Ayurvedic diabetes treatment is a natural way to reduce raised blood sugar levels to normalcy by adopting suitable food habits and lifestyles along with Ayurvedic medicines. Diabetes is one of the most common and neglected health conditions for many people. A disciplined lifestyle along with the right diet can help to control the raising sugar levels and their complications. Ayurvedic medicines for diabetes will help to reduce the sugar levels to normalcy by correcting the manner of development of diabetes.

Is there any medicine for Diabetes in Ayurveda?

This is the most common question asked by a diabetic patient to an ayurvedic doctor. Many diabetic patients visit Ayurveda doctor in a stage when their sugar levels are raising continuously despite taking the medications regularly; others when they get diagnosed as diabetic for the first time, looking for some alternative solutions to reduce sugar levels without taking medication as they fear that once they start the medication they have to continue medications lifelong. Few also ask for ayurvedic medicines for diabetes thinking that ayurvedic medicines do not have any side effects even if consumed for a long time. Few feared taking daily insulin injections are also looking for an ayurvedic treatment to avoid getting injected daily.

What is discussed about diabetes in Ayurveda?

As we all know Ayurveda is an ancient medical science that dates back more than 5000 years. The classical textbooks of Ayurveda like Charka Samhita, Sushruta Samhita, Astanga Samgraha, etc… have mentioned various diseases. Of these diseases, prameha (a group of disorders of the urinary system characterized by frequent abnormal micturition) is one of the diseases which is mentioned as one among the eight dreadful diseases. The symptoms of prameha show some similarities to the symptoms of diabetes mellitus. The word prameha is derived from Sanskrit “Mih – Ksarane” which means passing water/urine. The prefix “Pra” stands for excessiveness both in frequency and quantity. Therefore the term “Prameha” stands for excessive passing of urine in terms of quantity and frequency.
The general symptom of Prameha are

Prabhuta mutrata – Excessive passing of urine
Avila Mutrata – Turbidity of urine

According to the American Diabetes Association, the following are the common symptoms of diabetes:

Urinating often
Feeling very thirsty
Feeling very hungry – even though you are eating
Extreme fatigue
Blurry vision
Cuts/bruises that are slow to heal
Weight loss – even though you are eating more (type 1)
Tingling, pain, or numbness in the hands/feet (type 2)

So looking at the symptoms we can find similarities between diabetes and prameha and diabetes can be considered one among the group of disorders explained in the context of prameha.

How do Ayurvedic medicines work in Diabetes?

According to Ayurveda, all the materials in the universe are made up of five basic elements they are Prithvi, Ap, Agni, Vayu, and Akasha. They are also known as mahabutas or Pancha mahabutas. The human body is also made up of these panchamahabutas and the dosas are known as functional aspects of the panchamahabutas. The dosas are the reason for the health and disease in the body. The variation in the dosas by various means will lead to ill health and maintaining it in its normalcy is health. We have three dosas that govern the health status of the body. These dosas are namely Vata, Pitta, and Kapha. Each dosha is made up of panchamahabutas with varied predominance like

Vata Dosha – Akasha and Vayu Mahabhuta
Pitta Dosha – Agni and Ap Mahabuta
Kapha Dosha – Prithvi and Ap Mahabuta

Ayurvedic approach to Diabetes (prameha) & Types of Prameha:

There are 20 types of prameha explained depending on dosha predominance. The signs and symptoms of these twenty types of prameha are also varied from each other.
Now let us look at the signs and symptoms of Diabetes
The treatment of prameha depends on the type of Prameha as discussed below including various medications, purificatory procedures like panchakarma, diets, lifestyle modification, etc…

All living things are made up of panchamahabhutas (5 elements) namely akasha, Vayu, Agni, jala, and Prithvi. These in combination constitute three types of doshas (energies) vata, pitta, and kapha. The disease is caused by an imbalance in these energies.

