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BACKGROUND: Prediabetes is an intermediate state of hyperglycemia, which acts as a precursor to Diabetes mellitus if left untreated. Nisha (Curcuma longa) and Amalaki (Emblica officinalis) combination has been advocated as drugs of choice to treat the early manifestations of Diabetes mellitus. OBJECTIVE: This prospective, randomized, single-blind, placebo-controlled, comparative study was planned to assess the efficacy and safety of Nisha-Amalaki capsules in preventing progression to Diabetes mellitus in prediabetic patients when administered for 6 months. METHODS: The study was conducted on prediabetic participants randomized to receive either Nisha-Amalaki (500 mg) or placebo one capsule twice a day for six months. The effect of study medications on IDRS (Indian Diabetes Risk Score), BMI (Body Mass Index), blood sugar, serum insulin, HOMA-IR (Homeostasis Model Assessment-Estimated Insulin Resistance), HbA1c (glycated hemoglobin), oxidative markers, Ayurvedic symptoms and Quality of Life (QoL) scores was assessed at regular intervals. RESULTS: 58 of the 62 participants enrolled completed the study. Significant fall in IDRS score [p < 0.001], BMI [p < 0.001], fasting, and 2 h post-OGTT sugar, insulin, HbA1c, HOMA-IR, and oxidative stress markers [p < 0.001] was observed in patients receiving Nisha-Amalaki at 6 months. Ayurvedic symptoms and QoL scores also improved at 6 months in the treatment group. CONCLUSION: Treatment with Nisha-Amalaki capsules improved all study parameters including insulin sensitivity at 6 months as compared to placebo in prediabetic patients. Thus Nisha-Amalaki should be considered as prophylactic therapy in prediabetics to delay progression to diabetes.

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BACKGROUND: Prediabetes is a condition before manifestation of diabetes. It is associated with biochemical change in body due to disturbances in food habits, sleep patterns and sedentary lifestyle. Conventional system of medicine has limitations, however Ayurvedic medicines can be effective for management of this condition. OBJECTIVE: To compare the efficacy of Vamana Karma (∼therapeutic emesis) followed by Darvyadi Kwatha (∼herbal decoction) with that of oral medication of Darvyadi Kwatha with lifestyle modification in reducing HbA1c of the prediabetic participants. METHODOLOGY: After approval of IEC and registration under clinical trial registry of India, 40 patients were registered in two groups suffering from prediabetes in the trial. The primary criteria were HBA1c, FBS & PPBS along with secondary criterias like Agnibala (∼strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength) relief in signs & symptoms of Prameha and quality of life (SF-36 Score). RESULTS: Statistically significant results were observed in both the parameters: (primary & secondary) within the group [VM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001) and SM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001)] and between the group [HbA1c (P < 0.01), FBS (P < 0.01), SF-36 score (P < 0.001) as well. CONCLUSION: The present clinical study suggests that there is significant improvement between the groups. On comparision, it was found that treating prediabete.s Shodhana was more safe & effective than Shamana.

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Diabetes mellitus is a growing concern all over the world. There are no many published literature available documenting the effectiveness of Ayurveda intervention on diabetes mellitus. This report is about a case in which successful reversal of diabetes mellitus was achieved in a patient who reported with glycosylated Hb percentage (HbA1C) as high as 14.87%. The patient had classical symptoms of diabetes mellitus viz. excessive thirst, fatigue and frequent urination. His fasting blood glucose level was 346 mg/dl and post prandial glucose level of 511 mg/dl. Further more his HbA1C was as high as 14.87%, thus diagnosed with diabetes mellitus. Based on his specific clinical symptoms the patient was diagnosed with kaphaja prameha. Treatment was given according to classical Ayurveda intervention for kaphaja prameha. The patient responded well to the treatment. His HbA1C reduced to 6.05% in a span of eight months. The case report shows the effectiveness of Ayurvedic intervention in diabetes mellitus. It is limited in its scope as it is a case report, nevertheless this can be taken up as an information that may lead to new research and advances in the field of clinical practice in Ayurveda.

