Diabetes 2003
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Diabetes 2003

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This is PPT on Diabetes Mellitus explaining Allopathic & Ayurvedic approach of Pathology & Tratment .Prepared By Dr.Sachin Sarpotdar with Prof.Dr.R.R.Deshpande

This is PPT on Diabetes Mellitus explaining Allopathic & Ayurvedic approach of Pathology & Tratment .Prepared By Dr.Sachin Sarpotdar with Prof.Dr.R.R.Deshpande

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    Diabetes 2003 Diabetes 2003 Presentation Transcript

    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 1 Diabetes Patho-physiology and Principles of management Dr.Sachin Sarpotdar BAMS, MSc(Health Science) Ayurved Physician and Panchakarma Consultant. 8/24/2013 1
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 22 Diabetes -Historical Aspects • This term was used first time by Aretaeus of Cappadocia, the Greek physician. • Paul Langerhans described Islets in the pancreas in 1869. • Belgian scientist Jean de Meyer used the term “Insulin" in 1909. • In 1921 the insulin was purified after the series of experiments, by J.J.R Macleod, Charles Best, Frederick Banting and James Collip. • However one of the Ayurvedic classics “Charka Samhita” long back ago(800-600 BC) has described the term “Madhumeha” which has the same meaning as that of Diabetes Mellitus. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 338/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 44 • In the year 2007; the diabetes was the 5th leading cause of mortality. • 246 million people world wide have diabetes. • Worldwide;daily 200 children are grabbed by diabetes. • Worldwide;3 million deaths occur per year due to diabetes. • More than 314 millions people have impaired glucose tolerance. Problem Estimation 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 55 Prevalence- o It is projected that by year 2025 the prevalence of DM will be 5.4% with global diabetic population reaching 300 million. o Diabetes is prevalent in the age group 45-65 in developing countries and in developed countries it is in the age group above 65 years. Mortality Rate-  1.5 to 2.5 times higher than that of general population.  Diabetes has recently escalated in all age groups. Problem Estimation 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 6 Clinical Presentation. • A 53 years old man • C/O Burning micturation-since 2 weeks • Fatigue & pain in the calf muscles since 2 weeks. • Weight loss of 2 kg in a last 1 month. • Recurrent boils • Adv investigation- Haemogram, Urinalysis, BSL-F & PP, Lipid Profile 8/24/2013 6
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 77 What is Diabetes? • It is a metabolic disorder, specifically, an abnormality in the way the body utilizes the glucose, due to an absolute or relative deficiency of the hormone insulin or resistance by the body tissues to the action of insulin. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 88 What is Diabetes? Diabetes is a syndrome of impaired carbohydrate, fat & protein metabolism. It is caused by lack of Insulin secretion or decreased sensitivity of the tissues for the Insulin. The characteristic feature is hyperglycemia. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 99 • Type 1 DM : Insulin Dependent Diabetes Mellitus. (10%) • Type 2 DM : Non Insulin Dependent Diabetes Mellitus. (80%) • Gestational Diabetes Mellitus • Malnutrition Related Diabetes Mellitus • Other Types : Secondary to pancreatic, hormonal, drug induced & other abnormalities. Types of Diabetes Mellitus 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 10 Three modes of Hyperglycemia • Lack or decrease Insulin production • Insulin resistance • Increased Glucose production by Liver. 108/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 1111 Contributory factors Kapha Dosha (One of the biological humor) Meda Dhatu (Fatty tissue) Watery waste products, body components like urine, sweat, lymph etc.  Reproductive and regenerative body fluids. (Various hormones, growth factors and healing factors)  Oja (Vital sap) 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 1212 Types Types Genetic (Sahaja) Life style originated 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 13 Was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. Type 1 diabetes 138/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 14 Type 1 diabetes This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors. 148/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 15 Was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly.  As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes 158/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 16 Type 2 diabetes  Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity.  Indians are at particularly high risk for type 2 diabetes and metabolic disorder.  Type 2 diabetes is increasingly being diagnosed in children and adolescents. 168/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 17178/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 1818 Etiological and Risk factors. • Food crazy people. • Sedentary lifestyle. • Yogurt / Curd / Dahi. • Processed food consumption. • Milk derived products in excess. • New cereals in excess. • Carbohydrate rich products. • Alcohol. • Genetic predisposition. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 1919 Causes • Genetic factors • Obesity • Viral infections • Endocrine effect • Malnutrition • Maternal diabetes • Secondary to other diseases • Other factors 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2020 Pathogenesis Diabetes occurs when the body does not produce any Insulin or when the body does not utilize Insulin effectively. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 21  Polyuria  Polyphagia  Polydipsia  Hyperglycemia  Wasting  Loss of Libido  Ketosis  Dehydration 218/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2222 • Polyuria : Frequent urination • Polydypsia, Polyphagia • Weight loss • Extreme fatigue & weakness • Mental weakness & lack of concentration • Cuts & bruises which heal slowly or not heal properly. • Tingling or numbness in the extremities. • Blurred vision • Infertility Signs and Symptoms 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2323 Pathogenesis – Phase 1 Diabetes (PRAMEHA) Genetic predisposition Environmental factors Lifestyle factors Sleep in day time Lack of physical exercise Sedentary habits 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2424 Diabetes as a complex phenomenon The interplay of Nidana – Etiological & risk factors Dosha – Biological humors Dushya – Various contributory body components in the disease All above factors make diabetes as a complex phenomenon 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2525 Pathogenesis – Phase 2 Dhatvagnimandya (Low metabolic conversion) Fat metabolism (Meda) Protein metabolism (Mamsa) Waste product excretion (Kleda) 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2626 Pathogenesis – Phase 3 • Increased production of water soluble waste products. • Excess loss of body components through urine. • This leads to severe weight loss. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 2727 Pathogenesis – Phase 4 • Pathological consequences o Impaired fat metabolism – Weight gain or weight loss, excess sweating with bad odor and skin diseases. o Impaired protein metabolism – Muscle wasting & nephropathy. o Waste product excretion – Increased volume of urine along with loss of some metabolically important substances like glucose. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 28 Risk Factors • Family history of diabetes (i.e., parent or sibling with type 2 diabetes) • Obesity (BMI 25 kg/m2) • Physical inactivity • Previously identified with IFG, IGT, or an A1C of 5.7–6.4% 288/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 29 Risk Factors • History of GDM or delivery of baby >4 kg (9 lb) • Hypertension (blood pressure 140/90 mmHg) • HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L) • Polycystic ovary syndrome. • History of cardiovascular disease 298/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 3030  Blood sugar-Fasting & Postprandial.  Urine test-Urine ®,Urine sugar, Ketone bodies.  Oral glucose tolerance test-OGTT.  Glycohemoglobin test. Diagnostic tests 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 3131  Blood sugar-Fasting & Postprandial.  Urine test-Urine ®,Urine sugar, Ketone bodies.  Oral glucose tolerance test-OGTT.  Glycohemoglobin test. Diagnostic tests 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 32 Glucose Tolerance Test (OGTT) • Fasting BSL is measured • 1gm/kg glucose is given Usually 75gm of Glucose in 250-300 ml of water on an empty stomach or overnight fasting • Each half hour BSL and urine sugar measured in standard test in modified version 1 hr, 2hr BSL measured 328/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 33338/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 34 Interpretation of OGTT • Indicated in new diagnosis • FBSL- 110 – 125 mg/dl i.e. impaired glucose tolerance test • Any BSL 200 mg/dl i.e. Diabetic • 140-200 mg/dl Impaired Glucose Tolerance 348/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 3535 Diagnostic criteria • Fasting blood glucose if >126 mg/dl. • Blood glucose if >200 mg/dl after 2 hours of OGTT. • Symptoms of Diabetes plus Random blood sugar if above 200 mg/dl. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 3636 Screening test • After 45 years of age screening test should be performed annually. • BP monitoring. • Ophthalmic checkup. • Renal function test. • Examination of feet 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 3737 1. Coronary artery & peripheral vascular diseases. 2. Diabetic nephropathy 3. Diabetic neuropathy 4. Diabetic ketoacidosis 5. Diabetic coma 6. Problems in Diabetic retinopathy 7. matrimonial relations Diabetic complications 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 38388/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 39398/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 4040 Diabetic foot 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 41 Dhanvantari Foundation Incorporation Chicago 41 Diabetic Complications in Ayurvedic Perspective. • All the complications of Diabetes are due to early degeneration. • Vata and Pitta are the two biological humors which are responsible for early degeneration and emaciation. • Both of these bioenergies are light & sharp and are responsible for altered sensory and motor functions.