Mostly diabetes is traced as an imbalance of kapha energy which is compromised of earth and water.
Each dosha when getting aggravated vitiates the dushyas like medas, rakta, sukra, ambu, vasa, majja, and mamsa and leads to 20 types of prameha. Different doshas having entered the urinary tract in the vitiated state give rise to the respective type of meha with their own dominance.

Prameha for a common man to understand can be considered urinary anomalies.
Acharyas have given the prognosis of prameha as 10 types of kaphaja pramehas curable, 6 types of pitta manageable, and 4 types of vatika pramehas incurable.

Different categories of prameha are described depending on the colour taste touch and smell of the urine with the predominance of respective doshas. For example in kaphaja prameha urine is characterized by white colour, sweet taste, cold touch and smell like flesh. Similarly, pittaja pramehas are to be determined. Vayu itself is colorless. Therefore the different type of vata dominant prameha is characterized by the grey or red colour of urine as a result of the specific action of vayu.

Prodromal symptoms of Prameha

All the three vitiated dosas produce the following prodromal symptoms in the course of prameha as explained by acharya Caraka

jaṭilībhāvaṁ kēśēṣu – Matting of hair
mādhuryamāsyasya- Sweet taste in the mouth
karapādayōḥsuptatādāhau – Numbness and burning sensation in hands and feet
mukhatālukaṇṭhaśōṣaṁ – Feeling dryness in mouth palate and throat pipāsām – Thirst
ālasyaṁ – Lethargy or laziness
malaṁ kāyē – Increased waste production in the body kāyacchidrēṣūpadēhaṁ – adherence of
body waste in the orifices of the body
paridāhaṁ – Burning sensation in various parts of the body
suptatāṁ cāṅgēṣu – Numbness in various parts of the body, ṣaṭpadapipīlikābhiścaśarīramūt
rābhisaraṇaṁ – Attraction of insects and ants to the body and urine
mūtrē ca mūtradōṣān – an abnormality of the urine
visraṁ śarīragandhaṁ – urine smells like raw flesh
nidrāṁ, tandrāṁ ca sarvakālamiti – Excessive sleep and drowsiness throughout the day.

Prameha Types with Modern Correlation

A. Kaphaja Prameha

Udakameha – urine has characteristics similar to water
Pre diabetic stage – causes decreased reabsorption of water and excessive loss of water through urine.
Ikshumeha – urine has characteristics similar to sugarcane juice.
Pre-diabetic stage – when the liver is unable to metabolize excessive glucose due to hepatic insulin resistance and thus the presence of glucose in urine.
Sandrameha and sandraprashadhameha –low-density urine with a transparent upper layer. Layered urine (top layer of chylomicrons, a middle layer rich in protein, and the bottom layer containing fibrin clots and cellular debris)
The intermediate stage between pre diabetic and diabetic mellitus starts with the involvement of the kidneys.
Sura Meha – In this urine looks like sura or alcoholic preparation (yellowish) with a clear top and thick bottom.
Lalameha – urine has slimy material. Albuminuria (heavy whitish foam in urine )
Shuklameha – urine has white color that of pasted flour. Progressive stage of diabetic mellitus type – 2 with the further derangement in the functioning of nephrons.
Shanaimeha – reduced urinary flow with increased frequency. Stage of diabetes involving advanced nephropathy.
Sitameha – urine will have cold touch. The patient gets frequent micturition which is exceedingly sweet and cold. Stage of kidney failure and the presence of the ammonical substance in urine.
Sukrameha – speramaturia
Autonomic diabetic nephropathy leads to retrograde ejaculation of sperm.
Sikatameha – urine having a sand-like substance.

B. Pittaja Prameha ( stage of infection and inflammation in diabetes)

Ksharameha – the smell of urine-like alkalies. Increased urinary ph due to UTI
Kalameha – patient passes black color urine. Highly concentrated urine due to dehydration.
Nilameha – passes urine having a sour taste and color like a feather of a casa bird. Blue color urine is indicative of bacterial urinary tract infection.
Raktameha – passes urine having a red color, saline taste, and smell of raw fish. Microscopic haematuria.
Manjishtameha – smell like raw flesh and colour like the juice of manjishta. Gross haematuria due to urinary tract infection.
Haridrameha – patient passes urine having a pungent taste and colour like haridra.