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Abstract The aim of this study is to provide a real picture of the disease burden of Prameha in society. The study was performed in Government Ayurved College and Hospital, Nagpur, Maharashtra during Oct 2015-Mar 2016. Total 60 patients of newly diagnosed type 2 diabetes mellitus attending the Kayachikitsa Opd of GAC Nagpur were included for the study. The subjects details were recorded in case report form. The CRF included many variables such as sociodemographic factors, presenting symptoms, risk factors such as hypertension, obesity and glycaemic status, family history of diabetes and physical activity. Other parameters like BMI, glycosylated haemoglobin, fasting and post prandial blood sugar and fasting lipid profile were documented. Descriptive and bivariate analyses were carried out using the XLSTAT software (2020). Amongst 60 subjects, 65% were male and 93.3% were adults. 78% of subjects were following sedentary lifestyle and 40% had family history of diabetes. The results revealed that, obesity, family history of diabetes, uncontrolled glycemic status, sedentary lifestyles, and hypertension were prevalent among the Prameha subjects. The characterization of this risk profile and early detection of prameha by observing poorvarupa will contribute to designing more effective and specific strategies for screening and controlling Prameha in Maharashtra, India.

Asunto(s)

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Continued rise in incidence and prevalence of diabetes globally warrants an effective strategy for its prevention and control. Prevention of diabetes seems more logical to attempt seeing its health care burden, long dormancy, systemic affliction and poor general awareness. Pre-diabetes is the intermediate state of erratic glucose metabolism without overt features of diabetes. This state seems to be a crossroad having a possibility to either convert into clinical diabetes, remain dormant or return to normal glucose control depending upon the efforts made. Unfortunately, due to the paucity of apparent clinical symptoms, this state embedded with reversal possibility, remains unexplored. Ayurveda account of prameha purvarupa (subclinical features of diabetes) may be proposed as the foundation upon which clinic-based pre-diabetes identification and subsequent prevention may be explored. Knowing the symptoms for their reliable proximity with upcoming diabetes may turn to be sensible sensitizers prompting the people to abort the disease process in an effective and timely manner. Considering diabetes from its purvarupa to complications as disease continuum and exploring the opportunities to intervene in order to prevent, or manage the disease on the basis of shada kriyaa kaala therefore, has a huge translational potential warrants an urgent exploration.

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Background: Prediabetes is an alarming condition to control and prevent from developing diabetes mellitus which occurs due to the change in lifestyle and food habits. Timely untreated prediabetes turn into type-2 diabetes mellitus within a year and systemic complications such as retinopathy, nephropathy, and neuropathy could occur and in later stage multi system damage could take place. Aims: The ai of this study is to evaluate the efficacy of Vamana Karma (therapeutic emesis) with Ikshuvaku Yoga and followed by oral administration of Darvyadi Kwatha (herbal decoction) in the management of prediabetes. Materials and methods: After approval of IEC and registration under clinical trial registry of India, 20 patients suffering from prediabetes were registered in the trial. Diagnosis criteria were hemoglobin A1c (HBA1c), fasting blood sugar (FBS) and postprandial blood sugar (PPBS), and assessment criteria includes HBA1c, FBS, PPBS, along with improvement in Agnibala (strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength), relief sign and symptom of prediabetes (Prameha), and improvement in quality of life (SF-36 Score). Classical Vamana Karma followed by oral administration of Darvyadi Kwatha was done. Total duration of treatment was 45 days and last follow-up was done on the 120th day. Student's t- test was used for the analysis of parametric data. Results: After the treatment were observed that there is improvement in subjective as well as in objective parameters. Statistically highly significant result was observed in HBA1c (BT [day 0] Mean score 6.25 and AT [day 120] 5.63 [P < 0.001]), FBS (BT [day 0] mean score 120.05 and AT [day 120] 93.31 [P < 0.001]) and PPBS (BT [day 0] mean score 165.26 and AT [day 120] 112.84 [P < 0.001]), sign and symptoms of Prameha, Dehabala, Agnibala, Satvabala, and quality of life (SF-36 Score). Conclusion: The present clinical study concludes that therapeutic emesis (bio purification) followed by Darvyadi Kwatha as internal medicine shows significant result in treating prediabetes (Prameha) safely and effectively also control and prevent developing diabetes mellitus. None of the patient converted to diabetes mellitus on the day 120.

