On World Diabetes Day – Diabetes Mellitus

World Diabetes Day (WDD) is celebrated every year on November 14 to mark the birthday of Sir Frederick Banting of London ON, who, along with Charles Best, first conceived the idea leading to the discovery of insulin in 1921.

This day engages millions of people worldwide in diabetes advocacy and awareness. World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization in response to growing concerns about the escalating health threat of diabetes. It was adopted as an official United Nations Day in 2007 with the passage of United Nation Resolution 61/225. The campaign draws attention to issues of paramount importance to the diabetes world. Healthy Living and Diabetes is the World Diabetes Day theme for 2014-2016.

The logo for World Diabetes Day is the blue circle – the global symbol for diabetes which was developed as part of the Unite for Diabetes awareness campaign.

Diabetes Mellitus

Around 250 B.C., the name “diabetes” was first used. The word diabetes comes from Greek, meaning a “siphon”. Araetus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) – like a siphon. The word became “diabetes” from the English adoption of the Medieval Latin diabetes.

In 1675, Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means “honey”; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean “siphoning off sweet water”.

In ancient India people observed that ants would be attracted to some people’s urine, because it was sweet. The term “Sweet Urine Disease” was coined.

Key Points

• Diabetes is a long-term condition that causes high blood sugar levels.
• In 2013 it was estimated that over 382 million people throughout the world had diabetes.
• In Type 1 Diabetes – the body does not produce insulin. Approximately 10% of all diabetes cases are type 1.
• In Type 2 Diabetes – the body does not produce enough insulin for proper function. Approximately 90% of all cases of diabetes worldwide are of this type.
• Gestational Diabetes – this type affects females during pregnancy.
• The most common diabetes symptoms include
  • Polyuria – frequent urination
  • Polydipsia – intense thirst, and
  • Polyphagia – intense hunger.
  • Weight gain, unusual weight loss, fatigue, cuts and bruises that do not heal, male sexual dysfunction, numbness and tingling in hands and feet are also commonly reported symptoms.
• In Type 1 Diabetes, if you follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life.
• In Type 2, patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.
• As the risk of cardiovascular disease is much higher for diabetics, it is crucial that blood pressure and cholesterol levels are monitored regularly.
• As smoking might have a serious effect on cardiovascular health, diabetics should stop smoking.
• Hypoglycemia – low blood glucose – can have a deleterious effect on patient.
• Hyperglycemia – when blood glucose is too high – can also have a bad effect on the patient.

There are three types of diabetes:

1) Type 1 Diabetes Mellitus

The body does not produce insulin. It is also referred to as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years. Approximately 10% of all diabetes cases are type 1. Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. The prevalence of type 1 Diabetes among the under 20s in the USA rose 23% between 2001 and 2009.

2) Type 2 Diabetes Mellitus

Beta cells in islets of Langerhans do not produce enough insulin for proper function, or the receptors in the body do not react to insulin (insulin resistance). Approximately 90% of all cases of diabetes worldwide are of this type. Overweight and obese people have a much higher risk of developing type 2 diabetes. People with more of central obesity are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body’s cardiovascular and metabolic systems. It may respond to simple measures such as : loss of weight, following a healthy diet, doing plenty of exercise, and monitoring blood glucose levels regularly. However, type 2 diabetes is typically a progressive disease. Drinking just one can of (non-diet) soda per day can raise our risk of developing type 2 diabetes by 22%. The risk of developing type 2 diabetes is also greater as we get older. Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes.

3) Gestational Diabetes Mellitus

Diagnosis of gestational diabetes is made during pregnancy. This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.

The majority of gestational diabetes patients can control their diabetes with exercise and diet. Women whose diets before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counterparts whose diets were low in cholesterol and animal fats.

Pre-diabetes Mellitus

The vast majority of patients with type 2 diabetes initially have prediabetes. Their post-prandial blood glucose levels go higher than normal, but come back to normal. Studies indicate that some damage to the circulatory system and the heart may occur even at this stage.

Investigations

Doctors can determine whether a patient has a normal metabolism, is pre-diabetic or diabetic through three tests:

• The Hb A1c test: Glycated hemoglobin (hemoglobin A1c, HbA_1c, A1C, or Hb_1c; sometimes also HbA1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time.
  – at least 6.5% means diabetes
  – between 5.7% and 5.99% means pre-diabetes
  – less than 5.7% means normal
• The FPG (Fasting Plasma Glucose) test
  – at least 126 mg/dl (7.0 mmol/L) means diabetes
  – between 100 mg/dl and 125.99 mg/dl (5.5 to 7.0 mmol/L) means prediabetes
  – less than 100 mg/dl (5.5 mmol/L) means normal
  An abnormal reading following the FPG means the patient has impaired fasting glucose (IFG)
• The OGTT (oral glucose tolerance test)
  – at least 200 mg/dl (11.2 mmol/L) means diabetes
  – between 140 and 199.9 mg/dl (7.8 to 11.2 mmol/L) means prediabetes
  – less than 140 mg/dl (7.8 mmol/L) means normal
  An abnormal reading following the OGTT means the patient has impaired glucose tolerance (IGT)

Blood Glucose Regulation

Following is the list of known hormones which regulate blood glucose levels.