C. Vataja prameha

Vasameha – lipiduria (presence of lipid in urine) in nephrotic syndrome associated with type -1 diabetes mellitus.
Majjameha – the presence of bone marrow
Hastimeha – diabetic ketoacidosis.
Madhumeha – type 1 diabetes mellitus.

Madhumeha means “sweet urine” disease. When our blood sugar levels rise over a certain threshold, it spills over into the urine and can be detected. This is caused by an imbalance in metabolism which is termed “dhatu paka janya vikruti” which is primarily due to diminished digestive fire.

On the basis of etiology, Acharya Sushruta has mentioned two types of prameha are

Sahaja prameha (hereditary)
Apathyanimittaja prameha (Acquired)

Sahaja prameha is the one that will be present from birth itself. It occurs as a result of Bija dosha (genetic origin).
Acharya caraka has mentioned it as jata pramehi and said it is incurable.
Apathyanimittaja Prameha is the which occurs due to improper diet (Ahara) and (Vihara) lifestyle and their symptoms are as follows

Sahaja Pramehi (hereditary)

Krisha (Asthenic)
Rauksha (Dry body)
Alpashi (consumes less food)
Bahu Pipasa (Voracious thirst)
Parisaranasila (Restless always desires to wander)

Apathyanimittaja Pramehi (Acquired)

Sthula (Obese)
Bahuasi (Voracious eater)
Snigdha (Unctuous body texture)
Sayyasanasvapnasila (Like to sit down & sleep always)

Types of Prameha Depending on Curability

Sadhya (curable) Prameha – Kaphaja, Sthula, Apathyanimittaja
Yapya (manageable) Prameha – Pittaja Prameha
Asadhya (incurable) Prameha – Vataja Prameha, Jatapramehi

Madhumeha

Madhumeha is one among the vataja prameha. Acharya Sushruta named it as kshoudrameha. The meaning of Madhu and kshoudra are synonyms of honey. Sushruta has explained in detail about madhumeha as a separate chapter considering it as the advanced stage of prameha. In madhumeha, the urine color and taste will be like Madhu or honey and indicate the sweetness of urine.
When the prameha is not treated properly or untreated on time it will progress and lead to madhumeha.

Classification of Madhumeha

According to various texts, madhumeha is classified into two types

Avritajanya madhumeha
Dhatukshayajana Madhumeha

Avritajana Madhumaeha is caused due to the obstruction of vata by kapha and pitta. Dhatukshayajana Madhumeha is caused by the aggravation of vata by the loss of dhatus.

Pathogenesis of Prameha according to Ayurveda

The prameha though starts with the derangement of the kapha dosha later all three dosas get involved. Prolonged use of kapha in predominant food and d lifestyle will vitiate in kapha dosha in the body. The vitiated kapha interacts with the kleda, Sweda pitta, meda, rasa, and rakta (all predominant watery tissues) and gets localized in the basti and produces prameha.

Causes for Prameha

Food, drinks, and lifestyle which help in increasing meda, mutra, and kapha are the basic causative factors of prameha. Intake of too much sweet, sour, salt, fatty foods and drinks, intake of food which are heavy for digestion, slimy, cold, usage of freshly harvested grains, fresh alcoholic preparation, consuming meat of marshy places, sugarcane juice, jaggery, milk, sitting in one place for a longer duration, sleeping untimely excessively, etc…will help to increase kapha dosha in the body leads to initiate prameha pathogenesis.

