E-ISSN:2456-3110

Case Report

Diabetes Mellitus

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Exploring the Ayurvedic perspective and treatment protocols for Prameha (Type II Diabetes Mellitus) - A Case Study

Raskotra K1*, Gupta P2, Kamboj S3, Tiwari D4
DOI:10.21760/jaims.10.5.58

1* Kajal Raskotra, Final Year Post Graduate Scholar, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu and Kashmir, India.

2 Poonam Gupta, Associate Professor, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu and Kashmir, India.

3 Sunil Kamboj, Final Year Post Graduate Scholar, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu and Kashmir, India.

4 Deepu Tiwari, PhD Scholar, Department of Statistics, University of Jammu, Jammu and Kashmir, India.

Prameha is spreading as a dreadful disease and becoming a fearsome disease condition in a current scenario. It is known as the silent killer in today’s society. Prameha is Shleshma Pradhana Tridoshaja Vyadhi which is characterized by frequent urination. Diabetes is spreading worldwide. 463 million in the world and 77 million in India are affected by this disease.one in six people with diabetes in the world is from India. Prameha affects a large population in our society. There has been a sharp rise in diseases that are life-threatening. The World Health Organization highlighted a number of illnesses, including metabolic and cardiovascular conditions, as contributing factors to India's high mortality rate. Madhumeha was listed among the eight major illnesses by Acharya Vagbhata. The metabolic syndrome includes diabetes. An imbalance between insulin sensitivity and insulin secretion causes Type II DM, also known as non-insulin-dependent diabetic mellitus (NIDDM). Increased predominance during the past three decades has put a financial strain on many emerging nations.

Aim: To evaluate the contribution of Samshamana Karma to the management of Vataja Prameha w.s.r. to Diabetes Mellitus.

Materials and Methods: A 52 years old male patient came to OPD Jammu Institute of Ayurveda and Research, Jammu, on 14 June 2023 with a complain of Generalized weakness, Increase frequency of urination for one month.

Intervention: We prescribed Chandraprabha Vati, Triphala Guggulu and Madhumehari Churna orally. Significant relief was found in sign and symptoms and blood sugar level after treatment.

Conclusion: In the current case study, Ayurvedic oral medication was used to treat a Type II DM patient. The parameters under study were Prabhuta Mutrata, Daurbalya, Fasting Blood Sugar (FBS), Post prandial Blood Sugar (PP2BS), and Glycosylated Hb (HbA1C). After 3 months of treatment, we saw significant relief Prameha is a metabolic disorder. Heredity, sedentary life style, lack of exercise & Yoga, stress and improper diet habits are the main reasons for occurring diabetes mellitus.

Keywords: Prameha, Diabetes Mellitus, Type II DM, Madhumeha, Samshamana Karma, Ayurvedic Management, Chandraprabha Vati, Triphala Guggulu, Madhumehari Churna, Metabolic Disorder, Vataja Prameha

Corresponding Author How to Cite this Article To Browse
Kajal Raskotra, Final Year Post Graduate Scholar, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu and Kashmir, , India.
Email: 		Raskotra K, Gupta P, Kamboj S, Tiwari D, Exploring the Ayurvedic perspective and treatment protocols for Prameha (Type II Diabetes Mellitus) - A Case Study. J Ayu Int Med Sci. 2025;10(5):360-364.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-12 2025-04-26 2025-05-07 2025-05-17 2025-05-27
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© 2025 by Raskotra K, Gupta P, Kamboj S, Tiwari D and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(5)360
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Kajal R et al. Treatment protocols for Prameha (Type II Diabetes Mellitus)

Introduction

Ayurveda mentions three major vital places of the body as Trimarma,[1] which includes Hridaya, Shira and Vasti. Prameha, which is a group of diseases of Vasti is characterized by excessive passing of turbid urine. Prameha means diabetes which involves high level of blood sugar, frequent urination and presence of sugar in urine, etc. Ayurveda considered Prameha as Sadhya (curable), Yapya (paliable) and Asadhya (incurable) depending upon involvement of Dosha.[2] Sushruta describes it depending on physical appearance as; Saheja Prameha & Apathyani Mittaja. Saheja Prameha mainly relates to Bija Dosha (genetic disorder) while Apathyanimittaja related to ageing and disturbed life style. Ayurveda mentioned that Bahudravasleshma and Bahuabaddhameda are the main pathological factors for Prameha, further Ayurveda described that Nidana Sevana aggravates Kapha which vitiates Meda Dhatu and clinical manifestation of diabetes may observe. Prabhootha Mutrata, Avila Mutrata and Medo Dushti Lakshanas are the cardinal symptoms of Prameha.[3] Conduction of Brimhana, use of medicine, diet control, Panchakarma and balanced life style are some therapeutic measures which increase Dhatus and help to combat diabetes. This article described some therapeutic approaches for the management of Prameha based on literary study.