Controlling Diabetes

All types of diabetes are treatable.

Diabetes type 1 lasts a lifetime, there is no known cure. Patients with type 1 are treated with regular insulin injections, as well as a special diet and exercise.

Type 2 usually lasts a lifetime, however, it can be managed with or without medication, through a combination of exercise, diet and body weight control. Sometimes insulin injections are also required.

Patient has a significantly higher risk of developing complications especially if diabetes is not adequately controlled.

Complications linked to diabetes

• Eye complications– glaucoma, cataracts, diabetic retinopathy, and some others.
• Foot complications– neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated
• Skin complications– people with diabetes are more susceptible to skin infections and skin disorders
• Heart problems– such as ischemic heart disease, when the blood supply to the heart muscle is diminished
• Hypertension– common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke
• Mental health– uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders
• Hearing loss– diabetes patients have a higher risk of developing hearing problems
• Gum disease– there is a much higher prevalence of gum disease among diabetes patients
• Gastroparesis– the muscles of the stomach stop working properly
• Ketoacidosis– a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood.
• Neuropathy– diabetic neuropathy is a type of nerve damage which can lead to several different problems.
• HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome)– blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.
• Nephropathy– uncontrolled blood pressure can lead to kidney disease
• PAD (peripheral arterial disease)– symptoms may include pain in the leg, tingling and sometimes problems walking properly
• Stroke– if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly
• Erectile dysfunction– male impotence.
• Infections– people with badly controlled diabetes are much more susceptible to infections
• Healing of wounds– cuts and lesions take much longer to heal

Some Facts And Myths Regarding Diabetes

Many presumed myths keep making rounds. It is important to have an accurate picture of the disease. Some common diabetes myths are mentioned here:

• People with diabetes should not exercise– THIS IS NOT TRUE! Exercise is important for people with diabetes, as it is for everybody else. Exercise helps manage body weight, improves cardiovascular health, improves mood, helps blood sugar control, and relieves stress. Yoga has been shown to have an important role. Patients should discuss exercise with their doctor first.
• Fat people always develop type 2 diabetes eventually– Again, this is not true. Being overweight or obese raises the risk of becoming diabetic, they are risk factors, but do not mean that an obese person will definitely become diabetic.
• Diabetes is a nuisance, but not serious– Diabetes is a serious disease. Two thirds of diabetes patients die prematurely from stroke or heart disease. The life expectancy of a person with diabetes is from five to ten years shorter than other people’s.
• Children can outgrow diabetes– Child-onset diabetes is almost always type 1; insulin-producing beta cells in islets of Langerhans in pancreas do not produce insulin, so they will need to take insulin for the rest of their lives.
• Don’t eat too much sugar, you will become diabetic– A person with diabetes type 1 develops the disease because immune system destroyed the insulin-producing beta cells. A diet high in calories, which can make people overweight/obese, raises the risk of developing type 2 diabetes, especially if there is a history of this disease in the family.
• I know when my blood sugar levels are high or low– The only way to be sure about your blood sugar levels is to test it regularly. Even very slight rise in blood-glucose levels significantly raises the risk of ischemic heart disease.
• Diabetes diets are different from other people’s– Experts say that there is no need to buy special diabetic foods because they offer no special benefit as compared to the healthy things we can buy in most shops. Diabetics just need to eat healthy.
• High blood sugar levels are fine for some, while for others they are a sign of diabetes– High blood-sugar levels are never normal for anybody. Some illnesses, mental stress and steroids can cause temporary hikes in blood sugar levels in people without diabetes. Anybody with higher-than-normal blood sugar levels or sugar in their urine should be checked for diabetes.
• Diabetics cannot eat bread, potatoes or pasta– People with diabetes can eat starchy foods. However, they must keep an eye on the size of the portions. Whole grain starchy foods are better, as is true for people without diabetes.
• One person can transmit diabetes to another person– Diabetes is not infectious or contagious.
• Only older people develop type 2 diabetes– A growing number of children and teenagers are developing type 2 diabetes. Experts say that this is linked to the explosion in childhood obesity rates, poor diet, and physical inactivity.
• I have to go on insulin, this must mean my diabetes is severe– people take insulin when diet alone or diet with oral or non-insulin injectable medicines do not provide good-enough diabetes control. Insulin helps diabetes control. It does not usually have anything to do with the severity of the disease.
• If you have diabetes you cannot eat chocolates or sweets– People with diabetes can eat chocolates and sweets if they combine them with exercise or eat them as part of a healthy meal, provided blood glucose level stays within normal limits.
• Diabetes patients are more susceptible to colds and illnesses in general– A person with diabetes with good control is no more likely to become ill with a cold or something else than other people.

