Introduction

Diabetes is a serious long-term metabolic condition that develops when the body is unable to use the insulin that is produced or when insulin production is inadequate. A number of other metabolic disorders, including central obesity, hypertension, and dyslipidaemia, are linked to type II diabetes and contribute to the extremely high prevalence of cardiovascular morbidity and death. Excessive hepatic glucose production, peripheral insulin resistance, and impaired beta-cell secretory activity are the primary pathophysiological abnormalities associated with diabetes. Numerous consequences, including diabetic ketoacidosis, non-ketotic hyperosmolar coma, heart disease, stroke, kidney failure (nephropathy), foot ulcers, retinopathy, cataracts, and glaucoma, can result from diabetes mellitus if treatment is not received.^[1]

Diabetes affects an estimated 537 million adults worldwide between the age of 20 to 79 (10.5% of all adults in this age range). By 2030, 643 million people will have diabetes globally, increasing to 783 million by 2045.^[2] India leads the world with the largest number of diabetic subjects earning the dubious distinction of being termed the “diabetes capital of the world”.^[3]

Prameha is a Santarpanajanya Tridoshaja Vyadhi. According to Sushruta, excessive indulgence in Pramehotpadaka Aahara-Vihara leads to vitiation of Vata, Pitta, Kapha, which combines with Medodhatu. These vitiated Dosha and Dhatu proceed downward through the Mutravaha Srotas to get localized at Basti, causing Prameha.^[4] Ayurveda states that Madhumeha (Vataja Prameha) is Asadhya i.e., incurable, and considered as Mahagada. Allopathic management aims at pharmacologic intervention- Insulin and oral hypoglycaemic drugs. Insulin is important in type 2 DM when diet, weight loss, exercise, and oral medications cannot control blood glucose levels. Oral hypoglycaemic agents include sulphonylureas, biguanides, alpha-glucosidase inhi-bitors, meglitinide analogues, and thiazolidine-diones. The main objective of these drugs is to correct the underlying metabolic disorders, such as insulin resistance and inadequate insulin secretion. Ayurvedic management includes Shamana Chikitsa (intake of anti-diabetic drugs), Shodhana Chikitsa (Panchakarma therapy) and Pathya Aahara Vihara (dietary modification and lifestyle changes).

Table 2: Ashta Stana Pariksha

Treatment Protocol

The patient was Managed by Shamana medication and no Panchakarma was advised.

Treatment for the first 45days:

1. Cap MM (Proprietary medicine) - 1 capsule thrice a day before food for a period of 45 days.

2. Cap Vayastha (Proprietary medicine) - 1 capsule twice a day for a period of 45 days.

3. Tab Neuron plus - 1 tablet in the afternoon for a period of 45 days.

Treatment for the next 45 days:

1. Cap MM ((Proprietary medicine) - 1 capsule twice a day for a period of 45 days

2. Cap Vayastha (Proprietary medicine) - 1 Capsule twice a day for a period of 45 days.

3. Tab Chandraprabha Vati - 1 Tablet thrice a day for a period of 45 days.

A rigorous diet that excluded foods high in carbs, fried foods, and sugar was recommended, as well as a daily walk of 5,000–10,000 steps. Millets such as Bajra and Jowar were incorporated into the diet. The dosage of allopathic drugs was subsequently decreased.

Shilajatu has been reported to reduce macrophage and lymphocyte activation and migration, as a part of its immunomodulatory activity. Being an antioxidant, it will prevent damage to the pancreatic islet cell induced by the cytotoxic oxygen radicals.^[6,7,8] Long-term treatment with Shilajatu increases the number of β -cells of pancreas, i.e., which may result in better sensitivity of pancreatic β -cells with prompt secretion of a large quantity of insulin in response to hyperglycemia. Studies reveal the hypoglycemic effect of Shilajatu (100 mg/kg) is significantly higher than that of metformin (500 mg/kg).^[9]

Madhyama Khanda of Sharangadhara Samhita references Chandraprabha Vati as Prameha Hara. Karpoora exhibited inhibitory activities for α-amylase and α-glucosidase assays which are helpful for starch breakdown into glucose. It helps in pancreatic β-cell restoration and insulin secretion also. Ethanolic root extract of Kiratatikta showed significant anti-diabetic effect, with a notable decrease in blood sugar levels.^[10] The ethanolic extract of Dhanyaka had the antidiabetic activity by improving and regenerating the β cell in the pancreas and inhibiting the α-glucosidase enzyme in the small intestine.^[11] Guggulu contains Z-guggulsterones and E-guggulsterones which are purported to be the compounds responsible for the hypoglycaemic and hypolipidemic activity of the Guggulu.^[12] Tridoshaghna herbs like Guduchi and Guggulu balance all three Doshas, while Lekhana and Vyavaayi actions are supported by ingredients like Vacha, Ativisha, and Vida Lavana which helps in Samprapti Vighatana.

Cap MM is a proprietary medicine containing various herbal drugs like Guduchi, Vrushyagandha, Asana, Jambu and Haridra with potent anti-diabetic properties as per the recent research activities concerned. The probable hypothesis guides that this formulation stimulates the beta cells of the pancreas.

Along with the above interventions, regular yoga and diet followed by the patient were also to be well thought out for encouraging results.

Conclusion

Diabetes mellitus is a chronic illness that affects not only the individual but also the family and the economy of the community.