Ayurveda  for diabetes mellitus: hype, hope and beyond: Dr. Atul Rakshe
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Ayurveda for diabetes mellitus: hype, hope and beyond: Dr. Atul Rakshe

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Does Ayurveda really have a ‘treatment’ for Diabetes? ...

Does Ayurveda really have a ‘treatment’ for Diabetes?
Patients, students, doctors and scientists from across the globe ask this question often. We have been looking for the ‘correct’ answer to this question. Of late, we have been working on various autoimmune and degenerative disorders. In our clinics and through various research references, we have come up with highly encouraging results, especially in Type 2 diabetes.
This paper is a summary of my observations in clinical Ayurvedic practice in last 15 years.

‘Medicine for Diabetes in Ayurveda’ is a cliché. Though unanswered, this question brings many perspectives. We have chosen a path. A path that is based on experiments and observations. We hope, this path leads to having a ray of hope for the ones who did not have a choice but to have Diabetes.
Ayurveda believes that there is no substance in this world, which cannot be used as medicine.
We wish, the times would come when all the medical sciences unite to create a better and brighter protocol, which can solve or at least ease the life of a Diabetic and life as a whole.

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Ayurveda  for diabetes mellitus: hype, hope and beyond: Dr. Atul Rakshe Ayurveda for diabetes mellitus: hype, hope and beyond: Dr. Atul Rakshe Document Transcript

  • 1 Ayurveda for Diabetes Mellitus-hype, hope and beyond Dr. Atul Rakshe, Pune, India Ayurvedacharya, B.J., F.I.I.M., Maestro Di Ayurveda (Italy), Ayurveda Bhushan (2013) drraksheatul@gmail.com www.cozwecare.org 091 9422034506 Does Ayurveda really have a ‘treatment’ for Diabetes? Patients, students, doctors and scientists from across the globe ask this question often. We have been looking for the ‘correct’ answer to this question. Of late, we have been working on various autoimmune and degenerative disorders. In our clinics and through various research references, we have come up with highly encouraging results, especially in Type 2 diabetes. This paper is a summary of my observations in clinical Ayurvedic practice in last 15 years. All this began in 1999 when I was a fresh young Ayurveda practitioner. I was then working in different fields related to health and Ayurveda. I had recently started writing articles in leading newspapers, speaking regularly on state radio channel and I was the associate editor of Deerghayu- the most read Marathi Ayurveda publication. People started knowing our work, and started bringing patients with difficult diseases to our clinics. They were real eye-openers and guiding stars for the journey ahead. During one of my visits to my native place- Shrigonda, a small town around 100 kilometres from Pune, a woman was brought for treatment. This middle-aged woman had bronchial asthma since childhood and Diabetes for over a decade. Since she had very poor control on Asthma, she was advised to consume steroids. This was worsening her general health and BSL1 was almost out of control. When I saw her for the first time in 1999, she and the family had almost lost hope. She could hardly breathe and needed steroid-bronchodilator inhaler more than 10 times in 24 hours. Her BSL were over 200 fasting and over 350pp2, ; in spite of taking around 40 units of insulin twice every day. We gave her some medicines and observed for some days. After a month, her Asthma attacks started reducing. After 3 months, her BSL started improving. After around 12 months, her physician reduced the insulin doses to 8units. Moreover, miraculously enough, after 2 years from the first visit, her insulin was completely stopped. We continued her Ayurvedic medicines for over 5 years, tapered and stopped. She did not require even oral hypoglycemics for next some years. Her BSL values were monitored regularly. Now, after over 13 years, she is on a very low dose of Metformin. She is living with her family, sons and grandchildren. I could witness this journey of a woman, from that day of first consultation, when she had lost hope and surrendered to the ever-growing misery and doom until today, when she is still living to show a ray of hope to many like herself. Her Asthma and her Diabetes showed us a path. Later, we tried similar medicines on dozens of people with Diabetes. 1. Blood sugar levels 2. Post-prandial
  • 2 Probably, India has the maximum number of people prone to Diabetes and its complications. Last three decades have brought many changes for the people in this country. Life here has turned the life upside down, almost like a roller-coaster ride. ‘Genetically modified’ food to feed the second largest human community on this planet; enormous increase in domestic and workplace stresses; sudden loss of physical activity; information technology and technology in general has made people laziest than ever. Diabetes Mellitus has never had such fertile soil and such favourable conditions in the history of this disease. Main reasons for Diabetes could be summarised as lack of exercise, increased stress, high calorie diet and some genetic factors. No wonder, India has already become the Diabetes