 Ayurveda in Diabetes Mellitus

Diabetes was known to ancient Ayurveda and Yoga experts thousands of years ago.  The Indian physician Sushruta in 400 B.C. described the sweet taste of urine from affected individuals, and for many centuries to come, the sweet taste of urine was key to diagnosis. Diabetes Mellitus is known to Indians from Vedic period onwards by the name Asrava (Prameha). Diabetes is also known as Madhumeha (means passing sweet urine) in Ayurveda. The knowledge and effectiveness of diagnosis can be understood from the fact that Ayurveda has classified Diabetes (madhumeha) into 20 different types!

Types of diabetes , Causes and Symptoms

Two types of Prameha from management point of view has been described:

• Krisha Pramehi (Lean Diabetic), and
• Sthula pramehi  (Obese Diabetic)

They are classified in Ayurveda on very similar grounds as Diabetics are classified in IDDM and NIDDM respectively.

On the very similar pattern we find the classification as

• Sahaj pramehi (Congenital) and
• Apathaya nimmitaj (due to overeating and wrong eating habits).

Ayurveda clearly defines diabetes.  Diabetes Mellitus was known to Hindu Civilization since vedic period by the names:

• Asrava(Prameha),
• Madhumeha, or
• Maharoga(Major Disease),

as almost all parts of the body and every cell of human physiology are affected.

It also disturbs 5 sheaths of the body –

1. annamaya kosha {Food sheath},
2. pranamayakosha{Energy sheath}, 
3. manomaya kosha{Mind Sheath},
4. vijnana maya kosha{IntellectualSheath} and
5. anandamaya kosha{Bliss Sheath}.

According to Ayurveda, prameha is divided in 4 major types (and total 21 types)

• Kapha type (again divided into 10 types)
• Pitta type (again divided into 6 types)
• Vata type (divided into 4 types)
• Juvenile diabetes for children (for unhealthy practices of parents and/or due to the sins of past-birth)

The main cause of prameha (diabetes) are lack of exercise and consumption of excess food having ushna, snigdha and guru nature. Foods that increase kapha, medhas and mootra are the major factors for prameha.

Yashcha kinchith vidhiranyepi sleshma medho moothra samjananam sa sarva: nidana vishesha.

Classification of Prameha (Diabetes) :

According to Ayurveda , Prameha (Diabetes) can be classified in two categories :-

1)      Apatharpana uthaja prameha describing the lean diabetic and

2)      Santharpana uthaja prameha relating the obese diabetic.

Classification according to Causes of diabetes :-

1)      Sahaja prameha (congenital)

2)      Apathyanimittaja prameha (due to over eating and poor habits)

Classification of Diabetes according to Dosha :-

According to Ayurveda, Prameha (diabetes) is a tridoshaja vyadhi.  However the predominance of any one dosha and dooshya enables its classification into

• Vataja Prameha
• Pitaja Prameha, &
• Kaphaja Pramehas.

They are further sub classified into 20 sub categories according to characteristics of urine, its volume, dhatu being excreted through urine.

Normally, Prameha (Diabetes- Madhumeha ) is classified by Ayurvedic Practitioners according to dosha predominance viz.

1) kapahja,

2) pithaja,

3) vathaja,

4) kapha-pithaja,

5) kapha-vathaja,

6) pitha-vathaja, and

7) vatha-pitha-kaphaja.

Sannipatha, kevala vathaja and kapha-vthaja(to some extent) and pitha-vathaja can be considered as IDDM. And others are considered as NIDDM.

According to Sushruta, Dosha predominance is the primary factor in Diabetes Complication.  According to him Malabandha (Constipation) is a complication of this disease as the patient has a concentration of Meda.  In such cases laxatives of average doses are not effective.

According to Brihathrayees, pidika (diabetic carbuncle) is a major complication of prameha (Madhumeha).

Complications as per Dosha :-

Kaphaja

• Avipakam– indigestion
• Aruchi– Loss of appetite
• Chardi– Vomiting tendency
• Athinidra– Excessive sleep
• Kasam– Cough
• Peenasam– Cold with running nose

Pittaja

• Vasthimehanyotoda – Pain in Bladder & urinary path
• Mushkavatharanam – Pain in testes
• Jwara– Fever
• Daham– Burning sensation
• Trishna– Thirst
• Amlika– Acidity
• Moorcha– Giddiness
• Vitbhedanam– Loose Motion
• Hridayashoola– Pain in heart region
• Nidranasam– Loss of sleep

Vataja

• Udavartham-Upward movement of vatha.
• Kambam-Tremor
• Hridgraham-Gripping pain in chest region
• Lolatha-Affinity
• Soolam-Pain
• Anidratha-Insomnia
• Sosha-Wasting
• Kasam-Cough
• Swasam-Difficulty to breath
• Badhapureeshathwa        –Constipation

According to Charaka.  There are three types of prameha.

