Sunday, September 12, 2010

Diabetes – a life style disorder

Ayurveda an age old science, explains this disease as Prameha wherein the prime symptom is excessive and frequent urination. As per Ayurveda Prameha is a disorder primarily related to the various abnormalities associated to the urination which further leads to a group of metabolic disorders(Prabhut avil mootrata). Diabetes- a Greek word that literally means fountain/ tap, was later associated to a disorder characterised by excessive production of the urine, there on a word mellitus was added to it which means honey. Sushruta- father of modern surgery explained the similar disorder much before the origin of modern medical science, and named it as Madhumeha. The word is made up of two words, Madhu – honey, Meha – Urine.

One can get the idea of similarity between two disorders explained by two different systems of medical sciences. Madhumeha is a disease in which subject frequently secretes a lot of urine (polyuria) with increased thirst (polydypsia) and associated with increased hunger (polyphagia). As per Ayurvedic methodology of diagnostics, it is decided depending upon clinical symptoms with a thorough urine examination. Charaka explained an easy methodology of diagnosing this disease based on a prodromal sign wherein ants are attracted to the urine of the patient.

Diabetes, which is generally considered as a life style disorder; caused by excessive consumption of unplanned and unwholesome diet associated with excessive sleep or non physical exertion, as per Charaka (Asya sukha, Swapna sukha…). By mentioning above causative factors Charaka might have predicted the modern life style which could be realized by prevalence of this disease in urban part of the world. Adding further to the list of causative factors, it includes excessive indulgence in the food which is rich in fat and quite heavy to digest for a prolonged duration, which is again a style icon of urban population which includes a fascination for junk food with carbonated beverages without much physical exertion. No doubt that Ayurveda also considers this disease as a genetic disorder (Beej Dosha). All such factors leads to vitiation of the Kapha (water metabolism) which in turn results in Prameha or diabetes.

Ayurveda classifies Diabetes in 20 types which actually emerge out of their individual dosha vitiation viz- a- viz from Vata, Pitta and Kapha. Sushruta being first to identify Madhumeha, which arises due to the predominance of vata dosha is a peculiar form of prameha in which sufferer frequently passes large amount of sweet urine and have been enlisted among the incurable diseases. Having said incurable, Madhumeha/ Diabetes comes under the diseases that need to be managed with continuous and through efforts through out the life span. It becomes incurable due to the involvement of all three doshas, meda, Rakta, Shukra, Ambu (water portion), Vasa, Lasika, Majja, Rasa, Oja (Sap of life), and Mamsa which are called as ten vitiated factors (Dasa dooshya). So it is extremely important for the patients, who think that swallowing a pill will cure their diabetes and they can eat anything and everything, to follow the proper dietary advice in association with proper exercise regimen.

From the point of view of treatment, Ayurveda classifies diabetics under two divisions, 1. Obese and strong, 2. Emaciated and weak. Category second is advised to be treated by improving their nutrition and lifting up their absorption level by judicious use of food supplementations and medicines. This kind of patient should be avoided for deep cleansing therapies until unless his general health condition is improved remarkably. While obese and strong patients should be subjected for the oleation (if necessary) and fomentation followed by deep cleansing by means of Vamana (induced vomiting) or Virechana (induced purgation). Once the through cleansing is achieved, patient is again kept on balanced diet to control the disturbed physiology.

Generally barley is considered to be helpful for maintaining and avoiding Madhumeha. Barley flour could be mixed with wheat and gram flour to be consumed in the form of baked bread. Fenugreek seed powder or sprouts can be used to achieve an additional effect in maintaining Madhumeha. Sushruta suggests a judicious use of Shilajeet to control Madhumeha. One must understand that Diabetes management treatment should be done under the strict supervision of a qualified Physician only and a regular check on Blood Glucose level is must. Chronic Hyperglycemia results in serious and long standing effects on other organs of the body and may also lead to Diabetic Neuropathy.

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