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Contribution of Ayurveda for the Treatment of Diabetes Mellitus

Prof. J.K. OJHA, Head of the Department of Dravyaguna, Institute of Medical Sciences, Banaras Hindu University ,

Varanasi

What is Diabetes: -

Diabetes mellitus is a disease characterised by High 'Blood Sugar and finding of Wasted Sugar in the urine because Pancreas fails to supply enough effective insulin.  The body is therefore unable to use foods (Carbohydrate, Protein and Fat) properly and due to that foods are not changed into the energy that the body ceils need to sustain 'life and keep the Body functioning in normal manner.

In the Words of Charaka

For the first time this disease has been diagnosed as Madhumeha in Charaka (2000 B.C.) an authentic treatise of Indian Medicine.  A Biogenic approach as a trace and test of this disease by the use of ants and flies over urine and body have been narrated in this literature.  It is a matter of great attraction that in Charaka this disease has been Included as one of the genetic disorders in which Beejdosh means abnormalities in sperms and ova of parents has been mentioned. Further, over eating of Rich diet, which contains much of Madhur (Sugar), snigdha (Fatty substances) and lack of exercise and Physical work have been described as etiological factors. Not only this malnourished and hard labour, mental strain, worry, fear are also referred as causative factors of this disease.

Classification of Diabetes according to Ayurveda: -

1. Curable - Can be cured

2. Incurable - there is no cure

3. Palliable - Treatment required during whole life time..

Clinically Diabetes were further studied and grouped into three such as; Sthoola and Balwan - (Obese and strong) mean maturity. Onset of Diabetics. - They would be cured.

Krisha and Paridurbal - Emaciated and weak.  They would be palliable.

Jatah madhumeha - Born and Child diabetics. They were incurable.

Treatment during those days:

A triangular approach to treat a Madhumehi (Diabetic) has been clearly recommended such as :

1)         Diet therapy

2)         Drug therapy

3)         Exercise and Yoga therapy

All the therapies were equally important in sustained way for longer duration.  With the help of these three ways Diabetic people would maintain their good health by keeping the normal blood sugar levels.  Had it not been controlled through processes entire diabetic people would have been died already.  That is why traces of this disease and genetic patient are found in history as well as in modern time.  Because Insulin and other oral drugs for the treatment are available in India only for the last one or two decades.

Treatment at Present:

Insulin was invented in 1922 by Banting and Best of Canada and was changed the entire set up of treatment.  Though Insulin has saved the lives of thousands and lacs of diabetics, and increased the longevity also. However, due to its continuous use some of the complications have started becoming a fatal and life became very pitiable.

Some reports have been published by P. White of- Joslin Clinic U.S.A. as mentioned below

Cause of Death in Juvenile Diabetics

The fatal cases studied wore divided into two groups. Pre-insulin era (Before the use of Insulin) and Post-insulin era (After the use of Insulin).  In Pre-insulin era Ketoacidosis (Coma due to High Blood sugar) accounted for 74% of death. Cardiovascular, infection, Renal failure etc Were very nominal as cause of death, but in Post-insulin era cardiovascular disease replaced Ketoacidosis as the main cause of death after insulin was available for the management of diabetics.  They survived long enough to develop myocardial infarction, arteriosclerosis heart diseases and cardiac failure which accounted for high percentage of the deaths.  Renal failure became the second most common cause of death in post-insulin era.  The incidence of cardiovascular death increased progressively during the second and third decades and it became the Reading cause of death by fourth and fifth decades.  Since insulin became available cardiovascular, kidney complication have clearly emerged as leading cause of death.  Among the survivals ischemic heart disease is considered the major hazard of long terra diabetics.

Regarding Oral Hypoglycemic agents the following facts have come to light.

1.  Rastinon (Talbutamide) induces Haemolytic anaemia: (P.Malacarus et el, 1977

2.  Diabenese (Chloropopamide)-produces intro vascular haemolysis in Diabetics (P.Malcarus, 1977).

3.  D.B.I. Phenformine - The food & drug administration of U.S.A. in 1977 has decided to withdraw D.B.I from the market as this drug may constitute a significant health risk lactic acidosis may develop and death even may result in diabetic patient using this drug. This result is based on mounting scientific data from studies in U.S.A. and other countries.  Other drugs have started producing cardio-vasculopathy & Coma and death in the Diabetics.

The above data made us to think over the problem in order to provide good health along with control of Blood Sugar by the help of Ayurvedic approach.

We decided to find out safe, cheap and easy herbs and method to take, care of Diabetics; Following triangular approaches were adopted

1. Diet Therapy.          

2. Drug Therapy         

3. Exercise and Yoga therapy

(A) We recommend easily available Veg and Non-Veg diet such as Parched cereals in the form of Bread or Sattu or as per the liking of patients Wheat, Barley and Bengal gram, parwal, Karaila, Mothi, Guler, Pulses (not Urad) curds, milk, eggs, meat soup etc. amounting to (1500 -2200 cal.) in desired amount.