• Sadhya  – curable
• Yapya    – Palliable
• Asadhya – Incurable

Sadhya: Describes patients who have been diagnosed very early in the onset of prameha (Madhumeha). In this category of patients , there can be those who are sthoola  (obese) and the origin of their disease is in apathyaja (poor living habbits)

Yapya: Patients under this catagory have Pittaja prameha & certain types of kaphaja prameha.However Yapya (palliable) helps control the disease with treatment.

Asadhya: Describes the incurable version of prameha (Madhumeha) & inherited diabetes.Sahaja patients suffering from this variety are Krisha (lean)

Involvement of Ojas in Prameha (Madhumeha)

Ojas is the essence of life, an extract of the seven dhathus (Elements) Rasa(Chyle), Rakta (Blood),Mamsa (Muscles), Majja(Marrow), Asthi (Bone), Meda (Brain & Spinal Cord), Sukra (Sperm & Ovum), Ojas (Mahadhatu=Superior Dhatu) represented as bala {strength }of the body. The ojus in a healthy person determines the physical, psychic, sensory motor functions of the body. The biochemical component of the body which is reddish, white, slightly yellowish in colour residing in heart and other vital organs of the body. If ojas is distrubed, degeneration will be fast and result in decreased life span. In prameha the ojas (life essence) is expunged from the body through all navadwaras especially through urine & sweat.

Ojas gets imbalanced in prameha in two ways:

1. Through obstruction in blood vessels (srothorodha)
2. Degeneration of the body components is dhatu kshaya this can cause both cardiac & nervous system disorders.all this is ojakshaya meaning an imbalance in Ojus.

Management of Prameha (Madhumeha)

According to Ayurveda the line of treatment of prameha is strictly on individual’s constitution.

1)      The prakrithi of the patient

2)      Dosha predominance of disease

3)      Dooshya vitiation

4)      Obstruction in srothus

5)      Manasika Prakrithi

6)      Ahara & Vihara

7)      Samskaras or Hereditary factors etc…

In general Diabetes Mellitus (Vathaja prameha) patients are advised to have Bhrimhana medication & diet which increases dhathus in the body.

Herbs useful in treatment of Diabetes :-

Specifications :-

Latin Name : Pterocarpus marsupium – leguminosae

Rasa (Taste) : Kashaya (Astrigent), Tikta (Bitter)

Guna (Characteristics ) – Lakhu (Light), Ruksha  (Rough)

Veerya (Potency) – Sheeta (Cold)

Vipaka (Post digestion effect) – Katu (Pungent)

Actions according to Ayurveda :-

• Rasayana : Vijaysar rejuvenates each and every cell of the body.
• Raktasodhana : Vijaysar purifies the blood and removes all toxins from it.
• Krimirogahar (Antihelmenthic) : Vijaysar is very useful in disease which originate from external causes like infection, worm infestation etc.
• Pramehaghna : Vijaysar is useful in all disease which involve discoloration of urine including diabetes (Madhumeha).

For thousands of years, ancient physicians have been successfully treating Prameha with the Ayurvedic measures and drugs. Many drugs have already been screened for their anti-diabetic property/blood sugar lowering property. The importance of diet and exercise is also stressed in Ayurveda. The Ayurvedic diet regimens and the recipes may serve as a good replacement for the Diabetic patient. Though many of the diabetic drugs that are used today have a good sugar lowering (Hypoglycemic property they essentially act only symptomatically. The management modalities can be categorized as:

• Vyaayam (Exercise),
• Pathya (dietary regulation),
• Panchakarma (Bio-purification procedures) and
• The use of therapeutic measures (Medicines).

The herbal drugs used in the management of Prameha are bitter, astringent and pungent in taste. Some of the widely used herb apart from Vijaysar for the management of diabetes is as follows:

1. Eugenia jambolana:(Jamun beej churna) Dry seed powder of Jamun fruits have to be used in a dose of one-teaspoon twice/thrice daily with lukewarm water.
2. Gymnema sylvestre: (Gudmar patra churna) Dry leaves of this plant have to be used one teaspoon daily with lukewarm water. The leaves when chewed render the mouth tasteless to sweet for 45 min to one hour.
3. Pterocarpus marsupium (Vijaysar churna) Bark of this plant is available in the form of powder. Cubes or Vijaysaar glasses are also very popular & Effective.  The piece of Vijaysaar is kept in water overnight or water is kept in the glass is consumed early morning on empty stomach. One should discard these cubes or glasses once there is no color change observed in water.

