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(Disease having similar symptoms in Ayurved- Madhumeha or Prameha )

What is Diabetes?
What are the types of Diabetes?
What are the etiological factors of Prameha?
What are the signs and symptoms of Diabetes?
What are the premonitory symptoms according to ayurveda?
Who is susceptible to diabetes?
What are the complications?
How can we prevent complications?
Feet care
Eye Care
Kidney Care
Skin Care
How to prevent diabetes?
Heart attacks and strokes

What is Diabetes?
Diabetes in common terms mean the disease ‘Diabetes mellitus’. Basically, diabetes mellitus is a
disorder of the body’s means of utilizing sugar, or glucose - the body’s basic fuel.
During digestion, food is converted to glucose (sugar) and then transported to the body cells for
energy by insulin. In diabetes, food is changed into glucose readily enough, but insulin (a hormone
secreted by the pancreas) is either lacking or unable to do its job properly.  Glucose then builds up
in the blood, leading to high blood glucose (blood sugar) levels.
Thus as described previously, insulin is necessary for glucose circulation in the blood stream to
enter the cells, where it supplies the energy to run the functions of your body. If glucose does not
enter the cells, it is virtually useless, and the cells of the body starve. In short; the body’s cells
require insulin to maintain a constant energy supply. There are two exceptions to this general rule.

1.Insulin is not necessary for glucose to enter the cells of the brain.
2.When you are exercising, the muscle cells can extract glucose from the blood without insulin.

What are the types of Diabetes?

There are two basic kinds of diabetes mellitus - type 1 and type 2.
Type 1 or IDDM - Insulin dependent diabetes mellitus
Most often becomes apparent in childhood or infancy. The pancreas does not produce enough
insulin to meet the body’s needs and daily insulin injections are necessary here.
Type 2 or NIDDM (Non insulin dependent diabetes mellitus)
This type of DM most often becomes apparent in middle age or later. Here the pancreas produces
some insulin, but the body cells resist the insulin’s action. Here rather, body enables to use it
Often the type 2 has none of the classic diabetes symptoms, and the disease is usually discovered
during a routine laboratory exam. Typically the patient is middle aged and overweight. Usually he or
she is inactive.
Ayurved describes twenty types of pramehas (urinary diseases) that get converted into

What are the etiological factors of Prameha?

According to ayurveda following are etiological factors of Prameha (DM)-

All Kapha promoting regimens like idle sitting, oversleep, excessive use of curd, meat soup of the
domestic, aquatic and marshy animals and their milk, new cereals and drinks, products of jaggery
etc are. etiological factors for prameha.

Sushruta says, that an idle man who sleeps during day or who is in habit of taking sweet liquids or
cold and unctous (fat making or emollient) food will be an easy victim of this disease.
Further Charaka in (Nidan sthana) elaborates type wise etiological factors in which he mentioned
specific type of food / food preparations. He mentioned some type of new grains in which he gave
some typed rice. New legumes like harenu and urad ( black gram), preparations of rice i.e. payasa
(‘kheer’ i.e. rice cooked with milk), Krushara (‘Khichadi’ i.e. rice cooked with pulse, vilepi (  paste
like preparation), immature curd, milk etc. exertion, anger, excessive sexual intercourse, excessive
physical exercise, suppression of natural urges, fasting, excitement, anxiety  and uneven body
postures, this all in excess and for prolong time give rise to three types of prameha.
What are the signs and symptoms of Diabetes?
The symptoms of diabetes mellitus may come on gradually and can be mild. At first people may not
recognise the early signs of this disease. That’s why it is important to learn about diabetes.
As these persons are sweet, their body shows some signs.

1.Frequent urination, especially at night
2.Unusual thirst
3.Fatigue (feeling tired)
4.Ravenously hungry
5.Sudden weight loss
6.Blurred vision
7.Slow healing infections or wounds.
What are the premonitory symptoms according to ayurveda?
1.Matting of hair, excessive increase of hair and nails.
2.Sweetness in mouth.
3.Numbness and burning sensation in hands and feet.
4.Dryness in mouth, palate and throat.
5.Thirst, liking for cold.
7.Feeling of dirtiness of the body.
8.Burning sensation and numbness in body pats.
9.Crawling of bees and ants on the body and urine.
10.Morbidities in urine
11.Fleshy smell in body, slackness in body (Shithilangata)
12.Frequent sleep and drowsiness
13.Smearing in heart, eyes, tongue and ears.