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BACKGROUND: Type 2 diabetes is a lifestyle-related disorder that affects around 422 million individuals in India. Integration of AYUSH (Ayurveda) with the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was conceived on pilot basis at Gaya, Bihar, to provide integrative treatment for non-communicable disease patients and to manage the burden of non-communicable diseases in India. OBJECTIVES: The objective of this study was to analyze the effect of Ayurveda intervention, lifestyle modification and Yoga in the management of type 2 diabetes under NPCDCS-AYUSH integration project. MATERIALS AND METHODS: A multi-centric, open-labeled, prospective, comparative clinical study was conducted at 17 community health centers and 1 district hospital. Population over 30 years of age was screened and prediabetic or type 2 diabetic individuals were enrolled in two cohorts, i.e., pre-diabetic (Cohort A) and type 2 diabetic (Cohort B). Each cohort was further divided into two groups: Group A1 was advised for lifestyle modification and Yoga and group A2 was given Ayurveda medication in addition to lifestyle modification and Yoga. Similarly, group B1 was advised for lifestyle modification and Yoga along with allopathic medication and group B2 was given Ayurveda medication, i.e., Mamajjaka, Amalaki and Guduchi powder in addition to lifestyle modification and Yoga along with allopathic medication. Treatment was given for 6 months. Data were analyzed through paired t-test. RESULTS: A significant reduction was observed in fasting blood sugar level in groups A2 and B2 (P = 0.001) and also in the postprandial blood sugar level in Groups A2 and B2 (P = 0.001). Further, improvement in subjective symptoms such as polyuria, polydipsia, polyphagia, blurred vision and weakness was found in all the groups, while non-healing ulcer does not show any improvement. CONCLUSION: The study reveals that Ayurveda intervention, i.e., Mamajjaka Churna (1 g), Amalaki Churna (3 g) and Guduchi Churna (3 g) two times a day effectively controls blood sugar level in pre-diabetic and type 2 diabetic patients and improves the disease management with lifestyle modification and Yogasana as well as with allopathic treatment.

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BACKGROUND: Stress is a potential contributer to chronic hyperglycemia. Pitta Prakriti (body constitution) individuals are more prone to stress and the prevalence of type 2 diabetes in stressed out individuals is much more. Aim of study was to evaluate the role of stress in hyperglycemia in individuals of Pitta predominant constitution and to assess the effectiveness of Mahatiktaka Kashaya in stress-induced hyperglycemia. METHODOLOGY: A cross-sectional study was carried out in 100 Pitta predominant patients having fasting blood sugar level greater than 140 mg/dl, to find the association of stress and hyperglycemia, using International Stress Management Association questionnaire followed by open lebelled clinical trial with Mahatiktaka Kashaya (Decoction). Trial drug was administered at a dose of 15 ml twice daily for 14 days. Assessment was done before and after the treatment. OBSERVATION AND ANALYSIS: 80% of Pitta predominant individuals have reported stress-associated hyperglycemia. Overall effect of Mahatiktaka Kashaya in major domains of Stress Assessment Questionnaire, i.e., symptoms, stability and strategies was significant. Furthermore, the trial drug showed significant improvement in biochemical parameters of diabetes. CONCLUSION: The study concludes that there is significant association between stress and hyperglycemia in the individuals of Pitta constitution. Mahatiktaka Kashaya is found to be highly significant in stress-associated hyperglycemia in the above said group.

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BACKGROUND: Lifestyle disorders are the leading cause of death and disability worldwide. Type 2 diabetes is one such disease with high incidence in low- and middle-income countries such as India. Changed lifestyle, lack of exercise, increased consumption of fatty, fast-food items, improper dietary habits and sedentary life are the main contributory factors for this, which are showing upward trend in India. AIMS AND OBJECTIVES: The aim of the study is to identify the lifestyle factors, physical activities and psychological factors associated with type 2 diabetes among the patient aged between 20-60 years. MATERIALS AND METHODS: A cross-sectional survey study was conducted on selected 150 patients of type 2 diabetes within 1 year of diagnosis. A survey questionnaire was used to collect the data for fulfilling the aims and objectives of the study. RESULTS AND OBSERVATIONS: 150 patients of type 2 diabetes were observed on various dietary factors, physical activities and life style factors. CONCLUSION: On the basis of survey psychological factor association with type 2 diabetes and dietary factors, physical activities and psychological factors observed in survey study. The obtained data exposed that intake of heavy, high fatty food, physical inactivity, day sleep and psychological distress as the main lifestyle factors associated with type 2 diabetes.