4.Ficus bengalensis (Nyagrodha twaka churna) This is banyan tree bark. A decoction of bark is to be prepared and consumed twice daily in a dose of 40 to 80ml. The decoction is prepared by taking around 25-50gms of bark to which 4 cups of water are to be added. It is heated to make one cup, which has to be consumed.

5. Shilajeet Popularly known as Rock salt, various reputed companies have Granular or powdered form of Shilajeet available. Though not very useful in reducing the blood sugar it is an excellent remedy to for loss of libido in males and in case of generalized weakness.
6. C. Tamal (Tejpatra) This is very commonly used as a spice in preparing food products. A diabetic patient may make a point to add the leaves of this plant in his food. Also the powder of leaves may be consumed.
7. Fenugreek seeds (Methi churna) Seeds of Methi have to be soaked in warm water overnight and chewed early in the morning with warm water. One may take powder of these seeds with warm water twice daily.  Methi powder may be added to the wheat flour to prepare chapattis.
8. Momordica chirantia Karvellaka (Karella) Juice of Karela should be taken early in the morning in a quantity of 20 ml.  The dried whole fruit powder can also be consumed in the dose of ½ to 1 teaspoon twice daily.
9. Embelica officinalis (Amala) When fresh Amla are available one may take Amla juice 20 ml daily or otherwise powder of Amla fruits may be taken twice daily.
10. Curcuma longa (Haridra) Haldi powder along with Amla juice is a very good combination in patients of Diabetes. It is especially useful in prevention as well as treatment of patients of Diabetic eye disease. Haldi can be put in milk as well.
11. Kirat tikata (Chirayata) A decoction of this plant is to be taken daily early morning. It is a very popular remedy used in all parts of the country for various skin disorders and hence forms a perfect remedy for skin infections in Diabetics .

An ayurvedic physician may advise adjuvant ayurvedic drugs. Not only do these help in lowering the blood sugar but also prevent the long-term complications of diabetes. We shall name some of these combinations/preparations:

• Chandraprabha vati: In a dose of 500 mg twice or thrice daily. This is specially used in patients having Diabetes with Urinary tract infection or in females having leucorrhoea. This can be used along with Gorshuradi guggul in the same dose.
• Trivang Bhasma: This is a combination of three bhasmas namely Naga, Vanga and Yashaha Bhasma. It is to be taken in a dose of 125mg twice daily available in the form of powder. It is very useful in conditions where there is excessive urination, Male sexual problems as well as to treat generalized weakness.
• Dhatri Nisha: A combination of Haldi powder and Amla Rasa and has to be taken early morning and is especially useful in eye condition.
• Vasant Kusumakar Rasa: A very useful tonic for diabetics especially useful in the stage of complications it has to be consumed in a dose of 125 mg twice daily. Along with having a general tonic effect it also helps in Diabetic eye condition and in preventing various conditions developing due to Nerve weakness.
• Arogyavardhini
• Mamajjaka Ghana vati
• Jambvasava
• Pathyakshadhatryadi kashaya
• Panchanimba churna

Along with regular use of vijaysar, following herbs can also be used depending upon symptoms

1)       Diabetes with Arthritis: Yograj guggul, freshly prepared decoction of Dasamoola, Rasna saptak, a paste of sunthi or Dasang lepa may be applied on the affected joint.

2)       Diabetes with constipation: Powders like Gandharva haritaki, Isabgool, Panchaskar, Hingvastak can be used to relieve constipation.

3)       Diabetes with burning sensation in the soles and palms: this can be well managed with Mangista Ghana vati, chandrakala rasa, Chandraprabha vati, pravaal pisti, Guduchi satva etc

4)       Diabetes with cough: Diabetic patient suffering of chronic cough may given powders of Yasti madhu, Kantakari, Vasa, Shati etc. Ayurvedic cough syrups available in the market are not safe to be taken by a diabetic patients

5)       Diabetes with excessive thirst: Excessive thirst may be managed with the use of cold infusions (heema) of Dahayanak, usheera, Chandan etc. Praval, Guduchi, may also be used.

6)       Diabetes with excessive urination: excessive urination can be treated with the use of Trivang bhasma, jasad bhasma, etc

7)       Generalised weakness and fatigue are the usual symptoms that can be treated with the use of herbs like shatavari, Ashvagandha, Bala Yastimadhu. Complications like tapyadi loha, Vasant kusumakar rasa are also very effective

8)    Impotence is a very distressing symptom of a diabetic patient. By assessing the age of the patient they may be advised Ashwagandha, Kaucha beeja, musali etc.