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 42 Dhanvantari Foundation Incorporation Chicago 42 Diabetic Complications in Ayurvedic Perspective. • These are also responsible for low immune mechanism, altered immunity & autoimmune mechanism. • These are directly or indirectly responsible for recurrent infections and give inflammatory response. • Due to the dryness of Vata and it’s obstructive nature the blood flow get affected; which, deteriorate the tissue perfusion. • Pitta leads to faster degenerative & metabolic transformations in the body tissues; which leads to tissue destruction i.e. “Dhatu Pak”
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 43 Treatment of DM • Should be Started with non drug therapy • It include diet control • Regular exercise • Normalizing life style • Alcohol abstinence • Vegetarian diet • Reducing stress 438/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 44 Treatment of DM • Start with non drug therapy • It include diet control • Regular exercise • Normalizing life style • Alcohol abstinence • Vegetarian diet • Reducing stress 448/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 45 Insulin  It is must in certain cases • Type I DM • Infection • Pregnancy • Operative procedure • Short term treatment • Complications like keto acidosis 458/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 46 Insulin Formulations • Human ACTRAPID – 40 U/ ml (Regular Insulin) • Human MONOTARD – 40 U/ ml (Lenteinsulin) • Human MIXTARD 30/70 - 40 U/ ml (30 % soluble insulin + 70% isophane insulin) 468/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 47 Preparations of insulin • Insulin is mainly divided into short acting and long acting • Short acting (regular) is always clear and long acting (ultra lente) is turbid • Two can be mixed together for treatment • Insulin may be from animal source i.e. Pork or beef.But now-a-day human insulin is used, which is less antigenic 478/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 4848 Appear ance Onset Peak Dur Short acting clear 1 2-4 6-8 Long acting turbid 4-6 14-18 24-36 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 49 Clinical Use of Insulin • 0.6 -1.2 IU/Kg/day • 2/3 dose should be given in morning before breakfast • 1/3 dose should be given in evening before dinner • Morning dose should be split as 1/3 neutral and 2/3 Isophane (NPH) • Evening dose should be split 50-50% in combination 498/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 50 Adverse effect of insulin • Hypoglycemia • Local reaction like swelling, erythema, or stinging sensation at site of injection • Allergic reactions which are uncommon to human insulin 508/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 51 1. Glibenclamide (Glyburide) Generic Name Glibenclamide Brand name DAONIL, EUGLUCON Size of tablet 2.5, 5 mg Tab Doses 2.5 – 15 mg OD When taken Before meal Duration of action 18 – 24 hr Price 5.25, 9.50 INR 518/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 52 2. Glipizide 52 Generic Name Glipizide Brand name GLYNASE, GLIPI, GLIDE Size of tablet 5 mg Doses 5 – 20 mg OD/BD When taken Before Meal Duration of action 12 – 18 hr Price 5, 6 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 53 3. Gliclazide 53 Generic Name Gliclazide Brand name Diamicron, Dianorm, Reglide Size of tablet 30, 40, 80 mg Doses 40 – 240 mg OD/BD When taken Before Meal Duration of action 12 -24 hr Price 70 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 54 4. Glimepiride 54 Generic Name Glimepiride Brand name GLYPRIDE, GLIMY, GLIMER,AMARYL Size of tablet 1,2,3,4 mg Doses 1 – 6 mg OD When taken Before first meal Duration of action 24 hr Price 46, 74, 101 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 55 1. Repaglinide 55 Generic Name Repaglinide Brand name EUREPA, RAPLIN Size of tablet 0.5,1,2 mg Doses 1.5 – 8 mg q.d. When taken Before each meal Duration of action 2-3 hr Price 56, 92. 