Nidana (Ch.Chi.6/4)

आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि |
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम् ||

Prameha Dosha Dushya (Ch.Ni.4/7)

Doshas like Kapha, Pitta & Vata and Dushya like Medas, Shukra, Ambu, Vasa, Lasika, Majja, Rasa, Ojas and Mamsa are responsible for the causation of Prameha which is of 20 types.

Samprapti (Ch.Chi.6/5-6)

Samanya Samprapti

Due to Aetiological factor, there is an increase in amount of Kleda in body, as result of which there is an increase in amount of Sleshma, Pitta, Meda, & Maamsh. Through Sleshma etc., there is a blockage of Prakrit Gati of Vata. Due to which this Aavritvata by brings essence of Dhatus, Oja, into Vasti region, produces Prameha Disease.

This disease produces Vatik, Pattik, Sleshmik symptoms depending on the intensity of the Doshas. In this way, the body attains decay by the release of Ojas.

Vishishta Samprapti

Kaphaja Prameha's - The vitiated Kapha contaminates the fat, flesh and the body fluids accumulated in the urinary bladder and causes 10 types of Prameha's that are Kaphaja Prameha.

Pittaja Prameha's - Similarly, Pitta aggravated by consumption of hot foods and other etiological factors contaminates the fat, flesh and body fluids causing 6 types of Pittaja Prameha's.

Vataja Prameha's - When Pitta & Kapha get deteriorated in quality & quantity in comparison to Vata, Vata Dosha gets aggravated & pulls Dhatus i.e., Vasa, Majja, Oja & Lasika into urinary bladder causing 4 types of Vataja Prameha's.

Samprapti Ghataka

Dosha - Drava Sleshma Pradhan Tridosha
Dusya - Meda, Sukra, Ambu, Rasa, Vasa, Ojas, Majja, Lasika
Srotas - Mutravaha, Medovaha
Srotodusti - Sanga, Ati Pravritti
Adhisthana - Vasti & Sarvsharir
Agni - Dhatwagnimandya
Vyadhiswabhaw - Chirkari
Sadhyata and Asadhyata - Kaphaja -Sadhya
Pittaja - Yapya
Vataja - Asadhya

Purvarupa (Ch.Chi.6/13-14)

  • Sweda, Angagandha
  • Shithilangta
  • Shayyasana
  • Ghana Angata
  • Kesha, Nakha Ativridhi
  • Sheeta Priyata
  • Gala Talu Shosha
  • Madhura Aasya
  • Kara Pada Daha
  • Mutre Pipilika

Rupa (Ch.Ni 4/44)

  • Prabhootha Mutrata

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Kajal R et al. Treatment protocols for Prameha (Type II Diabetes Mellitus)

  • Aavil Mutrata
  • Krisa
  • Rauksha
  • Bahu Pipasa
  • Parisaranasila
  • Sthula
  • Snigdha
  • Delaying to recovery of any injury
  • Urinal dysfunction
  • Disturbed appetite

Chikitsa Sutra (Ch.Chi.6/15)

स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च |
सम्बृंहणं तत्र कृशस्य कार्यं संशोधनं दोषबलाधिकस्य ||

Specific Therapies

संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान् |
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च ||२५||

Purificatory therapies including specifically emesis and fasting therapies, administered at the appropriate time, cure Kaphaja types of Prameha. Similarly, Pittaja types of Prameha are overcome by purgation, Santarpana (refreshing therapy) and alleviation therapies.

Various formulations

दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही |
क्षौद्रेण युक्तामथवा हरिद्रां पिबेद्रसेनामलकीफलानाम् ||२६||

The patient suffering from Prameha should take the decoction of Darvi, Surahva, Triphala and Musta mixed with honey. He may also take Haridra along with the juice of Amalaki.