Permitted food for Diabetics according to Ayurveda :

Wholesome diet habit for diabetes:
1. Shigru(drum stick)
2. Haridra(turmeric)
3. Amalaki(goose berry)
4. Shyamaka-Setaria italica (L.) Beau.
5. Kodrava- Paspalum scrobiculatum,Linn.
4. Yava(barley)
5. Godhuma(wheat)
6. Mudga(green gram)
7. Kulattha(horse gram)
8. Patola(snake gourd)
9. Karavellaka(bitter gourd)
10. Maricha(pepper)
11. Lashuna(garlic)
12. Jambu(blue berry)
13. Vyayama(exercise) etc

Prohibited diet for diabetics according to Ayurveda:
1. Kanda- moola (root-rhizome)
2. Ikshu (sugar cane juice)
3. Taila(oil)
4. Ghrita(ghee)
5. Guda(jiggery)
6. Kanjika/shukta(sour beverages)
7. Madya(alcohol)
8. Pishtanna(carbohydrate rich food)
9. Anupa mamsa(flesh of marshy land)
10. Dadhi (curd)
11. Navanna (new grains)
11. Divaswapna (day sleep etc)

7 Effective Home Remedies for Controlling Sugar

Ayurveda recommends many simple home remedies to keep diabetes under control. Incorporating one or two of these remedies into your daily diet plan can help you prevent or at the least manage your blood glucose levels.

1. Mix half a teaspoon of turmeric powder + 1 teaspoon of amla powder + half a tablespoon of methi seeds powder in half a glass of water and take daily in the morning on an empty stomach.
2. Mix honey with barley that is soaked overnight in Triphala decoction (available at Ayurveda stores) and have it several times during the day.
3. Juice of bitter melon or gourd can test the toughest amongst us. But when taken on an empty stomach it works wonders at balancing our blood sugar level.
4. Grind and mix 100gms of fenugreek (methi) seeds, 50gms of turmeric and some white pepper. Take one teaspoon of this powder with a glass of milk twice daily.
5. Soak one teaspoon of fenugreek overnight in water and drink it with water or milk in the morning.
6. A tablespoon of the juice of the Indian gooseberry mixed with a cup of fresh bitter gourd juice is said to enable the pancreas to secrete insulin, if it is taken daily for two months.
7. Drink a glass of water with 10 tulsi leaves, 10 belpatras and fenugreek leaves early in the morning on an empty stomach.

Yoga in Diabetes

Effectiveness of Yoga at preventing and treating diabetes is due to its emphasis of a healthy diet and lifestyle as well as its ability to balance the endocrine system, massage and tone the abdominal organs, stimulate the nervous and circulatory systems, and reduce stress. Pranayama or breathing exercises offer still greater hope.

Stress has been shown to play an important role in diabetes by elevating blood glucose levels and increasing the odds of developing certain complications, such as heart disease, stroke and infections. And having a chronic disease that requires major lifestyle changes and constant monitoring can be very stressful in itself. Research now shows that chronically elevated levels of cortisol (hormone produced by the stress response) can lead to blood sugar problems, insulin resistance, and diabetes. Yoga and meditation are the two best practices to reduce stress and yoga has been shown to dramatically lower cortisol levels in the body.

All steps of Ashtanga Yoga, viz., Yamas, Niyamas, Asanas, Pranayama, Pratyahara, Dharna, Dhyana and Samadhi, are important and should  be adhered to in the same order. In health or disease, it’s always better to know and choose yoga postures and pranayama exercises according to the prakriti and  vikriti of the person.

In general, exercise is a highly effective part of diabetes treatment because it increases insulin sensitivity and lowers blood sugar. Many studies have reported the beneficial effect of the practice of yoga on diabetes, confirming that the practice of postures can stimulate the insulin producing cells in the pancreas. Yoga has also been proven helpful for weight management, blood sugar control, as well as lowering of the dosage of diabetic medications.

Yoga Postures

Forward bends, twists and prone (belly down) poses all compress the abdomen to stimulate the pancreas, with prone poses being the most effective. Use forward bends and calming poses to reduce stress. In addition to acting on koshas and balancing chakras, yoga postures improve lymphatic circulation and hence body immunity. Yogic postures done with focus on breath, bandha, drishti and proper alignment are meditative and help in detoxification. Two reasons that yoga is particularly great for diabetes is that it:

• Rejuvenates pancreatic cells, through alternate abdominal contractions and relaxation, during asanas (yogic postures which produce relaxation) and breathing exercises.
• Reduces blood sugar due to muscular exercise involved in the asanas.