142 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 56 2. Nateglinide 56 Generic Name Nateglinide Brand name GLINATE Size of tablet 60, 120 mg Doses 180 – 240 mg q.d. When taken Before each meal Duration of action 2-3 hr Price 55, 91 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 57 a. Metformin 57 Generic Name Metformin Brand name GLYCIPHAGE, GLYCOMET Size of tablet 250,500, 850 mg Doses 0.5 - 2 gm q.d. When taken Before each meal Duration of action 6 – 8 hr Price 5.5, 11, 14 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 58 Pioglitazone 58 Generic Name Pioglitazone Brand name PIONORM Size of tablet 15, 30 mg Doses 15 – 45 mg OD When taken Before dinner Duration of action 24 hr Price 35.5, 51 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 59 a. Acarbose 59 Generic Name Acarbose Brand name GLUCOBAY Size of tablet 25, 50 mg Doses 25 – 100 mg TID When taken Before each meal Duration of action 4 – 6 hr Price 42, 50 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 60 b. Miglitol 60 Generic Name Miglitol Brand name MIGLIT, MIGNAR Size of tablet 25, 50 mg Doses 25 – 100 mg TID When taken Before each meal Duration of action 4 – 6 hr Price 60, 108 INR 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 6161 Anti Diabetic Herbs- Minerals & Compound Drugs • Most of the anti diabetic herbs are astringent and bitter. They contain tannins & flavonoids. • These have Anti-Kapha properties. • Drugs are metabolic regulators( Deepan) • Drugs with Pachan quality are beneficial. • Drugs with cleansing property are preferred. • Drugs reduce the Kleda i.e watery waste product by decreasing its production or eliminating it through urine. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 62 Anti Diabetic Herbs- Minerals & Compound Drugs • Research work across the world have focused on their - • cytoprotective, anti inflammatory, immune boosting and antimicrobial actions. • Stimulate insulin secretion. • Inhibit auto antibodies. • Inhibit hepatic gluconeogenesis and regulate the FBS. • Increase the glucose utilization and reduce the insulin resistance. 628/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 63 Anti Diabetic Herbs- Minerals & Compound Drugs • These herbs improve the lipid profile and used as metabolic regulators. • Some of these herbs are Nephro protective. • These herbs inhibit the new abnormal growth of the vessels and inhibit the platelets sticking • Minerals are used to induce the enzymes and regulate the metabolism. This is done by regulating the transcription process. • Compound products improve the nutritional status. 638/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 6464 Important Pancreatic Stimulants & Insulin Sensitizers. • Amalaki-.Emblica officinalis • Bibhitak-Terminalis belerica. • Haritaki-Terminalia chebula. • Shunthi-Dry ginger • Marich-Piper nigrum. • Pimpali-Piper longum. • Turmeric. • Daruhalad-Berberis aristata • Guduchi-Tinospora cordifolia. • Lodhra-Symplocos recemosa. • Nimba-Azadirachta indica. • Chandan-Santalum album. • Usheer-Vetiveria zizanioidis. • Khadir.-Acacia catechu. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 6565 Herbs for Prevention of Insulin Resistance. • Amalaki-.Emblica officinalis • Bibhitak-Terminalis belerica. • Haritaki-Terminalia chebula. • Shunthi-Dry ginger • Marich-Piper nigrum. • Pimpali-Piper longum. • Turmeric. • Daruhalad-Berberis aristata • Guduchi-Tinospora cordifolia. • Karela (Bitter Gourd)- Momordica charantia. • Meshshringi- Gymnema sylvestre. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 66 Ayurvedic Products • D.B.T= 1-2 BD/TDS • Diabecon 1-2 BD/TDS • Vijaysar Ghan =1-2 BD/TDS • Daruharidra Ghan =1-2 BD/TDS • Meshashringi cap= 1 BD • Haridra cap= 1-2 BD • Karela cap= 1BD/ TDS • Vrikshamla cap- 1 BD 8/24/2013 66