capital. Of late, Diabetes Mellitus has been among the top killers. Almost like an epidemic, its direct and indirect effects have been defeating the healing systems time and again. Newer investigations like HbA1c have been only evident of the poor control on Diabetes and its’ possibilities. A very typical progression in Type 2 Diabetes is seen. In Diabetes patients, ‘beta cells’ of pancreas start dying. Almost all the medical sciences are trying to discover a medicine, which can slow down or stop this process of ‘dying’ of beta cells. Generally, as soon as a person comes to know about the abnormal blood sugar levels, he rushes to a doctor. The doctor advices him some changes in lifestyle and restrictions in food alongwith the oral hypoglycemics and –or insulin. With due course of time, these oral hypoglycemics do not work enough efficiently. The doctor advises to increase the doses or changes the medicine altogether. The reason being the pancreatic cells, which are already ‘weak’, get ‘exhausted’ with that certain medicine. This results in increased demand of oral hypoglycaemics, eventually no result with oral medicines. This situations compels to start the Insulin injections. The duration between the point of knowing the abnormal BSL and starting Insulin is different in all individuals who have Diabetes. The age group to have Diabetes has shifted from 40+ to 30+. It makes its management even more difficult. Earlier the onset of the disease, earlier are the chances that the person will develop ‘resistance’ to specific drugs like oral hypogycemics and insulin. It has become a routine event to meet people with Diabetes and its complications. The complications can be frozen shoulder, retinopathy, neuropathy, loss of libido, non-healing wounds, recurrent urinary tract infections, renal failure, skin diseases and many more. These complications can be seen even in people who have blood sugar levels within normal limits consistently for months together. Therefore, even if the blood investigations show ‘normal’ BSL values, we cannot be sure that the person will not get any complications. We were looking for a ‘blend’ of modern age philosophy and ancient Ayurvedic wisdom. As we go further, we tried to find a way out.
  • 3 As we all know, Diabetes Mellitus is not a disease that comes from somewhere outside. Unlike a bacterial or viral infection, it is an autoimmune disease, where some cells of the body start working against other cells of the same human being, automatically. Our focus was to see if ‘we could slow down the rate-of-dying-of-the-beta cells’, rejuvenate the pancreatic cells and if possible, ‘outsource the digestion of sugar’. Ayurveda offers many herbal-mineral medicines, Dinacharya (lifestyle modifications), Ahar (changes in food) and panchakarma procedures to ‘detoxify’ the organs and systems in order to treat ‘Prameha’. Prameha is the closest description to today’s Diabetes Mellitus. There can be some relevance to what is similar in both Ayurveda and modern Allopathic scientific scripts. For example: Udakameha = Diabetes insipidus, Ikshumeha = Alimentary glycosuria, Madhumeha = Diabetes mellitus, Sandrameha = Phospaturia, Surameha = Acetonuria, Pishtameha = Chyluria, Shukrameha = Spermaturia, Sikatameha = Lithuria, Lalameha = Albuminuria. However, some questions remain unanswered when we try to treat Diabetes on similar guidelines on which we would diagnose and treat Prameha, its stages and complications. For instance, ancient Ayurbedic texts like ‘Charaka samhita, ‘Sushrut Samhita’ and Ashtanga Hridayam (popularly known as Vagbhat samhita) explain various types of Prameha. The main diagnostic feature of each Prameha type is the ‘change in colour or consistency or density of urine kept for certain duration’. We tried this in many ‘normal’ and diabetic patients. The results were confusing. In many ‘Prameha chikitsa’ verses which explain the treatment of Prameha; Honey is advised as the anupana (Vehicle = a substance with which the medicine should be consumed). Honey can be disastrous for blood sugar levels if taken one or two tablespoons a day. For us, the most important line-of-thinking was the concept of ‘Agni’. Ayurveda describes yakruta (Liver). Pleehaa (Spleen) and Swadupinda (Pancreas) as the root places (moola sthana) of agni. Agni is the ‘energy’ that converts substances, materials and tissues to another. For example, agni is the one which ‘converts’ rays of light into vision, food into tissues (7 dhatus) and helps excrete ‘mala’s i.e. wastes out of the body. The organ ‘Agnyashaya’(Agni-ashaya. Ashya mean ‘home’. Agnyashaya means home of agni) is Pancreas- swadupinda. We found this concept of Agni very similar to the pathophysiology that ‘beta cells’ of pancreas generate insulin and hence are responsible to Diabetes. We selected herbs and minerals on following criteria: 1. ‘Agni’vardhaka (For the ‘balance’ of agni – the converter) 2. Amapachaka (For the elimination of ‘toxins’ which may be born of ‘undigested’ food and still remain in the body stuck in different ‘channels’ of body tissues. 3. Rasayana (For rejuvenation which may counter the ‘damage’ of tissues) 4. Help the reduction of dependence on the ‘medicines’. We believe that within each living body there is a ‘factory of medicines’, which is constantly working. We tried to find way to boost its’ mechanism.