Some yogic postures provenly beneficial in diabetes are:

1. Surya Namaskar (sun salutation)
2. Setubandhasana (bridge pose)
3. Pavanamuktasana (wind relieving pose)
4. Trikonasana (triangle pose)
5. Tadasana (mountain pose)
6. Sukhasana (easy pose)
7. Padmasana (lotus pose)
8. Pashimottanasana (posterior stretch)
9. Ardhmatsyendrasana (half spinal twist)
10. Pawanmuktasana (joint freeing series)
11. Bhujangasana (cobra pose)
12. Vajrasana (thunderbolt pose)
13. Dhanurasana (bow pose)
14. Halasana (plow pose)
15. Naukasana (boat pose)
16. Bhujangasana (cobra pose)
17. Shavasana (corpse pose)
18. Anila Asana

Pranayama

Practice Pranayama to increase circulation of blood, oxygen and prana to facilitate healing and for stress reduction. Ashwin, the breath, is said to be the physician of gods. According to Vedas, it heals all maladies, with a name or without it. Recent years have witnessed a rise in interest in the healing powers of pranayama and myriad of studies have proven its positive effects on health. Pranayama has immense healing potential, and in expert hands, can work wonders. Pranayama is a great way to boost immunity. It is the bridge between the physical body and spiritual body and optimizes the flow of Prana. In general, some exercises like:

• Bhastrika
• Ujjayi
• Kapal Bhati
• Anulom Vilom
• Moorchha
• Vibhag Pranayama
• Mahat Pranayama
• Sama Vritti Pranayama
• Visham Vritti Pranayama etc.

have been shown to help in diabetes. Please check the details of some breathing exercises here.

To offer the advantages of this yogic science of breathing, SAVY launched Dr Sahdev’s ‘Breathe and Heal’ Program ,a stepped program based on some very safe and healing breathing exercises in 2012.

Meditation 

Meditation reduces stress, calms the mind and activates the body’s natural healing abilities. You can use one of the following by itself and/or at the beginning and end of yoga practice:

• Yoga Meditation,
• Third Eye Meditation
• Prana Healing Meditation

Yoga Nutrition

Diabetes has been linked to the western lifestyle, as it is rarely seen in cultures that consume a natural non-processed, non-refined diet. Because of the standard Western diet that is high in sugar and dead carbohydrates that turn to sugar, the pancreas becomes exhausted and the cells are overworked. A yogic diet that is high in fiber, whole grains, legumes and vegetables is recommended to lose excess weight and stabilize blood sugar levels. With the synergetic combination of yoga, regular aerobic exercise and healthy diet diabetes can be controlled and quiet often reduced or even cured.

Some studies on raw vegetarian diet claim miraculous results.

Marma Therapy

Marmas can also be called minor chakras; they are vital points in the body through which life energy flows. There are 108 marmas and they are classified into different groups. Some marmas are very important in diabetes, and if massaged with proper pressure/technique, order, oil, duration etc., can help a lot in prevention as well as relief. Some points for diabetes are :

1. Indrabasti
2. Hridaya marma
3. Tala Hridaya
4. Urvi Marma
5. Stanarohita Marma
6. Guda Marma

Activation of these and other important points by massage with specific herbal oils, medicated ghrita in a gentle manner with discrete motion is highly beneficial. All this must be undertaken under the strict supervision of a well-trained expert with actual experience.

Ayurvedic/ Yogic massage based on Marma Therapy is quite beneficial. This is done not only as a means to relieve stress but also for deeper therapeutic reasons. It assists in hormonal balance. Most masseurs are not trained in such specialized massage, so, finding a knowledgeable expert becomes very important.

Mudra Vigyan and Kriya Vigyan

Various hand postures (hasta mudras) are said to have very beneficial effect in health and disease.

There are five hand mudras which are quite effective in diabetes. Practice for 45 minutes daily at a stretch or three times of 15 minutes each, depending on your comfort level.

1. Surya Mudra

Method:

1. Sit or stand straight.
2. Stretch your hands to your front.
3. Bend your ring finger so that it touches the root of thumb.
4. Keep the other fingers spread out, apart from each other.

2. Pran Mudra

Known as the Mudra of Life, it helps in improving the vital force of life and activates your Mooladhara Chakra or root chakra. Thus, it empowers you wholly within. The mudra, when practiced without fail, helps in detoxifying your body. Practicing this mudra alongside Apan Mudra has been proven to offer relief to those suffering from diabetes.

Method:

1. Sit down in a relaxed position, preferably, Padmasana (Lotus pose), with your eyes closed. Those who are uncomfortable in this position can opt for performing the mudra in Tadasana (Mountain Pose).
2. Focus on your breathing.
3. Keep your hands on your sides.
4. Bend your little finger and ring finger to touch the thumb.
5. Keep the index finger and middle finger straight.

Make sure that you perform this mudra with both the hands.

3. Apan Mudra

The mudra, also called the mudra of purification, is one of the easiest yoga mudras. It aids in striking a better balance between the elements within the human body. Thus, it ensures that the unwanted toxins are flushed out properly from your body. This mudra results in frequent urination for eliminating the wastes, thus lowering the blood sugar levels.

Method:

1. Sit in Padmasana or Vajrasana. Those who have knee problems can opt for standing in Tadasana.
2. Keep your hands stretched to your front.
3. Bend your thumb, middle finger, and ring finger in such a way that their tips come together.
4. Keep the little finger and index finger straight.