Sushruta mentioned an interesting symptom of Madhumeha patient as - "he seeks a halting place
while walking, wants a place to sit on while walking, lies down if he finds a sitting place and sleeps
if he lies down".

Who is susceptible to diabetes?

Prameha approaches immediately to the person who is a compulsive eater and has dislike for
bathing and walking, who is dull in activities, over obese, over unctuous and voracious eater.
What are the complications?

Diabetes can be a very serious disease if it is not treated and controlled. People who have
diabetes are more likely to develop certain medical problems than others who do not have
diabetes. Long-term complications of diabetes are harmful effects that may happen after someone
has had the disease for a number of years.
People with diabetes are more likely to have:
1.Eye problems - blindness, diabetic retinopathy
2.Kidney problems - diabetic nephropathy.
3.Heart trouble - heart attacks and strokes.
4.Sores on the bottom of their feet.
5.Nerve problems - Diabetic neuropathy.
According to ayurveda Prameha’s, when chronic, give rise to thirst, diarrhea, fever, burning
sensation, debility, anorexia, indigestion, and boils due to sloughing of muscles.
In ‘Madhava Nidana’ according to vitiated doshas complications of that particular type of prameha
is mentioned.
Kaphaja Prameha - Indigestion, loss of appetite, vomiting, too much of sleep, cough and running
Pittaj Prameha - Pain in the urinary bladder and penis, cracks in the skin of the scrotum, fever,
feeling of burning sensation, thirst, sour eructation’s, fainting and diarrhea.
Vataj Prameha - Udavarta (reverse peristalsis), tremors, heartache, desire for eatables of all
tastes, pain, loss of sleep, emaciation, cough and increased breathing.

How can we prevent complications?

If diabetes is treated and controlled properly by diet and medications we can prevent further
complications of which are more dreadful than disease.
Two more commonly occurring acute problems while diabetic management are Hypoglycemia and

Hypoglycemia - Is the medical term for an abnormally low amount of glucose in the blood commonly
referred to as ‘low blood sugar’. For people with type -I diabetes, hypoglycemia is most common
complication of insulin therapy. The incident of hypoglycemia among type- II diabetes is
considerably lower.

People with type -II may face a risk of hypoglycemia if they are on a fixed dose of oral sulfonylurea
diabetic medication, and / or they -skip a meal or reduce their food intake for any reason, indulging
in weight reduction diets, fasting and illness; Performs sudden and intensive exercise, consume
excessive alcohol, too much insulin delayed meal etc.

Symptoms range from mild to severe -
2.Increased sweating
6.Palpitations or rapid heart beat
7.Sensory changes (e.g. - tingling of lips, blurred or double vision).
9.Changes in behavior or work performance.
10.Confusion, not able to awaken.
11.Lethargy, staggering
What should I do then?
1.Take food containing sugar or sugar sweetened juices / glucose powder etc or chocolate.
2.Do not give anything by mouth if patient is not conscious.
3.Call doctor.
4.Do not give insulin and it is equally important to make sure everyone in your family and or those
working with you also know about these symptoms

How to prevent Hypoglycemia?

1.Take the prescribed amount of your oral hypoglycemic drug or insulin. Don’t interfere or change it 
at your own.
2.Do not change your medication without contacting your physician
3.Alert your physician regarding drugs, which may be prescribed for another medical condition
certain drugs, may affect your blood sugar level.
4.If you have any symptoms that you suspect may be related to hypoglycemia. Immediately
contact your physician as it’s onset is rapid.
Hyperglycemia - is the medical term for an abnormally high amount of glucose in the blood.
Commonly referred to as a ‘high blood sugar’ level. If the blood sugar level elevates markedly, the
metabolism is thrown off completely and the blood becomes more acidic. This is called diabetic
Ketoacidosis. This is danger that the patient could go into a diabetic coma and die. Underline
cause of this is taking too little insulin, failure to follow diet, infection, fever, emotional stress etc.
Symptoms -