  • 4 Before starting to design a Diabetes management protocol, we decided some rules: 1. Only Type 2 Diabetes cases were studied. 2. Oral hypoglycemics, Insulin, multivitamins and other allopathic medicines were continued simultaneously. They were reduced, altered or tapered as BSL1 s started improving, with routine involvement of the same Physician (M.D. Medicine) who managed the patient before coming for Ayurvedic treatment. 3. Some patients came to us, as soon as they were diagnosed with Diabetes. They were asked to consume only Ayurvedic medicines. They were advised to take Oral hypoglycemics consult a physician only if there was no improvement in 3 weeks. 4. Our goal was to find out whether there can really be some Ayurvedic medicines which could help in a) better control on Diabetes b) Controlling the possibilities and progress of diabetes complications. c) Enhancing the effect and efficacy of oral hypoglycemics and insulin if already started. d) Improvement in quality of life and sense of wellbeing. We named our Diabetes management protocol as ‘Madhumitra’. Madhumitra line-of-action has three ways:  To boost the Agnyashaya (Panceras)  Improve functioning of Liver cells  Improve the health and functioning of excretory systems The ‘design module’ of Madhumitra suggests three basic principles: 1. Accept: To have a difficult autoimmune disease like Diabetes is certainly difficult to accept. ‘Why me?’ is the question which remains unanswered and keeps one from accepting the fact. ‘Something has changed, and i ‘have to’ accept it happily’- is the key! 2. Abjure: Food, habits and other factors that will worsen the situation should be well known and avoided. 3. Act: Many people just ‘plan’ and ‘decide’ to change. Change can only be achieved if one follows certain changes as the philosophy, as the rule as the protocol or as program of his living. ‘Madhumitra’ mainly includes the following:  Diet modifications  Lifestyle modifications  Ayurvedic medicines Diet: A specially designed ‘Diabetes diet’ is prescribed to each patient. Dietary changes mainly include low calorie, low sugar, high protein, low fat, high fibre diet. Lifestyle modifications: Simple changes in daily routine are suggested. They include: 1. Avoid water* , fruits, beverages or sweets immediately after food.
