An Ayurvedic Review on Diabetes mellitus (Madhumeha)

*Corresponding author: vshinde509@gmail.com Abstract: Today's era is dominated by disorders of life style and Ayurveda is the best solution to these disorders. Ayurveda is often referred as “Science of life" but it is more of a science that deals with prevention of mental & physical disorders. It is one of the oldest systems of medicine. Prameha, as described by Acharya Charka & Sushruta is one of the disorders that have emerged out of urban life style. The causes and symptomatology of Madhumeha described few thousand years back run parallel with the causes of Diabetes Mellitus mentioned by the system of modern medicine. Hence, Madhumeha can be co-related with diabetes mellitus. In all, 20 types of Prameha have been described based on the predominance of Vata, Pitta & Kapha. 1 ' Madhumeha' is a subtype of Vataja prameha 2 . There are four types of Vataja Prameha i.e. Vasameha , Majjameha, Hastimeha and Madhumeha. Ayurveda includes Prameha amongst Ashto Mahagada 4 . It is of two kinds viz one due to vata vriddhi caused by dhatu kshaya and another by vata vriddhi caused by obstruction of channels of vata by other doshas 5 .


INTRODUCTION
Diabetes is one of the leading causes of morbidity and mortality in the world 6 . In modern medicine, in spite of tremendous advancement till date an ideal drug which can cure diabetes is not yet available and still scientists are struggling to search an effective and harmless therapy. The International Diabetes Federation estimated that the number of diabetes patients has doubled from 19 million in 1995 to 40.9 million in 2007 and it is projected to increase to 69.9 million by 2025 7 . Almost 11% of urban population above the age of 15 is having diabetes. WHO estimated that diabetes and heart disease tolls India approximately to $210 billion and it is supposed to increase up to $ 335 billion in next 10 years. Considering the etiopathogenesis as mentioned by Acharya Charka, it can be scientifically stated that Madhumeha is a life style disorder and by means of proper Dincharya, Ritucharya, Pathya -Apthya and Ayurvedic formulation we can treat diabetes and reduce its prevalence and complication .Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both 8 . Ayurvedic remedies for Madhumeha (Diabetes mellitus) are the oldest among all the available therapies, which includes in the Prameha category. Prameha are a list of urinary disorders, especially characterized by profuse urination with several abnormal qualities due to imbalance of Doshas. In Madhumeha the urine becomes (sweet and smells) like honey. It is of two distinct types, one due to the aggravation of Vata on account of the Dhatukshya and the other due to Kapha-meda Avarana (Blockage of channel along with Vata prakopa). When there is condition of Avarana (blockage of the channels/ activity) there are the additional symptoms of the vitiation of the particular Dosha without any other apparent cause. Sometimes the symptoms are mild and suddenly they appear in severe form which is difficult to cure.

Etiology-
Sedentary habits and the pleasure of excessive sleep, milk and its preparation, newly harvested cereals, new/ fresh wines, preparations of jaggery (canesugar preparations) and all other Kaphaaggravating factors are the causes of the diabetes syndrome. 9 and Dushyas (substratum of pathology), response occurs in the form of non-manifestation or otherwise of the disorders. When these three factors do not combine together or if combined after a long time or in weakened state, disorder will not be there, or it will manifest lately, or in a mild form or without all the said symptoms. On the contrary, the result will be contrary. Thus is said the cause of response in the form of non manifestation or otherwise of all disorders. 11 Premonitory Symptoms 12 -There premonitory symptom are-feeling of burning in the palms and soles, heaviness in body, urine is sweet, bad in smell and white in color, stupor, debility, profound thirst, dyspnea, more accumulation of dirt in the palate, throat, tongue and teeth, hairs on the head adhering to one another and more growth of the hairs and nails.

Pathogenesis
Clinical Features 13 -The general features of the diabetes syndrome is the passage of profuse and/ or turbid urine, the urine becomes like honey and the entire body becomes very sweet 6 .

Classification of Diabetes Mellitus 14 :-
Type-1 Diabetes Mellitus-Type 1 diabetes, formerly called juvenile diabetes, is usually diagnosed in children, teenagers and young adults. Type 1 diabetes may develop in adults. This is an autoimmune disease causing specific destruction of Beta-cell of pancreas which result in an absolute insulinopaenia.
Type-2 Diabetes Mellitus-Type 2 diabetes, formerly called adult onset diabetes, is the most common form and has an insidious onset. It is commonly seen in adults, but can occur even in childhood. Weight loss is uncommon unless hyperglycaemia is severe while ketosis is rare. Familial inheritance is very common. This form of diabetes usually begins with insulin resistance and initially there is a counter regulatory hyperinsulinaemia. With time, the pancreas loses its ability to secrete enough insulin in response to meals and clinical diabetes develops.