Prognosis of Prameha

All ten kaphaja prameha are said to be curable as the dosha and dushya have similar properties, kapha dosha is dominant and the treatment principle adopted here will act on both medas and kapha together.
Pittaja pramehas are said to be manageable due to the incompatibility in the line of treatment ie the dosha and dushya are having a predominance of different qualities. The vitiated medas in the pathogenesis of the disease are similar to those of the affected dosas and the treatment of pitta and meda have a mutual contradiction. so it is said to be manageable.
Vataja prameha is said to be incurable because of the different qualities of dosha (Vata) and dushya (medas) and the severity of the disease.

Diagnose of Prameha

Prameha can be diagnosed through its pre-symptoms, signs, and symptoms as explained in the ayurvedic text. Today due to technological advances in the medical field one can detect diabetes in the early stage itself through blood and urine analysis. Regular health check-ups can prevent the accidental diagnosis of diabetes. When some have a family history of diabetes, a sedentary lifestyle, or erratic food habits must undergo to know their health status at regular intervals.

Ayurvedic Examination

Ayurvedic texts say that first to diagnose the disease properly and then think over the treatment. For diagnosing the disease, stage, and state of the disease Ayurveda mentioned about eight types of investigations which are also known as Asthavidha Parikshas. They are namely

Nadi Pariksha – Pulse Examination
Mutra Pariksha – Urine Examination
Mala Pariksha – Stool Examination
Jihwa Pariksha – Tongue Examination
Shabda Pariksha – Speech Examination
Sparsha Pariksha – Examination through touch
Drik Pariksha – Visual Examination
Akriti Pariksha – Examination of size, shape

All these investigations will help to identify the nature of the disease, state, stage of the disease, the predominance of the doshas, etc… will help.

How does Ayurvedic Diabetes Treatment Work?

Whatever we consume through food, drink, activities, etc.. will lead to either increase or decrease in the doshas in the body. If the variation is under limit then there won’t be any major permanent alteration in the dosas and the health will be maintained. But if one starts to overuse of particular food, drink, or indulge in a particular activity will lead to an increase in particular dosas more than its limits. If one continues a similar activity a particular dosha will start getting accumulating in its place. If similar acts continue then the aggravated doshas start to get circulated all over the body. When there is an obstruction to these circulating doshas they will get lodged in a particular area in the body and starts vitiating the functions of those areas. The altered function will produce a symptom indicating the initiation of the disease. Ayurveda explains the stages of disease formation in six stages from the accumulation of doshas to the disease exhibition stage.
So we now have some basic idea of how the disease starts in the body. In a similar manner, each and every substance in the universe is made up of panchamahabutas, may it be plants, minerals, animals, etc…these substances are predominant certain mahabutas in them. This predominance will produce particular quality in those materials like the taste, action, potency, etc…The ancient sages found these secrets and started using them to control the doshas in the body to be healthy or to bring back the normalcy in the body when they get imbalanced.
Ayurveda widely used various plants, minerals, and metals in its medicinal preparation. They work depending on their six qualities. they are taste, quality, action, potency, and taste after transformation. This is how Ayurveda works in treating any disease.

Treatment for Prameha (Ayurvedic Diabetes Treatment)

In all the pramehas the three doshas are involved and in madhumeha, vata also gets aggravated predominantly. So depending on the aggravation of doshas, the treatment will be decided.
Acharya Caraka has said that the patients who are obese and strong should be administered purificatory (shodana) therapies and those who are weak should be treated with nourishing (bhrimhana) therapies.
Acharya Sushruta also opines that the prameha patients who are weak or emaciated should be treated with nourishing (santarpana) therapies and those who are obese should be treated with apatarpana (undernourishing) therapies.
Prameha chikitsa mainly depends on these three pillars

Food (Ahara)
Lifestyle (Vihara)
Medicine (Oushadi)

Diet Therapy (Ahara chikitsa)