  • 5 2. A walk for 4 to 5 minutes after each meal. 3. Consume warm water during meals. 4. A healthy breakfast is necessary. Avoid late and heavy dinners. 5. Consume two almonds soaked overnight in water and 2 walnut seeds each morning. 6. Eat an apple or an ama each morning. Since exercise is equally important, we generally prescribe following exercises; out of which a patient is advised to follow at least one routinely. 1. A set of 12 Suryanamaskar (Vedic method of salute-to-sun. It includes different postures, a specific Sanskrit ‘mantra’- a composition that establishes control on breathing during the postures) is most advised. Suryanamaskars provide the best ‘stretch’ and twist to muscles, joints and soft tissues. They also establish a specific ‘calmness’ and rhythm in the physical, emotional activity which further helps to reduce physical-mental stress.) 2. A brisk walk for 40 minutes a day is also advised. Ayurvedic medicines: 1. Chandraprabha vati 250mg tablet (Shrangadhar Samhita) One tablet twice a day; at morning, empty stomach with ½ cup of warm water and one tablet at bedtime after at least 1 hour after dinner. 2. Panchtikta Ghrita guggul One to two tablets twice a day; at morning, empty stomach with ½ cup of warm water and one tablet at bedtime after at least 1 hour after dinner. 3. A blend of Triphala choorna (Blend of powders of fruits of Terminalia chebula, Terminalia bellerica, Emblica officinalis :Bhavaprakasha Nighantu) 1.5 gms and Haridra(Turmeric powder 0.5gms with ½ cup of warm water at bedtime after at least 1 hour after dinner.. 4. A blend of following herbs ½ table spoon - 0.5gms twice a day; at morning, empty stomach with ½ cup of warm water and at bedtime after at least 1 hour after dinner. Each 1-gram powder has approximately following quantity of herbs:  Patola (Fruit of Trichosanthes dioica Roxb.) 30mg  Indrayava (Seeds of Wrightia tinctoria)30mg  Kutaki (Picrorhiza kurroa) 30mg  Vasa (Adathoda vasica) 30mg  Nimba patra (Leaves of Azardichta indica) 30mg  Methika ( Fenugreek seed- Trigunella foenumn-graceum linn.) 30mg  Gudamaar (Leaves of Gymnema sylvestre) 30mg  Chitraka (Roots of Plumbago zeylanicaLinn.) 10mg  Tejapatra (Leaves of Cinnamomum tamala Nees & Eberm.) 10mg  Anantamool (Root of Hemidesimus indicus R. Br.) 30mg  Bilwapatra (Leaves of Aegel marmelos) 30mg  Usheera (Root of Vetiveria zizanioides) 30mg  Bhumyamlaki (Leaves of Phyllanthus niruli) 30mg  Jeeraka (Seeds of Cuminum Cyminum) 20mg
  • 6  Chirayata (Swerita chirata Buch-Ham. Ex C. B. Clarke) 30mg  Jambu (Seed of Eugenia jambolana Lam.) 40 mg  Lodhra (Symplocos racemosa Roxb.) 30mg  Khadeera (Bark of Acacia catechu Willd.) 30mg  Amalaki: (Fruit of Emblica officinalis Gaertn.) 30mg  Bibhitaka (Fruit of Terminalia Bellerica Roxb.) 30mg  Haritaki (Fruit of Terminalia chebula) 30mg  Ashwagandha (Withania somnifera) 40mg  Nimba twak (Bark of Azadirachta Indica) 30mg  Karela(Powder of Momordica charantia Linn.) 40mg  Shweta Chandana (Sandalwood, Santalum album) 30mg  Haridra (Curcuma longa Linn.) 30mg  Vijayasar (Keeno Tree: Pterocarpus marsupium) 40mg  Twak (Bark of Dalchini- Cinnamomum zeylanicum) 20mg  Punarnava (Root of Boerhaavia diffusa) 40mg 5. In some cases, we prescribe Tab. Asanad vati (Proprietary: Ayurveda Rasashala Pune. Ingredients Saptaparni, Asan, Lodhra, Arjuna, Karanja, Khadir, Pooga, Saga, Indrayava, Shirisha, Wala, Mocharas, Palashabeej, Jeetasaya, Shilajatu, Meshashringi blend triturated with Aloe vera (Kumari) juice. Asanad was prescribed to those with BSL PP above 300, especially Pitta Prakruti people. In the chart below, we present some case studies at a glance so that one can have a brief idea about the prognosis of individual patients with different age groups and complications. Sr.Number Patient’s name, age, sex Date of first consultation, BSL, USL F/PP Treatment for DM if any Complications, other symptoms Date of last follow up, BSL F/PP Treatment Complications status 1. Dattatraya P. 45/M 18/04/2009 249/334 ++/+++ No treatment Pain in both heels, dry eczema 25/01/2013 180/210 Nil/Nil Only Ayurvedic treatment No pain in heels, eczema healed 2. Archana V. 42/F 19/04/2012 230/272 +++/++ Proteins trace, pus cell 10-12 No treatment Dryness on palms 07/06/2013 158/183 Nil/Nil Only Ayurvedic Treatment No protein/ pus cell in urine, dryness of palms reduced 3. Nagesh L. 62/M 12/06/2011 147/326 Absent/++++ Albuminurea, Severe weight loss 13/06/2013 158/190 Nil/Nil All allopathic medicines were discontinued by the patient against medical advice after first consultation No Albumin found in urine, weight gain 2kg