Make sure that you perform this mudra with both the hands. Combine this mudra with Vayu mudra and practice regularly for preventing and curing diabetes.

4. Gyan Mudra

Also known as Chin Mudra, it can be practiced by the diabetics to enjoy deep relaxation. It helps in relaxing the body and eliminating stress and other mind-related issues.

Method: The mudra, in general, is practiced alongside meditation poses.

1. Choose a sitting position, such as Padmasana, Vajrasana or Sukhasana, depending on your ease of doing so. You can even choose Tadasana, if you can concentrate without any trouble. Those who find it difficult to follow any of the yoga asanas can opt for sitting relaxingly on a chair. Keep your eyes closed.
2. Keep your back straight; head and chest should be held high. Focus on your breathing.
3. Keep your palms on your knees. Palms should face upwards.
4.  Bend the index finger to touch the thumb’s tip, while the rest of the fingers are kept straight.
5. Performing this Mudra while chanting will yield more effective outcomes.

5. Linga Mudra

Lingam, in Sanskrit, means phallus – the male reproductive organ. This mudra is helpful for those who are suffering from diabetes. It helps in activating the fire element within the human body, thus generating intense heat. This, in turn, causes an increase in metabolic levels. The higher the metabolic levels, the more the chances of a person losing weight. This, automatically, lowers blood sugar levels, offering relief from diabetes.

Method:

1. Sit down in Padmasana, Vajrasana or Sukhasana or choose to stand in Tadasana.
2. Clasp your hands stretched in front of the body while keeping the fingers intertwined.
3. The thumb of your left hand should point upward. Circle it with the right thumb and right index finger.
4. Inhale and exhale normally and maintain the position for 15 minutes.

Nabho Mudra – Breathe and Heal

Also, Nabho mudra and Khechari mudra, when done properly along with certain Pranayamas, are said to have a curative effective.

Panchakarma requires strict supervision by an expert. Shatkarma is a set of six detoxifying procedures, viz., Neti, Dhauti, Nyauli, Basti, Kapal Bhati, Tratak, which are said to remove the toxins from the body and thus help the body recover from any ailment.

NADA YOGA AND MANTRAS

All disorders in Ayurveda have been correlated to karmic influences. Hence chanting Mantras with appropriate gestures is very helpful. The selection of Mantras and time to chant depends on the natal chart and its interpretation.

Mantras influence the vibratory functions of cells and help them work in specific synchronization with the brain. Over a period of time it helps to cleanse the body of toxins. These therapies must be followed with strict guidelines of diet and lifestyle.

VEDIC ASTROLOGY AND GEMSTONES

Gemstone therapy and Vedic astrology have been shown to be useful in diabetes.According to Astrology, planetary Combinations which causes Diabetes are:

• Two or Three Malefic Planets if posited in Watery Signs
• Two or Three Malefic Planets posited in the 6th House.
• Two of Three Malefic Planets posited in Libra or in 7th house
• Moon afflicted by Sun or Mars in Watery Signs
• Venus afflicted by Sun or Mars in Watery Signs
• If the 6th lord is posited in 8th or vice versa

Astrologically, Diabetes can be cured by wearing two gems:

1. Red coral, and
2. Yellow sapphire.

There are certain rules for wearing the stone:

1. The Gemstones shall be worn in silver.
2. Gemstones shall be energized by purification.
3. The Gemtones shall be worn in right hand.
4. Gemstones can be worn in a single pendant where Yellow Sapphire shall be fitted on the right hand side and Red Coral on the left hand side.

At SAVY we offer Yoga Therapy for Diabetes Mellitus and other ailments.

Also, please look up here for upcoming workshops, or

Contact Us

Learn all that directly under expert guidance of one of the most qualified faculty in the world! Your Yoga Teacher – Dr Jitender K Sahdev E-RYT 500 D.Sc., Ph.D.,MD, is a Yoga Therapist /Yoga Teacher in London with over 37,000 hours of Traditional Yoga teaching experience. A Surgeon by profession from India with almost three decades of experience in Medicine, he utilizes Yoga as a complementary therapy for optimizing the health and wellness of his clients and for easing symptoms associated with disease. He trained under doyens of Yoga in India for almost four decades. He is a Yoga Therapist in Canada.

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Dr Jitender K Sahdev

Note : Yoga Therapy is best administered in an individualized manner though some generalized guidelines have been provided for all.

You should check with your health care professional before starting this or any new therapy or exercise program or breathing routine. This is especially important if you have any pre-existing health conditions, such as high blood pressure, migraines or heart or lung ailments. Women who are pregnant or think they might be pregnant should consult their physician before performing any of the breathing or physical exercises or undertaking any therapy program.

The information contained in the program is not intended to serve as a replacement for professional medical advice. Any use of the information in these programs/ workshops is at the reader’s discretion, risk and responsibility. The studio, author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained herein. A health care professional should be consulted regarding your specific situation.