Avoidance of the causative factors is the first line of treatment. In Ayurveda, it is called nidana parivarjana. All the ayurvedic scholars and texts firmly advocate nidana parivarjana for the management of the disease. The food which is predominant with opposite qualities of the pathogenesis and disease is advised with careful assessment. It is also advised depending on the state and stage of the disease. Prameha is caused mainly due to improper food habits and lifestyle so dietary and lifestyle modifications are the primary things to change along with maintaining a good state of digestive power (Agni)

Lifestyle (Vihara)

When we look into the causative factors of prameha it is evident that leading a sedentary lifestyle, lack of physical activities or regular exercise, sleeping during the daytime, and in excess will lead to an increase in kapha in the body and are the reason for the initiation of prameha. Acharya’s has advocated regular physical exercise, wrestling, riding in horse, long way, or any kind of physical activity that acts as physical exercise.

Medicine (Aushadi)

There is numerous medicinal preparation advised in the treatment of prameha. From the single herbal drug to multi-herbal combinations in various forms are mentioned in the textbooks of Ayurveda. It is evident that Kapha dosa plays the predominant role in prameha and the dushyas have a similar nature. Most of the medicines used in treating prameha are having the bitter (thikta), Katu (pungent), and Kashaya (astringent) in taste as they are opposite to the qualities of the kapha and dushyas like meda.

Few combinations of herbs mentioned in ayurvedic texts in treating Prameha

In Kapha aggravated condition prepare any one of these decoctions and consume adding Honey

Haridra + Dhatri swarasa + Honey
Darvi +Surahwa + Triphala + Musta made boiled and used
Chitraka + Triphala + Darvi + Kalinga + honey
Guduchi Swarasa + Honey
Amalaki Swarasa + Honey

In pitta predominant condition any one of the following decoctions is prepared and consumed adding honey.

Rodra + Abhaya + Toyada + Katphala
Patha + Vidanga + Arjuna + Dhanwana
Gayathri + Darvi + Krimihrut + Dhava

In vata, predominant condition ghee or oils should be prepared using the above-said drugs.

Ushira + Rodhra + Arjuna + Chandana
Patola +Nimba + Amalaka + Amrita
Rodhra + Ambu + Kaliyaka + Dhataki

Foods and drinks prepared by using Yava and Godhuma should also be soaked in the decoctions mentioned above before their preparation.
For a prameha patient who is weak should be nourished well with food and medicines without increasing the medas and urine.

Panchakarma Treatment for Prameha

Panchakarma treatment is the five purificatory procedures that help to eliminate the morbid doshas from the body. In the treatment of prameha panchakarma is advised depending on the predominance and strength of the doshas and the strength of the patient.
One should be careful while administering panchakarma therapies to prameha patients as it does the apatarpana (undernourishment) it should be done only who are strong. For weak patients and those who are not suitable for panchakarma therapies dosha shamana (treatments that help in mitigating the doshas) treatments are administered.
External treatments like dry powder massage, heavy physical exercise, keeping awake at night, and other such activities which help to mitigate kapha and medas are also beneficial in prameha patients.

Complications of Prameha

According to Caraka the complications associated with prameha are

Thrishna – Excessive Thirst
Atisara – Diarrhoea
Jwara – Fever
Daha – Burning sensation
Daurbalya – Weakness
Arochaka – Anorexia
Avipaka – Indigestion
Putimamasa – putrefaction of muscle tissues
Pitaka – Boils
Alaji – Red or white colour vesicles causing severe pain on rupture.
Vidradhi – Abscess

Prameha Pidakas (Diabetic Carbuncle)

Pidakas are correlated with carbuncles. These are blisters or boils formed as a complication of prameha. Pidakas appear in the skin, usually elevated or discolored in nature, and present in muscle joints or vital parts.
Prameha pidakas are,

Sharavika – it means disc or earthen pan. Boils are convex in margins and concave in the center, grey in colour associated with slough and pains.
Sarshapika – it means mustard of white colour and is not very big but suppurates quickly and is very painful.
Kachapika – it means the carbuncles are elevated like tortoiseshell with a rough surface and burning sensation.
Jalini – with severe burning sensation and appearing like a network of fiber and is hard, sticky with big base and have splitting pain.
Vinata – deep-rooted boils, large, moist and painful appear in the back and abdomen.
Putrini – spread in a large surface area with small multiple blisters.
Masurika – blisters appear similar to lentils.
Alaji – red or white colour vesicles causing severe pain on rupture.
Vidari – carbuncles shaped like tubers of Vidari. They are hard and round in shape.
Vidradhi – it possesses features of the abscess.

