacordifolia),
disease. sleeping on left lateral position to Jambu, Asana (Pterocarpus
Ayurveda prescribes the use aid digestion and prevent the build marsupium Roxb.), Saptaparna,
of tiktashaka (bitter vegetables) up of Ama (toxic metabolites). Amalaki have promising results in
like bitter gourd, fenugreek, Lifestyle management: managing Prameha. Complications
bottlegourd, snake gourd in This being a burning cause of can be managed by the use of herbs
managing Prameha. Grains like the disease, should be checked like Arjuna (Terminalia arjuna),
green gram, kodo-millet; mustard at right time. Ayurvedic texts Pushkaramoola (Inularacemosa),
oil are helpful in resolving the highlighting the importance of Gokshura (Tribulusterrestris),
disease. Use of meat is not vyayama (physical activities) Triphala, Dashamoola (roots of ten
restricted in Ayurveda; but the mention various activities like herbs) and Vacha (Acoruscalamus).
meat should be of preferably walking, running, jogging, Though Pramehais a complex
low calories (chicken meat). horse riding and swimming. disease, it can be managed
Most of the times liquids serve These should be practised by (except the hereditary type) with
as medicines in many dieases. Sthulapramehi (Type II DM) as Ayurvedic modalities. In its full
Sarodaka or kushodaka(liquids such activities reduce kapha and fledged state, treatment is the only
obtained after boiling and cooling meda. Practice of Asanas (Yogic option, but preventing its progress
water with heart wood of khadira posture), Pranayama (breathing to the stage of complications or
(Acacia catechu) and leaves of exercises) and meditation stabilize its origin is needed. By adopting
kusha respectively) can be used the mind and body and help healthy dietary regimen, lifestyle
as substitutes to normal drinking in managing the disease. Asanas and a good state of mind, we can
water in diabetic patients. like Vakrasana, Mayurasana, definitely Halt the Rise and Beat
One should always consume Matsyasana, and Hamsasanarender Diabetes.
warm and fresh food as it helps excellent results in managing the 
Filaggrin is a protein which is found in the skin, where it is involved in the formation of the
corneal layer and contributes to protective functions. The gene coding for filaggrin is situated on
the chromosome Iq21. It is the seat of several mutations which are significantly associated with
an increased risk of atopic dermatitis. Among these mutations, R501 X and 2282del4 are the most
significant in Europe and provoke a complete loss of expression of filaggrin. 14 to 56% of patients
affected by atopic dermatitis and 10% of the European population in general have at least one
allele of mutated filaggrin, which increases the risk of developing atopic dermatitis by 1.3 fold.
Although it is more significant, filaggrin is not the only gene associated with atopic dermatitis.
Other genes code for inflammatory factors such as some interleukins, proteases or their inhibitors.
- La Medecine en France

42 THE ANTISEPTIC Vol. 114 • July 2017