1.Increased thirst and urination
2.Ketones in urine
3.Weakness, abdominal pains, generalized aches.
4.Large amounts of sugar in the blood or urine.
5.Heavy, labored breathing
6.Loss of appetite, nausea and vomiting
What to do then?
1.First call doctor immediately.
2.Give patient fluids without sugar if able to swallow.
3.Test blood or urine frequently for sugar.
4.Test urine for Ketones
Long-term complications of DM and their preventive care
Feet care -
People with diabetes need to be extremely careful about their feet because neglect of foot care in
diabetic individuals can rapidly lead to serious complications of gangrene and amputation.
Diabetes can contribute to foot problems in two ways -
1.It can cause decrease sensation in the feet, so that injuries such as cuts and scrapes may go
2.It can cause decreased circulation to the feet, resulting in a reduced blood supply that may be
insufficient to fight infection and heal wounds
The risks of developing foot problems can be greatly reduced if you follow the simple principles of
foot care.


Check - Check your feet and toe’s daily for cracks, cuts, sores, blisters, bruises, corns, calluses or
redness, swelling. watch for signs of infection. Be sure check the bottoms of your feet.
[Ask your doctor to check the pulse in your groin, behind your knees and on the tops of your

Clean - Wash your feet everyday, using a mild soap and warm water not hot (Don’t put your feet
in water without testing it first with your hand). Then dry then completely, especially between the
toes. Dry with a soft towel. If your skin is dry or show evidence of cracking, use a moisturizing
cream to soften dry skin as directed by your doctor. If you have a problem of excessive
perspiration, dust your feet lightly with foot powder change stockings daily.

You can use shata-dhauta ghrita also for soften your skin. You can use chandan, lodhra or
shankha jeeraka powder for dusting your feet’s.

Care - Trim your nail’s  frequently, straight across, and don’t’ cut them too short. Clip your toe
nails straight across rather than deep into the corners. Let your doctor take care of calluses. It
helps if you soften your nails by soaking them in luke warm water for about 5-10 minutes before
cutting them. Exercise daily to help your circulation and do foot exercise as recommended by your
Cover - Never go barefoot. Always wear shoes or slippers even at home and especially in the dark
to protect your feet. Remember an unnoticed minor cut, scrape or burn can rapidly lead to a
serious infection in a person with diabetes.
Wear comfortable shoes that fit properly. Leather shoes or jogging shoes are advisable as they
allow your feet to ‘breathe’. Check shoes daily for foreign objects, torn linings or other irritants.
Wear clean stockings every day rather never wear shoes without socks.

Caution - Always walk in good light. Take care in dark and avoid slippery places.
Call - Call your doctor if you have swelling, soreness or any change in your feet. Treat any minor
irritations or injuries to your feet when you feel pain in the calves during walking or exercise.

Don’ts -

1. Don’t soak your feet unless recommended by your physician. Do not rub the skin too vigorously.
Never put the cream between your toes as this moisture could cause infection.
2.Don’t use tight shoes as they can cause irritation and injury. Avoid shoes made up of plastics.
3.Don’t go barefoot ever
4.Don’t try to remove ingrown toe nails. Don’t use razor blades, scissors or knives to remove
calluses or corns. Don’t use sharp chemicals or home remedies as drying medicines like iodine or
medicated corn pads etc. as they can cause chemical burns
5.Do not use hot water bottles, heating pads below feet.
6.Be very careful to avoid injury when you trim your toe nails. Do not dig into the corners of the
7.Avoid exposing your feet to extreme cold for long periods of time.
8.Don't Smoke. Smoking narrows the blood vessels and decreases circulation to the feet. Smoking
is not wise for anyone, and particularly dangerous for people with diabetes.

Eye Care

Diabetes can damage the blood vessels in your eyes. In medical terms it is known as ‘diabetic
retinopathy’. If this damage is not properly treated in it’s earliest stages, it may get worse and
even cause blindness. So it is important to make sure that you take necessary precautions to
protect one of your most important senses - your precious eyesight.
For that reason it is essential that you see an ophthalmologist at least once a year. If the
ophthalmologist notices some early damage to your eyes, he can treat you. This will help you to
prevent the eye diseases from getting worse.
Those who are below 40 years of age and wearing glasses, notice your vision getting worse, re-
examine your eyes.
For diabetics over 40, screening for glaucoma should be done every year or two because the
incidence of glaucoma increases with age.