(B) Exercises and Yogas -Regular walking (till tired), massage of oil, washing of cloth, other suitable exercises for hour morning and evening.

Yogas were recommend 12 types of yogic practice as routine of life hour morning and evening, such as 1, 2.

(C) Drugs- We have tried many drugs but out of that Vijaisar and Pushkaramool were found very encouraging. Vijaisar- Vijaisar was first introduced by Sushruta for this disease. For over 1 decade, we have been using this drug. About six thesis of M.D. & Ph.D. standard have been written on this drug.  On different aspects our observation and impression pertaining to its efficacy as mentioned below: -

One, It is useful in the form of water soluble extract of the heart wood of this plant collected from not less than 10 years old tree.  The doses vary from 50 gm. to 250 gm. per day as coarse powder to be boiled in water.  About 50 C.C. water extract should be given in divided doses for three times a day.  Now it is available in the tablet forms, which is quite convenient to the patients.  This plant is found mostly in the Himalaya and in the forest of M.P.

2.   It is useful in juvenile and enunciated diabetics because it contains Rasayana properties, which are responsible to rejuvenate the Beta cells of Pancreas.  Beta cells are responsible to produce insulin in the Body.  Insulin is the only drug to be given to these patients according to modern medical approach. No oral drugs are useful in these cases.  But we prescribe this drug, because it increases the secretion of Insulin in the body proved on radioimmvicesay.  Some chemical components have been taken out from this, which regenerate beta cells.

3. It provides a sense of well being and keeps normal health along with prompt symptomatic relief.

4.  Born Diabetic and child Diabetic (ageing from 4-14 years) it reduces the doses of daily-required Insulin by 40-160/£. Means with minimal doses of Insulin and Vijaisar keep the patient quite healthy along with subjective and objective improvements.

5.   It prevents the occurrence of complications, which very often appears by the use of Insulin as referred above earlier.

6.   Sometimes by the use of Vijaisar patients becomes free of symptoms though their blood sugar is not very effectively controlled.  But it is just reversed in the case of Insulin therapy or any modern antidiabetic therapy.  For example patients complain of many symptoms inspite of their blood sugar is controlled.

7.   For the patients of 14 years to 25 years we very rarely advise for Insulin, alongwith Vijaisar.  If required any oral hypoglycaemic drug like diabenese or Rastinon could be given as an adjunct to get the Bio-chemical results very effectively in these cases where they have used modern drugs for over 6 months, after a few weeks we advise to taper down the modern drug and later stop it.  Because sudden withdrawal of modern drug Vijaiaar does not give biochemical results immediately. Its mode of action is quite different to modern drugs.  But in fresh cases where no modern drug was used this Vijaisar alone gives all-round effective response. {Work discussed in clinical conference 1978, Bombay, K.E, Hospital).

Yoga & Vijaisar; In the cases of insulin dependent diabetics Insulin sensitivity Insulin reaction.  Insulin resistance we prescribe Yoga & Vijaisar.  Because Vijaisar increases the release of Insulin and by Yoga glucose is utilised by working muscles.  So increase in Insulin secretion and utilization of glucose both go side by side.  By Yogic practices patients get mental health improved by overcoming the stress worry and fear with enough strength in the whole body „

Puskarmool; This is found at the height of 1500 ft. on the ranges of Kuth Himalayas.  Its root is useful for this disease.  It is responsible to normalise the High blood sugar, raised cholesterol, over body weight in obese and strong diabetic. It cures the problem of diabetes by more than -50% of cases. After 2-3 months of treatment with Puskermool kwth, over 50% of the cases left the treatment because they do not want it further.  Puskarmoola has proved its effectiveness in cardiovascular changes in Diabetic by showing E.C.G. X--Ray and lipids profile within normal ranges.  It given tranquilizing effect also.

Conclusion: Science & truth are synonym to each other. Truth can be measured at any parameter.  The truth narrated in Ayurvedic Texts could be proved scientifically.  The description of Diabetes and its classification in Ayurvedic Texts stand exactly true in the same way as during these days. Triangular traditional approaches to the treatment of Diabetes mellitus appear to be most essential to provide normal health. for longer duration Diet, Exercise and Yoga should be adopted as a part of life for Diabetic patients.

Vijaisar alone is sufficient to treat the diabetic patient but in born Diabetic and child diabetic, some modern drugs are required as adjunct to it

a) Vijaisar and Insulin reduce the dose by 40% - 60% of daily-required Insulin without side effect

b) Vijaisar and oral Hypoglycemic replaces the insulin out rightly with; very encouraging response

c) Yoga and Vijaisar proved very effective in insulin dependent diabetic and insulin resistant cases (approved in 2nd World Diabetic Congress at Bombay from 14-17 November, 1981