Pathya (Upashaya)

Ahara:

1. Patient should eat roasted meat of animals and birds and various preparations of barley.
2. Cooked barley without adding any unuctus articles, Saktu (roasted corn flour) mixed with meat soup.
3. Barley soaked in decoction of Triphala and mixed with honey should be consumed. It acts as a Tarpana and helps to overcome the disease.
4. Cooked Shashtika rice mixed with soup of Truna Dhanyas, vegetables of bitter & astringent taste,

groups of vegetables and oil of Danti, Ingudi, Atasi, and Sarshapa.
5. The following eatables are helpful in case of Prameha: soft bamboos, wild variety of Kulattha, old wheat grains, Shali rice, Yusha of pulses of Kulattha, Mudga and pigeon pea, Vatyamanda (Manda prepared by cooking barley in water measuring four times), buttermilk, palm fruit, fresh banana fruit, Jambu, garlic pearls, Kharjura
6. Food stuff like Mantha, sour juice, powder made with meat soup of Vishkira (one having habit of eating waste products) and Pratuda (one having log beaks) as well as wild animals is considered as a good diet.

Vihara

1. During advance stage of disease patient should indulge in all kind of exercises regularly, sports, wrestling, sports, riding elephant and horses, archery etc.
2. Diabetic patient should undertake 100 Yojana journey on foot without using footwear and umbrella.
3. Patient should stay in the company of animals, consume their urine and dung and move along with them always.
4. Purification of body through bitter herbs like neem and Haridra should be applied to the patient.
5. Once the symptoms of Prameha disease are clear one should first have Langhana (fasting), Vamana (emesis) and Virechana (purgation).

Apathya (Anupashaya)

1. Avoid suppression of urine urge,
2. Smoking,
3. Fomentation and blood letting
4. Remaining seated by the side of soft cushion,
5. Sleeping during day time
6. Patient should not take fresh cereals, large amount of curd, sugarcane juice, contaminated water, meat of aquatic animals.

Case Report

Case History

52 years old male patient came to OPD in Jammu Institute of Ayurveda & Research, Jammu, on 14 June 2023 with complain of generalized weakness, incr. frequency of urination for one month. There is no history of dryness of mouth, bowel disturbances, chest pain, joint pain, unhealed ulcer etc.


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He was diagnosed as type 2 DM two months back and he had taken some herbal medicine without consult to doctor before coming to our hospital but not get satisfactory result. Apart from this he didn’t suffer from other medical problems like HTN, PTB, asthma, thyroid disorder etc.

Routine blood investigation was carried out. FBS was 140.2 mg/dl, PPBS was 241 mg/dl and HBA1C score was 7.3%.

Past History - No major illness

General Examination

  • Pulse: 76/min
  • BP: 135/80 mm of Hg
  • Weight: 78kg
  • Prakruti: Vata Kaphaja
  • Agni: Vishama
  • Kostha: Krura Samprapti Ghatak
  • Dosha: Kapha
  • Dushya: Meda, Mutra
  • Strots: Medovaha, Mutravaha, Annavaha
  • Udbhavasthan: Pakvashaya Samutthaja
  • Adhishthan: Mutravaha Strotas
  • Upadrava: Nil
  • Vyadhimarga: Abhyantar

Diagnosis - Vataj Prameha (Madhumeha), Navina Avastha (Type 2 DM)

Subjective Criteria

1. Prabhootamutrata

  • Grade 0 - Upto 5 times in day hours 0-1 time at night
  • Grade 1 - 6-7 times in day hours and 2-3 times at night
  • Grade 2 - 8-9 times in day hours and 4-5 times at night
  • Grade 3 - More than or equal to 10 times in day and more than 5 times at night

2. Daurbalyanubhuti

  • Grade 0 - Ability to perform routine activity with no feeling of exhaustion
  • Grade 1 - Unable to perform routine activity without feeling of exhaustion

  • Grade 2 - Feeling of exhaustion even on accustomed work
  • Grade 3 - Exhaustion even at rest

Objective Criteria

1. FBS
2. PPBS
3. HbA1c

Treatment Plan

Drugs:

1. Chandraprabha Vati

  • Dose: 500 mg two times a day
  • Mode of administration: Orally
  • Duration of treatment: 30 days
  • Anupana: Koshna Jala (Lukewarm water)