Kidney Care -
Diabetes can result in serious damage to your kidneys. The small blood vessels that are vital to
proper kidney function can be damaged by years of exposure of high blood glucose, high blood
pressure, or kidney infection. This is referred to as diabetic nephropathy.
The kidneys serve as the body’s filters. The 0problem is not noticed unless diabetes damages the
filters. If this happens, the kidneys don’t do as good job of removing waste and they make leak
protein into the urine. If this complication is not treated, the disease can become so severe that
you could loose your kidneys and require either kidney dialysis or a kidney transplant.

You can protect your Kidneys!
1. The first thing you must do is keeping your blood sugar levels as close to normal as possible.
This will minimize the possibility of damage to the tiny blood vessels that filter the blood.
2.Test your blood glucose level several times each day as directed by your physician.
3.Stay alert to bladder and kidney infections. Signs of infection are feeling you have to urinate all
the time, a burning sensation when you urinate and lower back pain.
4.Diabetic kidney disease is more likely to occur if you have untreated high blood pressure. High
blood pressure damages the small blood vessels; you should try to prevent it by reducing salt in
your diet. Change your diet to help bring it down.
5.Check your blood pressure regularly and begin treatment immediately if it is high.
6.Reduce your weight if you are overweight or control it and keep exercising.
7.Check urine and blood sample at least once a year for signs of kidney problems.
8.You can also protect your kidneys by taking immediate treatment for bladder or kidney infection.
9.Stopping ‘smoking’ if you smoke.
10.Keep your blood fat low / near normal and maintain your bloods fluidity to prevent atherosclrosis
/ hypertension.

Skin Care -
Peoples with diabetic mellitus are more prone to develop skin problems and infections. Skin
infection could be the first sign of diabetes. Poor control of blood glucose may cause an increase in
skin infections.

1.Skin infections can include athlete’s foot, impetigo (redness and cresting of skin) , yeast
infections, cellulites and boils.
2.Skin conditions such as dryness, itching, fatty deposits under skin, light brown depressed spots
on legs, blisters on leg and feet, rashes, hives or lumps at site of insulin injections.
How to Prevent diabetes?
1.When you have diabetes, monitor your blood glucose more often.
2.If your skin is dry, bath daily using a mild soap, apply moisturising lotion or cream to skin.
3.Use sunscreen lotion to avoid sunburn.
4.Treats cut and open wounds promptly and carefully.
5.Do not break blisters or cut corns. If blisters break open, treat it. If a sore becomes swollen,
reddened or begins to drain, contact your physician.
6.Take proper feet care
7.Rotate insulin injection sites to avoid lumps or depression in the skin.
8.You can use paste of ushira, twak, ela, agaru, chandana, for.
Heart attacks and strokes -
The blood functions well when it is in fluid from rather than viscous, flowing easily through the
Patients with diabetes are more likely to develop “hardening of the arteries i.e. Arteriosclerosis”
than other peoples who do not have diabetes. Arteriosclerosis is a condition in which fat builds up
in the large and medium sized arteries of the body. This build up of fat sticks to the interior walls
of the blood vessels and eventually hardens them. This fat and blood content platelets latter on
precipitates to form clots or thrombus in the blood vessels. Due to this, blood flow is slowed or
stopped or small clots can block the tiny vessels that nourish the eyes and the kidneys. This kind
of blockage is thought to be one of the major causes of blindness and kidney failure common in
diabetic individuals. This hardening of the arteries can cause a heart attack or a stroke too.
In order to minimise the probability of having a heart attack or a stroke protect your heart by
consciously trying to reduce risk factors for this complication.

1.Don’t smoke
2.Have a normal blood pressure, cholesterol level and weight. Don’t allow yourself to be
3.Maintain blood sugar within target range as advised by your physician.
4.Take regular exercise under physician's supervision and plan a diet low in cholesterol and fats.

Impotency -
Diabetic impotency affects at least 25% of diabetic males. Although neuropathy usually causes the
impotency in diabetic man.