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BACKGROUND: Chandraprabha vati is a classical Ayurvedic formulation, markedly used for mitigation of Prameha, which correlates in many ways with obesity, metabolic syndrome and diabetes mellitus. OBJECTIVE: The present study was aimed to investigate effect of Chandraprabha vati in experimentally-induced hyperglycemia and lipid profile alterations. MATERIALS AND METHODS: Antidiabetic effect of Chandraprabha vati was studied in fifty five Wistar rats. Graded doses of Chandraprabha vati (50, 100 and 200 mg/kg) were administered orally for 7 days to normal and alloxan-hyperglycemic rats (65 mg/kg, intravenously), and to glucose loaded normal rats for oral glucose tolerance test (OGTT). Fasting plasma glucose levels were assessed on different time intervals along with plasma cholesterol and triglycerides. Metformin (500 mg/kg, orally) was used as standard drug. RESULTS: Chandraprabha vati did not cause any significant reduction in plasma glucose levels of normal rats (p > 0.05) but normalized the impaired glucose tolerance at 60 and 120 min (p < 0.05-p < 0.001) in OGTT when compared to vehicle control. In alloxan-hyperglycemic rats, administration of Chandraprabha vati (200 mg/kg) significantly reduced plasma glucose at 3 h, 12 h, 3rd day and 7th day (p < 0.01-p < 0.001) along with reduction in cholesterol and triglycerides levels (p < 0.01-p < 0.001) when compared to diabetic control group. The effects were comparable with metformin. CONCLUSIONS: Chandraprabha vati exhibited anti-hyperglycemic effect and attenuated alterations in lipid profile. The results support the use of Chandraprabha vati for correction of Prameha in clinical practice.

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Diabetes mellitus (DM) with its devastating consequences is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. The characteristic features of DM have close resemblance with Prameha (obstinate urinary disorders including diabetes) in Ayurveda. Madhumeha is a Vatika subtype of Prameha that is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed if Samshodhana (bio-cleansing) is used in early stages of disease followed by palliative treatment. Vamana (emetic therapy) and Virechana (purgation therapy) are the Samsodhana Karma (bio-cleansing therapies) that are compatible to overcome this Aavarana (occlusion). A comparative study was planned to compare their efficacy in controlling blood sugar levels in patients with DM. Although none of them were completely able to control blood sugar in the long-term but the study yields some very interesting results in reducing the blood sugar levels which could be useful in the future studies related to DM.

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Triphaladi Kwatha, a polyherbal Ayurvedic formulation, is recommended by Chakradatta and Yogaratnakara in the management of Prameha which has resemblance with type 2 diabetes mellitus. The present study deals with development of pharmacognostical and preliminary pharmaceutical profile of Triphaladi granules. The pH (5% aqueous extract) was 6.0, water-soluble extract 48.66% w/w, alcohol-soluble extract 33.91% w/w, ash value 5.97% w/w, and loss on drying at 105°C was 6.53% w/w. High performance thin layer chromatography were carried out after organizing appropriate solvent system in which maximum nine spots were distinguished and few of the Rf values were identical in the alcoholic extract.

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The study was conducted with an objective of evaluating the role of Rishyagandha (Withania coagulans) powder in clinically diagnosed cases of Prameha. 53 Registered cases were divided into 3 groups; Group A (Rishyagandha fruits powder), Group B (Oral Hypoglycaemic Agent i.e. OHA), and Group C (Rishyagandha fruits powder and OHA both). Statistically significant improvement was observed in objective and subjective parameters in all 3 groups after completion of the course of treatment. Based on the results, it has been concluded that, Rishyagandha fruits powder is an effective therapeutic regimen in the management of uncomplicated cases of Prameha.

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Mineral drugs play an important role in Ayurvedic therapeutics. Looking to the superiority of the metals and minerals to that of herbal and animal drugs, the Rasavaidyas went on experimenting clinical trials over lot of metals and minerals and systematically separated some of them which were exclusively active therapeutically. Swarnamakshika is one such mineral which after proper purification and incineration become highly potent and utilised for diseases like Jwara, Pandu, Prameha, Shwasa, Kasa, Kushtha, Anidra, Apasmar etc.

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Diabetes mellitus is a common chronic metabolic disorder prevalent all over the world. Virechana is the Shodhana procedure that is specific for the elimination of vitiated Pitta and Kapha doshas. Thus, in the present study, the Virechana process has been selected prior to the administration of Shamana drug. Nyagrodhadi churna is mentioned in Chakradatta, which is modified into Ghana form for easy administration and dose maintenance. The present study was conducted in two groups: Group A, Nyogrodhadi Ghana vati (Shamana therapy) and Group B, Virechana and Nyogrodhadi Ghana vati (combined therapy). A total of 42 patients were registered for the present study, in which 34 patients completed the and eight patients were dropouts. After evaluating the total effect of the therapies, it was observed that the Virechana and Nyagrodhadi Ghanavati (combined therapy) provided better relief in the patients of Madhumeha in comparison with Nyagrodhadi Ghanavati (Shamana therapy) alone.