Sharavika, Kachapika, jalini, putrini, vidarika are difficult to cure. Sarshapika, masurika, alaji, vinata and vidradhi are easy to cure. These pidakas on complication leads to intoxication, visarpa, fever, and gangrene. Matured pidakas are subjected to incision and drainage. In the case of immature pidakas raktamokshana with jalukas are done.

According to vitiated dosha purification is done and medicines are given internally. Nimba (Azadirachta indica), guggulu (Commiphora mukul), patola (Trichosanthes dioica), guduchi (Tinospora cordifolia), manjishta (Rubia cordifolia) are commonly used to treat prameha pidakas.

Pathya in Prameha (Diet for Diabetes)

Pathya or the right diet is an important aspect of the treatment of prameha. The following can be advisable for a prameha patient.

Different types of corn flours can be used to prepare the mantha (a variety of herbal drink) is beneficial, Medicated decoctions, barley powder, food prepared by barely, food articles which are light to digest are good in prameha.
Cooked barley without adding any unctuous substances, barley porridge, roasted corn flour, pancake along with meat soup prepared from the animals and birds living in dryland is beneficial.
Old shali (variety of rice) mixed with soup of mudga are beneficial.
Cooked shashtika shali and trina dhanyas mixed with oils of danti, ingudi, atasi, and sharshapa are beneficial
Barley soaked overnight in the decoction of Triphala and dried made powder by roasting it taken along with honey is beneficial. It can be taken regularly by the patient suffering from prameha.
Barley can also be soaked in decoctions which are mentioned in kaphaja prameha and are also given to the patient in the roasted flour form, making pancakes along with other food articles and jaggery.

Apathaya in Prameha (What to avoid in Prameha)

Avoiding the causative factors that are responsible for the initiation of the prameha is itself considered as half of the treatment. Following are the few things to be avoided.

Asyasukham – Overindulgence in eating habits, sedentary lifestyle
Swapana sukham – Sleeping excessively and untie sleeping
Dadhi – Intake of curds regularly especially at night
Gramyaaudaka Anuparasa – Soup prepared from animals that are domesticated, aquatic animals, and animals of marshy land.
Paya – Milk and milk products
Nava Anna – food articles prepared with freshly harvested grains
Nava pana – Freshly prepared drinks
Guda Vaikrita – Various preparation of jaggery and
Kapha kruccha sarvam – All the food, drinks and activities which increase kapha

Prameha Treatment for those who can’t afford the treatment cost

All the prameha patients may not be wealthy enough to afford the treatment and the medication in the olden days. In astanga hrudaya, there are a few tips advised to prameha patients who can’t afford the treatment costs. They are
One should go on a walkabout 100 yojana distance is approximately 800 to 900 miles without using footwear or an umbrella leading a life like a muni or saint.
The other thing that a prameha patient can do is to dig a pond or water reservoir by himself or wander along with the herd of cows.
All these practices indicate the importance of leading simple life avoiding luxury and giving more importance to physical activities.

Conclusion

Prameha is one among the eight dreadful diseases mentioned in Ayurveda involving mutra haha srotos (urinary channel) and kapha dosa predominancy. Diabetes can be compared to one among the group of prameha disorder. Ayurvedic Diabetes Treatment can effectively manage prameha through the right application of Dietary changes, Lifestyle modification, and medication.

P.S – All the information given here is only for informative purposes and is not a substitute for medical advice. Please contact your doctor for your health needs. Self-medication is dangerous for your health.