diabetes mellitus in ayurveda herbal medicine

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Madhumeha-Diabetes mellitus:

Madhumeha-Diabetes mellitus Dr. M.Srinivas Naik Dept. of RASSASTRA Govt. Ayurveda Medical College Vijayawada

Definition:

Definition Diabetes mellitus (Gk; Diabetes-Overflow; Meli-Honey) Condition of increased blood glucose level due to the deficiency of insulin A diabetic excretes excess of blood glucose along with urine Excretion of sweet urine- glycosuria

Madhumeha:

Madhumeha Madhumehe- madhsamam / mootre jayate All mehas will end up in: Vataja meha / jata mehi / Beeja doshaja 2 types - dhatukshayajanya-vatavrudhi - Avruta margatvat / dhoshavruta pathe Shleshma medhasor ati dustyam Atimadhuryam / madhuryacha tanoratah : Asadhya-yapya

Types of DM:

Types of DM Type – 1 (IDD): appears at any stage of life and is characterized by subnormal secretion or no secretion of insulin(quantitative deficiency). Also called Juvenile diabetes (in children). Type – 2 (INDD): is a condition where enough insulin is produced but not utilized efficiently due to some functional disorder. Generally it occurs in Adults, particularly after age of 40yrs. It is also known as Maturity-onset diabetes .

Prevalence:

Prevalence According to one estimate, one out of every 6 persons is a diabetic in India. Lack of education, awareness and mismanagement of diabetes has posed a serious threat to human health. November 14 is celebrated as World Diabetic day In 1920, Canadian Physiologist Frederick Banting and Charles Best discovered existence of Insulin.

Why? So increased:

Why? So increased Stress Lifestyle Quality of Food Lack of awareness and education

Regulation of Blood glucose level :

Regulation of Blood glucose level The role of liver and pancreas in the regulation of blood glucose level can be explained in 2 stages : Stage 1: Condition of low blood glucose level [ Hypoglycemia ] Stage 2: Condition of high blood glucose level [ Hyperglycemia ]

Role of Liver:

Role of Liver The small intestine absorbs glucose which is finally conveyed to the liver. In the liver the glucose may be: Broken down into Carbon-di-oxide and Water(cell respiration) Converted into glycogen Converted into fats Passed on from the liver into the general circulation. The level of glucose in the blood at any given time is mainly determined by the above processes in the liver.

Role of Pancreas:

Role of Pancreas The endocrine part called Islets of Langerhams ( islets: scattered little islands ) produce the following hormones : Alpha cells: Produce Glucagon Beta Cells: Produce Insulin Delta Cells: Produces Somatostatin which inhibits secretion of insulin and glucagon Glucagon and Insulin stimulate the Liver, and insulin also acts on body cells.

Glucagon(hyperglycemic factor):

Glucagon( hyperglycemic factor ) When blood glucose level decreases from the normal limit – information reaches pancreas through Negative feed back. Produced by alpha cells of islets of Langerhams in Pancreas. (stimulated by sensory receptors) Reaches liver through blood Activates in Liver : Glycogenolysis: breaking down of glycogen into glucose Gluconeogenesis: synthesis of carbohydrates from non-carbohydrate compounds like fats and proteins. Thus Blood glucose level increases.

Insulin(hypoglycemic factor):

Insulin( hypoglycemic factor ) When blood glucose level increases beyond normal limit information reaches pancreas through Negative feed back mechanism. Produced by Beta cells of Islets of Langerhams in Pancreas. Mediates some changes in Body cells and in Liver. Body cells: Activates the body cells to absorb and utilize blood glucose.

Insulin(hypoglycemic factor):

Insulin( hypoglycemic factor ) Activates following process in Liver: Glycogenesis : synthesis of glycogen from excess glucose .(stored in liver( max.100g ) and skeletal muscle( max.400g )) Lipogenesis : conversion of still surplus glucose(strong chains) into fats. Inhibits Glycogenolysis and Gluconeogenesis . Thus, Blood glucose level decreases.

Effects:

Effects Diabetes mellitus leads to following effects: Glucose is not adequately utilized and oxidized. Permeability of glucose into the body cells decreases Rate of Conversion of glucose into glycogen decreases. Production of ketone bodies increases.

Samprapti:

Samprapti Vatavrudhi either by dhatukshaya or margavarana by anya doshas ( kapha,pitta ) Functional/structural impairmen ( shaitilyam-khavaigunya ) Bheeja dhoshajanya Interferes with dhatvagni / bhootagni Leads to srotosanga (functional) in Rasa &medhovaha srotas Kleda,Medha,kapha vrudha Menifestation of the disorder

Signs & Symptoms:

Signs & Symptoms Polydipsia – excessive thirst. Polyuria – excessive urination. Polyphagia – excessive eating. Hyperglycemia Glycosuria Dehydration – excessive loss of water and salts due to polyuria Loss of weight – catabolism of stored fat & proteins

Signs and Symptoms:

Signs and Symptoms Ketosis ( keto acidosis ): excessive fat metabolism leading to accumulation of ketone bodies like acetone & acetoacetic acid. Delayed tissue repair : High level sugar in the blood reduces resistance of bacterial infections and hence, an abnormal delay in wound healing.

Poorvaroopa & roopa:

Poorvaroopa & roopa Poly urea Poly pepsia Glycose urea Dantadheenam maladyatvam / nayana talu karnadini-medho doshat Pani pada daha Sweet taste in the mouth Rough hairs nakhati vrudhau

Investigations:

Investigations Detection: Estimation of Blood Glucose level: FBS,PPBS,RBS Glycated Hb Urine examination for sugar To know the causes: Thyroid and Lipid Profile CT and Pancreatic Scan Renal and Liver Function test Insulin Hormone level.

Management:

Management Life style Diet and Exercise Pancreatic stimulant/Agni deepaka Removal of Avarana / Rookshana,Pachana Use of panchakarma / Sthula pramehi Mastishkya Use of Rasayana

Panchakarma:

Panchakarma Samshodhana-vamana virechana Nasya-Stress factor conditions Vasti-rarely given Vyayama Udvartana Snana /Parisheka Lepa Dhara/ Mastishkya

Medicines:

Medicines Nisha amalaki Jambhoo beeja Karavellaka Triphala Bilvapatre Yavamalaka Mentye gudoochi Madhunashini Lodhra Katuka rohini Kirata tikta Kramuka Kthaka Vatsaka Asana

Formulations:

Formulations Nishamalaki Madhumardhan Nisha kathakadi kvata Kadira kramukadi Vasanta kusumakara rasa Tarakeshvara rasa Shilajatu vati Chandra prabha vati

Complications:

Complications Susceptible to all types of infections Atherosclerosis leading to Myocardial Infarction and Ischemic Stroke. Diabetic Nephropathy, Retinopathy, Neuropathy. Chronic Renal Failure Diabetic Gangrene Diabetic Skin Manifestations. Sudden Hyperglycemia leading to Insulin Shock Diabetic coma and death : Most of the symptoms mentioned produce drowsiness leading to diabetic coma and death, if untreated.

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