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Madhumeha/ prameha (diabetes mellitus): Care & diet by ayurveda
Dr. Imlikumba, Health Naturally Clinic, Mercy Building: Kevijau colony, Dimapur: Nagaland.  :  Jul/02/2017 07:11:PM
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(He that takes medicine and neglects diet wastes the skills of the physician.)
The word diabetes has been derived from two words, diabetes (Greek) which means ‘siphon through’ and mellitus (Latin)which means ‘sweetened with honey’.
Diabetes mellitus is a metabolic disease of multiple aetiology and described as Madhumeha/Prameha in Ayurveda. Diabetes mellitus is becoming fastest considerable diseases in the world.
India has being estimated with fastest growing population of Diabetics. The problem with diabetes mellitus is that it is very difficult to diagnose in the early stages. The preventive measures in Ayurveda can prevent the disease.
The main causative factor is said to be sedentary lifestyle and food habits.
However, a person stick to an Ayurvedic preventive strategy from the beginning can easily prevent this disease or control it if already suffering.
Etiological factors acc. to ayurveda :
Enjoying sedentary habits and the pleasure of sleep excessively, too much use of yoghurt and its preparation, meat juice of domestic, aquatic and swampy animals, milk and its preparation, newly harvested cereals, new/ fresh wines, preparations of jaggery (canesugar preparations) are the causes of the diabetes syndrome.
Purvarupa (premonitory symptoms) of prameha: The premonitory symptom are- feeling of burning in the palms and soles, body (skin) becoming unctuous and slimy, heaviness in body, urine is sweet, bad in smell and white in color, stupor, debility, profound thirst, dyspnea, more accumulation of dirt in the palate, throat, tongue and teeth, hairs of the head adhering to one another and more growth of the hairs and nails.
Clinical feature of prameha- The general feature of the diabetes syndrome is the passage of turbid urine, the urine becomes like honey and the entire body becomes very sweet.
Classification of prameha (acc to ayurveda):
A) Etiological classification:
 Sahaja Prameha (Growth onset/Juvenile/IDDM): Family history, Early onset, Asthenic constitution, Prone to complications.
 Apathyanimittaja Prameha (NIDDM): Over nutrition, Sedentary habits, Obese, Manageable with diet control and Herbo-mineral treatment (Apatarpana Chikitsa)
B) Clinico-pathological classification:
Ayurveda describes 20 subtypes of Prameha as different clinico-pathological conditions.
Kaphaja prameha 10 types (early diabetes): Overweight with Mild Hyperglycemia, Polyuria/Glycosuria.
• Udakameha- Clear urine in larger quantity without odour, feels cold sensation while passing urine.
• Ikshuvalikameha-Very sweet urine, cold, slightly turbid due to slimy substances and like crushed cane sugar.
• Sandrameha-Precipitate is deposited in the pot, if urine is kept overnight.
• Sandra Prasadmeha-Literally, sandraprasad means -some portion of urine is turbid & some is clean like un-distilled alcohol (Sura).
• Shuklameha-Urine seems to be mixed with some paste. While passing urine patient feels erection of body hairs. It is described as Pistameha by Sushruta.
• Shukrameha-Patient passes urine similar to quality of semen or semen itself may be mixed with urine.
• Sheetameha-Urine is very sweet & enormous with low temperature.
• Siktameha-Patient start passing small particles like sand in urine.
• Sanairmeha- Flow of urine becomes slow & patient feels difficulty in passing urine.
• Lalameha-Quality of urine is turbid & slimy. It is sticky & threads may be demonstrated like gum.
Complications of Kaphaja Prameha: Pratishyaya (coryza) Sharira shaithilya (laziness) Arochaka (anorexia), Avipaka (indigestion), Praseka (excessive salivation), Chhardi (vomiting) Nidra (hypersomnia), Kasa (cough).
Pittaja prameha -6 types (acute diabetes): Loss of weight, Hyperglycemia and Glycosuria, Urinary Tract Infection.
• Kalameha –Urine is blackish.
• Nilameha –Urine is bluish.
• Lohitameha –Urine contains blood and saltish in taste with putrid odour. It is described as Shonitmeha by Sushrata & Raktameha by Vagbhata & Madhava.
• Manjishthameha–Urine is pink like decoction of Manjishta having putrid odour.
• Haridrameha-Urine is turmeric yellow, pungent & associated with severe burning sensation.
• Ksharmeha–Not named on the basis of colour. Urine is like an alkali (ash) solution, in smell, colour and touch.