Exercise -
As we have discussed earlier obesity and inactivity or sedentary life style is a predisposing factor
for Diabetes. Inactivity or a very low level of activity in itself may destroy insulin sensitivity for
some people and may bring on type II diabetes. Even obesity, or too high proportion of fat in body
tissues is associated with marked insulin insensitivity. That’s why type II diabetes needs controlled
diet and adequate exercise rather than medications to control blood sugar level. For treating
diabetes exercise is a powerful therapeutic tool.
How exercise is beneficial to you?
1.Diabetic individuals who exercise regularly may be able to reduce their dosage of insulin that
stimulates insulin production.
2.Exercise acts like insulin to reduce blood glucose level.
3.When you are exercising, the cells of exercising muscle can extract glucose from the blood
without insulin. One theory is that by dilating the blood vessels, exercise allows even small
amounts of circulating insulin to be utilized. Thus causing a fall in blood glucose.
4.Besides having immediate effect of clearing the blood glucose it increases body’s sensitivity to
5.Burns calories to help with weight control.
6.Triglycerides or neutral fat molecules has found elevated in many type II diabetic persons.
Elevated fat level in the blood leads to insulin insensitivity. Regular exercise lowers triglyceride
levels and helps the body to burn fat more efficiently.
7.Exercise has been shown to elevate the HDL cholesterol level that is good cholesterol and
replacing them with the dangerous LDL fractions. This action helps prevent arterial occlusion, thus
protecting against heart attacks and strokes.
8.Thus by maintaining blood fluidity it could help prevent damage to the eyes and kidneys.
9.It alleviates your mood, improves sense. organises activities, gets you out of stress and involved
you in other activities than restrictive lifestyle.
10.Like the rest of the body, the heart muscle improves itself it’s ability to extract oxygen form
blood with exercise. This is particularly important if there are blockages that reduces the amount
of blood flow, for the heart can extract more oxygen from less blood.
11.New Researches states that Exercise is the only activity that can develops collateral
circulation. The body’s normal defense mechanism is to build additional blood vessels around the
blocked artery to ensure continued blood flow is “collaterals”.
12.Practice of regular exercise, wrestling, active sports, riding on a horse, long walks, practicing
archery etc. should be practiced according to ayurved in case where the diseases has made a
decided advance.
13.Diabetics can do various yogasanas, profuse anointing, bath etc (ch. chi - 6/90), dry massage,
keeping awake at night which mitigate kapha and are beneficial. Some yogasanas will help you as
they provide exercise to glands (Pancreas). Some of the poses of this stimulates nerve impulses to
pancreas and improves circulation.

Some Asana' s are
1. Pashchimottanasan  
6.Ardha Matsyendrasana / Matsyasana, Kapal Bhati Kriya
8.Pranayam-Nadi Shodhak, Ujjayi, Bhastrika.

Everyone, before starting an exercise program, should get himself checked by physician. Start
exercising slowly, probably with walking only rather than running or aerobic exercise at beginning.
This is the only safe and effective way to start this.

1.You should perform this under medical supervision or with some ones company as exercise
reduces blood sugar. Adjust your medicines according to your physician advice while exercising.
2.If you are hypertensive or have some heart problems take care while exercising.
3.Walk instead of driving short distances. Use the stairs instead of the elevator, get off the bus
two stops before your destination because remember any extra movement burns calories.

Diet -
The first step to control diabetes is the simply eating right quantity and at right time. In many
cases, diet along with routine blood glucose monitoring is the only treatment needed to control
blood glucose level.

Even diabetics have the same need of nutrition from food as any other normal individuals. But his
diet needs modification because the diabetics cannot utilize these nutrients as rapidly and
efficiently as a normal person.

In a diabetic; excess weight or obesity tends to complicate the disease even further. So the diet
plan for obese diabetic person takes into consideration the need to reduce the weight to normal.
On the other hand, if the diabetic is underweight, the diet should consider the necessity to raise
the weight to normal. In ayurved, line of treatment is also mentioned as per their body physic
(obese / lean).

How can you modify your diet?