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 67 Ayurvedic Products • Lodharasava- 3 tsf BD (After meal) with Warm Water. • Beejakarishta- 3tsf BD( After meal) with warm water. • Bhallataksava – (Rasashala) 2tsf BD with water. • Ayaskruti - 2tsf BD with warm water. • Mustharishtum- 3tsf BD with warm water. 678/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 68 Ayurvedic Products • Methi Ghan • Maka Ghan • Gudmar Ghan • Guduchi Ghan/Cap • Gokshur • Punarnava • Ashwagandha Churna Vati /Cap • Rasayan Churna 688/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 69 Ayurvedic Mineral Products • Jasad Bhasma • Abhrak Bhasma • Trivanga Bhasma • Suvarna Bhasma • Rajat Bhasma • Loha Bhasma • Suvarna Makshik Bhasma • Shilajeet 698/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 70 Ayurvedic Compound Products • Arogyavardhini • Chandraprabha • Saptamrut Loha • Gokshuradi Guggul • Triphala Guggul • Navak Guggul (Medohar Guggul) • Shilajatwadi Vati • Tapayadi Loha • Vasant Kusumakar 708/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 71 Patent & Proprietary Products • Amree Plus – Amil Pharma – 20 tabs- 84 INR • Yesaka Liq- Simandhar Herbals- 500-ml-180 INR • Madhumehari Chrna- Baidyanath- 100Gm- 97 INR • Madhumehari with Gold Tab- 40 tabs-560 INR • Jumbola Liq- Luna Pharma- 450ml- 190 INR 718/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 72 Patent & Proprietary Products • Ojamin Liq-Everest Pharma Pune- 1lit-450 INR. • Beejakarishtum Nisha Herblals- 400ml-220 INR. • Diabecon – Himalaya- 60 Tab-100 INR • D.B.T- Sharangadhar- 100 Tab- 190 INR. • Asanad Tablet – Ayurved Rasashala Pune- 728/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 7373 Eye diseases. • Retinopathy, cataract and glaucoma are more common in diabetic patients. • Eye is the sight of Pitta and bleeding tendency is the Pitta predominant condition. • In such condition “Bowel cleansing” is recommended. • Triphala decoction is used to wash the eyes and for bowel cleansing purpose. • For the prevention of eye diseases the compound TRIPHALA can be used in the form of MEDICATED GHEE. • This can be taken orally as well as locally. • Saptamrut Loha 2 BD 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 7474 Nephropathy. • Nephro protective herbs can be used. Some of the Nephro protective herbs are 1)Punarnava-Boerhavia diffusa. 2)Gokshur-Tribulus terrestris. These herbs can be given in the form of decoction or herbal tea. Medicated enema are also given. 3) Chanrprabha, Shilajatawadi Vati in a dose of 2 BD are also used. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 7575 Diabetic foot • Wound healing is the function of Shukra Dhatu. • It is associated with reproduction as well as regeneration. • Herbs like Shatavari, Ashwagandha are recommended in wound healing. • Dressing with Vrana Ropan oil to take care of ulcers. • Pressure relieving modification is essential. • Tapyadi Loha & Vasant Kusumakar are also used.8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 7676 Neuritis • Sensory and motor nerves are affected in diabetes. • As per Ayurveda sensory, cognitive and motor functions are regulated by Vata. • The skin is one of the site of Vata. • Oil is supposed to be the best for the control of Vata ailments. • Hence in the prevention of neuritis the oil massage is recommended. • Massage improves the local blood supply, lymph drainage and nerve conduction. • Massage also stimulate the Neuro-endocrinal system. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 7777 Infections. • Recurrent infections of skin, urinary and genital tracts are very common in diabetic patients. • Herbal bath ,local wash with herbal decoctions and herbal powders application to the skin are very effective in skin care. • Herbs like Nimba, Khadir, Daruharidra Triphala are used in the skin care and in its hygiene. 8/24/2013
    • 8/24/2013 Dr.Sachin SarpotdarDhanvantari Foundation Incorporation Chicago 78788/24/2013