Diabetes is a worldwide public health threat. There are more than 194 million people with worldwide and that number could reach 333 million by 2025. However, there are simple steps that each of us can take to reduce developing diabetes.
In 2000, the five countries with the largest numbers of persons with diabetes in India (32.7 million), China (22.6 million), the United States (15.3 million), Pakistan (11 million) and Japan (7.1 million).
At least 50% of all people with diabetes are unaware of their condition. In some countries this figure may rise to 80%.
Diabetes is one of the leading causes of death in most developed countries.
Diabetes is the leading cause of blindness and visual impairment in adults in developed countries.
Ayurveda Acharya Susruta (5th century B.C.) had described 20 different types of diabetes called as ‘Pramehas’. Prameha was meant to convey anomalies of urinary secretion. Diabetes in india has a long history since ancient time. The oldest reference of this disease dates back to more than 4500 years. The name of the disease found in ‘Devik yuga’ tells it has been known and treated by Indians long ago.
THE CRITERIA FOR DIAGNOSIS OF DIABETES
- FBS -Pre Diabetic 90-110mg/dl Diabetic(Without medicines) > 120mg/dl
- P.P.B.S -<120mg/dl is considered as Diabetes Mellitus
- HBA1C -< 6 is non-Diabetic, – >7 is Diabetic, >-6-7 is controlled Diabetic
SIGNS AND SYMPTOMS
- Excessive ingestion of food (Polyphagia)
- Excessive urination (Polyuria)
- Excessive thirst (Polydipsia)
- Recurrent abscess, boils, carbuncles or fungal infection.
- Delayed wound healing.
- Cataract appearing at an early age.
- Resistant pulmonary tuberculosis.
- Silent heart attack
TREATMENT FOR PRAMEHA
Prameha is mentioned as one of the maharogas, the disease can be divided into stages as it has been classified into kaphaja, pittaja and vataja prameha.
In the first stage of prameha where there is excess production of kleda in the body due to accumulation of improperly formed kapha that is sent out of the body through urine. The treatment should be focused to reduse kapha using kaphahara drugs.
In the next stage where the vata is in predominance due to the emaciation of the dhathus and ends in weakness of organs. This when we can see the symtoms of neuropathy. Devolp the treatment should be mainly to reduce vata. In the first two stages we might treat kapha, pitha or both. But in the last stage since the damage caused to the dhatus is due to vatha, it must be treated first or it may be fatal.
THE MANAGEMENT OF DIABETES MELLITUS
Aims of Treatment.
- The ideal treatment for diabetes would allow the patient to lead a completely normal life, to remain not only symptom-free but in positive good health, to achieve a normal metabolic state, and an escape the complications associated with long-term diabetes.
- Patients should realise as early as possible that it is upon themselves that success or failure will depend. The doctor can only advise.
- As soon as the diagnosis is certain the patient should be told and instruction and treatment begun forthwith. The average patient suffers initially from an acute anxiety reaction for which explanation is the best remedy. Moreover understanding is likely to lead to better cooperation in treatment.
- Awareness of proper dietary restrictions and excercises are important in diabetes.
Type of treatments:
- Shamanachikitsa (Curative treatment or drug therapy)
- Shodhanachikitsa (Purificatory treatment or panchkarma)
Medicines to Manage and control diabetes
**Note: Above medicines under doctor’s advice
Shodhana( Purification therapy)
In strong patients, one should employ purificatory measures like administration of emetics, purgatives and enema. The purificatory therapies are selected depending on the dominant dosha, e.g. emetics in kaphaja, purgatives in pittaja and enema in vataja type of prameha.
Depending on the intensity of the dosha, mild, moderate or severe measures should be employed. In obese patients, emetics are contraindicated but purgative and enema may be given. Patients with prameha usually require large dose of purgatives.
SPECIAL KERALA TREATMENTS TO IMPROVE THE HEALTH OF DIABETIC PATIENTS.
Warning: All instructions and medicines should be taken only under strict medical supervision of doctors
SAMPLES OF BALANCED DIABETIC DIETS
This diet is as close to the normal diet as possible so as to meet the nutritional needs and the treatment of the individual patient. This diet is slightly low in carbohydrates, but adequate in other food prin¬ciples.
|Green leafy vegetables||200||200|
|Fish/ Chicken without skin||–||100|
|A diabetic diet should provide|
|Fat||40 g and|
Milk , curd, jaggery , sugar ,meats of animals from marshland , cereals that are less than a year old and recently distilled alcohol ,laziness ,excessive sleep, inactivity all this increase kapha in the body, which lead to prameha.
Two varieties of prameha are described:
- Sahaja (Generic)
- Apathyannimitaja(Irregularity in habits)
This type according to Sushruta occurs in individuals with family history of diabetes. As per the recent studies we know that more than 50% of the subjects who had both parents diabetic develop diabetes compared to less than 16% of those with no family history.
As per the body type, prameha patients are divided into two groups for the treatment as sthoola (obese and strong) and krsha (emaciated and weak).According to Charaka Samhita, prameha are 20 types, which have the common symptom as excess urination and turbidity of urine. According to the predominance of dosa,prameha is classified into kaphaja prameha(10 types),Pittja prameha(6 types) and Vataja prameha(4 types).
The result shows that the kaphaja prameha patients are similar to gestational diabetes, pittaja prameha prameha patients are similar to types 2 diabetes and vataja prameha patients are similar to type 1 diabetes.
1).Type I DM
2).Type II DM
4).Drug Induced DM