1.Maintain a healthy weight. In case of underweight and overweight diabetics, increased or
decreased food intake itself.
2.Use sugar, salts only in moderation.
3.If you drink alcoholic beverages, do so in moderation.
4.Choose a healthy diet low in fat, saturated fat and cholesterol.
5.Optimal diet composition for the diabetic individual would contain between 70-80% of complex
carbohydrates, 10-15% of fat calories and 10-15% of protons and should also contain about 30-
40gms of dietary fiber derived from grains, fruits and bran.
[Carbohydrates, are a major food group which contains sugar and starch and this provides fast
acting energy, while digestion carbohydrates break down into glucose which must be utilized by
body cells, in order to use as energy. Insulin is needed to take glucose by cells. But in case of a
diabetic patient, lack of insulin or body’s inability to use it properly results in increase in blood
glucose level. So it is advised to the patients to control carbohydrate intake even eliminate it so
that body’s need for insulin can be reduced. During the course of time this above-mentioned type
of diet tried by many physicians was not found to be beneficial. Some Dr’s tried high carbohydrate
diet on those patients who are on high fat or high protein diet, the diabetes disappeared. Research
states that even in a normal individual, a fat rich diet could bring on diabetes that could be
eliminated by carbohydrate rich diet. The most striking advantage gained by this is the
improvement in physical and mental activity. Many researches has proved that the high
carbohydrate, low calorie diet can do much to patients keeping them relatively more comfortable
and able to successful withdraw insulin. [Ref-Canada Medical association Journal 26:46, 26:136,
1932, 1935;  British Diabetic association].

1. All concentrated carbohydrates like sugar and sweets should be deleted from the diet. The
major sources of carbohydrates are cereal and sugar and it’s products.
2.Avoid food that is deep-fried. Switch to other cooking techniques baking / roasting/ boil / broil
etc. Use nonstick utensils and microwave oven, they minimize your oil requirements.
3.Once you are at your correct weight, stay there by dietary control -eat less red meat, more
fish; remove excess fat from meat if you are non-vegetarian. Eat less butter, margarine, sweet
desserts and salad dressings etc. Eat salads along with your meal it will reduce large intake of
4.Diabetic of type I, should eat three normal meals with regular snacks in between meals. Snacks
should be light. It should not result in excessive eating.
5.Meals have to be eaten at fix times when you have DM. If you take insulin or oral medications, a
stricter schedule for taking meals is necessary to prevent your blood glucose from dropping too
6.As previously mentioned in etiological factors avoid excess and prolong use of sweet rice
preparations like payasa (khir), Vilepi (Paste like preparation) and Krushara (khichadi), Panaka
7.All patients should forego the use of different types of wine, water, oil, ghee, milk, sugarcane

What Diabetic patient should eat?

1.Use sufficiently old and maturated Sali and Shashtik rice, barley, wheat, chanak (gram), Adhaki
(kidney beans), horse gram (Kulattha) or green gram (mudga).
2.Meal should be taken with pot-herbs, bitter or stringent taste cooked with the oils of mustard or
linseed oil.
3.Ayurveda recommends barley rich diet for diabetes.
4.You should eat various preparations of barley with honey.
5.Flour of parched grains and various edibles made of barley impregnated with decoction of drugs
as mentioned in ayurvedic texts.
6.Dipped barley in decoction of Triphala for whole night and make a tarpana taken with honey.
7.Seeds of Bamboo (venu-yava) and wheat may also be used in above form.
8.If you take parched barley and grain flour (Saktu) regularly you wont get DM ever, says

Do's -

Yava (Barley), wheat, bengal gram (chana), jwar, shali rice, green gram, horse gram, varak, lentil,
venu-yava (bamboo seed),
Mustard, turmeric, black pepper, sesame seeds, cardamom, garlic, ginger, onion, saindhava salt
Bitter vegetables - Bitter gourd, drum sticks, fenugreek leaves / seeds, navalkol, cabbage, patol,
spinach, chaulai  cauliflower, french beans, cluster bean.
Carrot, radish, lemon, unripe banana, jambu, date (khajur), amalaki, pomegranate, tinduka (Indian
or gaub persimon), kapittha (wood apple), bel (Eagle marmalous)
Honey, Buttermilk, Mastu (curd water), hot water etc.

Don'ts -

Black gram, cow pea, double bean, maize, bajara, sago, Soyabean, pumpkin, ladies finger, sweet
potato, potato, aravi, mango, sapodilla (chikoo), talaphal, kohala, grapes, ripened banana etc.
Saturated oil’s, ghee, vanaspati ghee etc. alcohol, jam, preserved fruit juices, dry fruits,
chocolates etc.