Complications of pittaja prameha: Amlika (hyperacidity) Pipasa (excessive thirst) Jvara (fever) Daha (burning sensation) Murchchha (fainting) Atisara (diarrhea) Pandu (anemia) Vrishanavadaranam (cracking of the scrotal skin) Bastimedhra toda (pain in the penis and bladder region).
Vataja prameha -4 types (chronic diabetes): Severe Hyperglycemia with Glycosuria, Cachexia, Nephropathy, Neuropathy, Retinopathy, Cardio Respiratory Complication, Gangrene.
• Vasameha-Urine contains fat (vasa).
• Majjameha –Urine contains bone marrow (majja). It is described as Sarpimeha by Sushruta.
• Hastimeha –Lymph (lasika) is passed in the urine. Flow & frequency of urine is almost continuous (incontinence). Simile of such patients is given with adult elephant as regards passes of urine.
• Madhumeha –Essence of body – Oja, is passed in urine and its taste is sweet & little astringent like honey.
Complications of Vataja Prameha: Hridgraha (heaviness in the chest) Laulyam (excessive hunger) Anidra (insomnia) Kampa (tremors) Shulam (pain) Baddha purishatvam (constipation) Kasa (cough) Shwasa (dyspnea).
In general Type 1 Diabetes mellitus i.e. Krisha Pramehi patients are advised to have Bringhan medication as well as a diet which increase Dhatus in the body.
In type 2 Diabetes, Obese diabetic patients (Apathyanimittaja Rogi) with optimal body strength having intense increase of Doshas, Samshodhan (purification) of the body advocated.
• Snehana (preparation of oil internally &externally).
• Shodhana (Purification therapy under three category)Virechana, Vasti (Asthapana/Niruha).
• Shamana with drugs.
• Exercise and life style modification & following regular regimen of exercise, yogasana, pranayama and regular food & sleep, following Ritucharya & Dincharya.
Diabetes can be controlled by giving comprehensive attention to three aspects:
• Ahara (Diet)
• Vihara (Lifestyle management)
• Oushadha (Medicine).
Ahara (dietary management): The best foods to eat are those that are not sweet, not too oily, Ushna (warm) diet is recommended since it will ease digestion, In the diet importance should be given to Yava , Other spices with antidiabetic are Haridra, Dhanyaka, Jeeraka, Rasona, Methika, Cinnamom etc, Ayurveda recommends use of Anupana along with diet and any herbs that are being utilized like: Sarodaka, Kushodaka.
Cereals-Yava–Barley, godhooma- Wheat, Shyamaka, kodrava, bajara. Pulses- Mainly beans- Mudga,Chanaka (Bengal gram).Vegetables- Thiktha shakas, Methika, Nimba, Karavella, Patola, Rasona (Garlic), Udmbara.Fruits- Jambu, Talaphala, Kharjura, Bilwa
Pathya (beneficial in prameha)- Shyama, Kodrava, Uddalika, Godhum, Chanaka, Aadak and Kullatha which are old- are suitable to be used as foods by patients of Madhumeha (Diabetes). Vegetables of bitter taste (Tikta), meat of animals and eggs of birds of deserts like regions (Jangala mamsa), boiled Yava and its preparations, Mudag, Shali, and Shastika are all suitable as foods.
Apathya (harmful in prameha)- Shauviraka (fermented gruel), Sura (beer), Buttermilk, oils, ghee, jaggery, foods processed with sours, sugarcane, juice, food prepared from flour, meat of animals of marshy regions should be avoided from use.
Vihara (lifestyle management): Patients are advised to avoid laziness and sedentary lifestyle, emphasizes importance of regular exercise, including brisk walk, jogging, sports and so on, Patients are advised to to do Yoga.
Conclusion: In early stage of disease it is better to use ayurvedic drugs alone. In acute stage patients wherever found necessary, oral insulin promoter may be added. In chronic stage, insulin therapy may also be added as these cases are insulin dependent. Mental health promoting drugs, if added along with anti-diabetic therapy, will further potentiate anti diabetic effect of the principal drug by counteracting stress.
Ayurveda and modern medicine both are complimentary and supplementary to each other. Simultaneous administration of Ayurvedic drugs will not only potentiate therapeutic efficacy of the modern drug rather it will also reduce adverse effect of the modern drug.  There is no cure for Diabetes, Diabetes can only be controlled and prevented, and some people may go into remission. All pharmaceuticals claiming to cure you of Diabetes are false.
Note: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor. The drugs described in this article are for general information only. Anyone should not use these without consulting a qualified Ayurveda doctor.

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