2. Triphala Guggulu

  • Dose: 1000mg two times a day (4 tablet BD)
  • Mode of administration: orally
  • Duration of treatment: 30 days
  • Anupana: Koshna Jala (Lukewarm water)

3. Madhumehari Churna

  • Dose: 6gm two times a day
  • Mode of administration: orally
  • Duration of treatment: 60 days
  • Anupana: Koshna Jala (Lukewarm water)

Table 1: Effect on Subjective Parameters

SNSymptomsBefore Treatment (14/06/23)F1-30 Days (14/07/23)F2-90 Days (20/09/23) After Treatment
1.Prabhootmutrata311
2.Daurbalyanubhuti211

Table 2: Effect on Objective Parameters (Blood Sugar)

SNSymptomsBefore Treatment (14/06/23)F1-30 Days (14/07/23)F2-90 Days (20/09/23) After Treatment
1.Fasting blood sugar140.2 mg/dl90 mg/dl84 mg/dl
2.Post prandial blood sugar241 mg/dl76 mg/dl135 mg/dl
3.HbA1c7.3%NA5.60%

Madhumeha This observation shows that Ayurvedic treatment shows significant result in management of Madhumeha.


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Kajal R et al. Treatment protocols for Prameha (Type II Diabetes Mellitus)

Discussion

Ayurveda science of life is having great heritage of healing diseases. According to Ayurveda, Samprapti of Madhumeha occurs due to Strotodusthi mainly Mutravaha Strotas caused by vitiation of all Doshas mainly Bahudrava Shleshma & it shows Prabhut Avil Mutrata. Chandraprabha Vati contains, Chandraprabha (Karpura), Maricha, Vacha, Pippali, Musta (Rz.), Makshika Dhatu Bhasma (Makshika), Bhunimba (Kiratatikta), Yava Kshara (Yava) Amruta (Guduchi), Sarji Kshara (Svarjiksara), Daruka (Devadaru), Saindhava Lavana, Haridra, Sauvarchala Lavana, Ativisha, Vida Lavana, Darvi (Daruharidra), Trivrit, Pippalimula (Pippali), Danti, Chitraka, Patraka (Tejapatra), Dhanyaka, Silajatu, Gajapippali, Guggulu (Exd.) all have anti-diabetic properties. Triphala guggulu contains Triphala (an equal quantity combination of Haritaki (Terminalia chebula), Vibhitaki (Terminalia bellirica), Amalaki (Emblica officinalis), Pippali (Piper longum) & Guggulu (Commiphora wightii). Among many herbs, Triphala - three myrobalans (Terminalia chebula, Terminalia bellirica, Emblica officinalis) is a sugge. combination that possesses hypoglycemic qualities. Madhumehari Churana contains Jambu, Amra, Karvellaka, Mesasrngi, Methika, Bilva, Nimba, Sunthi, Satapushpa, Sonamukh, Bala & Babbula. Most of ingredients of Madhumehari Churana have Kashaya & Tikta Rasa property. Due to Kashaya & Tikta Rasa, it helps to reduce blood sugar level. Churna pacifies symptoms of Kapha due to Kashaya & Tikta Rasa & also pacifies symptoms of Pitta. As number of diabetic patients is growing in India as well as worldwide, numbers of patients suffering from complications will also rise. Hence it is high time to improvise our treatment plans & help to answer complicated situation. It is an observation in single case & more studies in this direction would help in establishing Ayurvedic treatment in this condition. After 3 months of treatment, patient showed significant relief in symptoms & drop down was seen in blood sugar levels.

Conclusion

Prameha Roga has been described since Vedic period. Changing life styles such as sedentary life, increased stress, strain, urbanization and tremendous change in the food pattern and dietic habits contribute a major role in the increased incidence of the Prameha in present era.

Thus, an extensive review of Brihat Trayi reveals that Prameha has been treated as a disease of importance since ancient times. From the results of the current study, it can be inferred that Shamana Aushadhi, together with the right dietary patterns and lifestyle choices, is the best way to control Madhumeha according to Ayurveda. The comprehensive strategy of Ayurveda, which makes use of the aforementioned notion, will unquestionably pay off in terms of not only controlling blood sugar levels but also avoiding difficulties brought on by Madhumeha.

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