  • 7 4. Shounak K. 50/M 25/05/2012 142/313 On Glucometer No treatment 6th nerve palsy Left Diplopia Headache 19/02/2013 136/193 Diplopia reduced. Bilateral vision and eyes almost normal 5. Rutuja S. 54/F 26/08/2012 72/ 350 T. Glynase 1½ BD T. X Met 500-2OD T. Jalra 1 BD Weight loss Weight 39kg 15/06/2013 90/155 T. Glynase1/2Hs T. X Met 500-2 OD T. Jalra stopped on 6/10/2013 Weight gain 1 kg 6. Premnath J. 35/M 26/11/2012 137/180 T. Diamet SR 500 1BD General Debility, Burning feet 04/05/2013 126/158 T. Diamet SR 500 reduced to ½ BD on 02/01/2013 Further reduced to only ½ after lunch.19/01/2013 General Debility reduced. Burning in feet reduced 7. Prabha R. 61/F 2/01/2007 180/289 Tab. Glycomet 1BD Recurrent UTI, General debility, Frozen shoulder 21/06/2013 110/125 T. Glycomet discontinued AMA in 2009 No UTI since 2010 General debility reduced Shoulder restriction and pain completely reduced 8. Uday p. 58/M 22/04/2013 186/232 +/++ T. Glycomet GP1 1 Before breakfast T. Glycomet GP2 Forte1 B Dinner T. Cilacan T 1 BD T. Sutamet 50 1 BD T. CTD 12.5 1 to 8 am Ecosprin 75 1 after lunch T. Lipicure TG Before breakfast Hypertension Hyperlipidemia 29/05/2013 122/162 9. M. Nadar 60/M 01/01/2009 169/260 Trace/++ Tenolol 501 HS Hypertension 05/02/2013 123/145 Trace/+ Hypertension remains with fluctuations 10. Vandana K. 48/F 30/062012 185/284 +/++ No treatment Hypothyroidism under Allopathy treatment, dry cough, uterine fibroids, anaemia, anal 05/07/2013 138/162 Only Ayurvedic treatment Complications severity and recurrence reduced
  • 8 fissures ‘Medicine for Diabetes in Ayurveda’ is a cliché. Though unanswered, this question brings many perspectives. We have chosen a path. A path that is based on experiments and observations. We hope, this path leads to having a ray of hope for the ones who did not have a choice but to have Diabetes. Ayurveda believes that there is no substance in this world, which cannot be used as medicine. We wish, the times would come when all the medical sciences unite to create a better and brighter protocol, which can solve or at least ease the life of a Diabetic and life as whole. References:  Madhavanidanam (Choukhamba prakashan Teeka- edited with- Madhukosh, Vimala, Madhudhara by Dr. Brahmanada Tripathi) Chapter:Prameharoganidana  Marathi Charakasamhita Chapter: Prameha chikitsa Adhyaya by Prof. Dr. P. H. Kulkarni  * Ashtangahridayam Sutrasthana by. Garde Chapter aahaaravidhivishesh Dr. Atul Rakshe is the founder president of Shree Niramay Ayurveda Kendra and Beyond horizons health and social circle (BHHAS India). He has worked as the convener of International Ayurveda Association (IAA) since 2001. He is the faculty and visiting consultant at Yukti (Portugal), Praanam (Spain), The heal school (Rome), Joytinat (Italy) and Ayurveda biologics (The Nederlands). He is the member of International Advisory board of The Ayurveda Federation South Afrca (TAFSA). He was the guest of honour of the first Dolce India festival at Corinaldo Italy. He is the founder member of Prof. P. H. Kulkarni School of Ayurveda at Rimini, Italy. He was the organizing president and organizing secretary of many International and domestic Ayurveda conferences dedicated to ‘Evidence based Ayurveda’. He is associate editor of Deerghayu annual (Marathi) and Deerghayu International (Peer reviewed English journal for Ayurveda and health sciences). He has received the title Maestro di Ayurveda (Italy 2010), Ayurveda Parangat 2011, Ayurveda best research paper award 2013, International Ayurveda Bhushan award 2013.