Diabetes (Prameha) – An Integrative Approach Through Modern Medicine and Ayurveda
- DR Dinesh Vats
- Sep 3
- 4 min read
Authors:Dinesh Vats [1],Shobha Bharti [2]
Introduction
Diabetes Mellitus is one of the fastest-growing lifestyle disorders worldwide, often called a “silent killer.” According to the International Diabetes Federation, India is home to over 77 million diabetics, and the number is rising rapidly. It is a heterogeneous group of disorders characterized by hyperglycemia with classical symptoms such as polyuria, polydipsia, and unintentional weight loss.
In Ayurveda, Diabetes is described under the broad category of Prameha, causing Mutravaha Srotodusti (a group of urinary disorders), with Madhumeha closely resembling Type 2 Diabetes Mellitus.
👉 Here, we explore Diabetes through both modern and Ayurvedic perspectives, with a special focus on integrative care.
🔹 Diabetes in Modern Medicine
Types: Type 1, Type 2, with subclassifications: maturity-onset diabetes of the young, neonatal diabetes, gestational diabetes, and corticosteroid-induced diabetes.[1]
Causes: Insulin resistance, impaired insulin secretion, genetic predisposition, obesity, sedentary lifestyle, high-sugar diet.
Symptoms: Excessive thirst (polydipsia), frequent urination (polyuria), weight loss, fatigue, blurred vision, burning sensations in hands and feet, and recurrent infections.
Complications: Retinopathy, nephropathy, neuropathy, cardiovascular diseases.
Clinical Observation (from our clinic):Most patients present late, often when complications have already started. However, as family practitioners, we are able to diagnose people at the prediabetic stage or in early diabetes (without complications), achieve target HbA1c, and provide patient counseling about lifestyle modification and diabetic diet.
🔹 Prameha in Ayurveda
Described in Charaka Saṃhitā and Suśruta Saṃhitā.
Suśruta definition:
“प्रमेहस्तु यदा मूत्रं बहु बहुं मुधा स्रवेत्।
शीतं सान्द्रं तमोऽविलं प्रावृट्कालजलोपमम्॥” [2]
Prameha is a condition where urine is discharged excessively, repeatedly, and without effort. It is cold, thick, turbid, and resembles muddy water in the rainy season.
Charaka definition:
“प्रमेहस्तु यदा मूत्रं बहु मूत्रं मुहुः स्रवेत्।
शीतं मधुरगन्धि स्यात् स स्निग्धोऽल्पस्वनः सदा॥” [3]
Prameha is a disease where urine is excessive, frequent, cold, unctuous, and often with a sweet odor. Patients usually have a Kapha–Meda dominant constitution.
Types: 20 types of Prameha are classified: Vataja (4), Pittaja (6), and Kaphaja (10).
Madhumeha: A subtype where urine becomes sweet like honey, considered parallel to Diabetes Mellitus.
Causes (Nidana)
“आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि।
नवान्नंपानं गुड़वैकृतं च प्रमेहहेतुः कफकृच्च सर्वं।।” [4]
Sedentary lifestyle, excessive sleep, intake of curds, milk, meat soups of domesticated, aquatic, and marshy animals, freshly harvested cereals with their drinks, and jaggery preparations—all increase Kapha and cause Prameha.
Genetic Predisposition
“जातः प्रमेही मधुमेहिनो वा न साध्य उक्तः स हि वीजदोषात।
ये चापि केचित कुलजा विकारा भवन्ति ताश्च प्रवढन्त्यसाध्यात।।” [5]
A person born with Prameha, or one afflicted with Madhumeha, is considered incurable due to genetic (bīja doṣa) defects. Hereditary disorders are also deemed incurable.
Image 1. Ayurvedic pathogenesis (Samprapti) of Prameha showing progression from Kapha imbalance to Meda dhatu disturbance, leading to Prameha and Madhumeha.
Symptoms (Pūrvārūpa)
“त्रयस्तु खलु: दोषाः प्रकुपिताः प्रमेहानभिनिर्वर्तयिष्यन्त इमानि पूर्वरूपाणि दर्शयन्ति ; तद्यथा -जटिलीभावं केशेषु ,माधुर्यमास्यस्य , करपादयोः सुप्तादाहौ , मुखतालुकंठशोषं , पिपासां , आलस्यं , मलंकाये, कायछिद्रेषुपदेहं , परिदाह सुप्ततां चांगेषु षट्पद पिपीलिकाभिश्च शरीरमुत्राभिसरणं, मूत्रे च मूत्रदोषान् विश्रं शरीरगंधा, निद्रां, तन्द्रां च सरवकालमिति। [6]”
Charaka Nidana 4/47 describes early signs of Prameha (Diabetes):
Neuropathy: Numbness, tingling, burning in hands/feet (karapādayoḥ suptādāhau).
Polydipsia: Dryness of mouth, palate, throat with excessive thirst (mukha-tālu-kaṇṭha-śoṣaṃ, pipāsām).
Fatigue: General lassitude (ālasyaṃ).
Acanthosis Nigricans: Dark skin patches (malaṃ kāye).
Carbuncles/Infections: Suppuration in body orifices (kāya-chidreṣu padeham).
Glycosuria: Ants attracted to urine (ṣaṭpada-pipīlikābhiḥ mūtrābhisaraṇam).
Polyuria: Altered urine quantity and turbidity (mūtre ca mūtradoṣān).
Diabetic Ketoacidosis: Foul body odor (viśraṃ śarīra-gandham).
Lethargy: Excessive sleep and drowsiness (nidrām, tandrām ca sarvakālam).
Image 2. Comparison table of Diabetic Neuropathy in Ayurveda vs Modern Medicine showing correlation, symptoms, management, and goals.
🔹 Diagnosis (Modern Medicine)
Blood glucose (fasting, post-prandial)
Glycosylated hemoglobin (HbA1c)
CBC, lipid profile, liver and kidney function tests
Thyroid function tests
Urine routine & microscopy, albumin-creatinine ratio
Fundoscopy (for diabetic retinopathy)
🔹 Management in Modern Medicine
Lifestyle: Healthy diet, exercise, weight management.
Medications: Metformin, sulfonylureas, alpha-glucosidase inhibitors, DPP4 inhibitors, SGLT2 inhibitors, GLP-1 agonists, insulin.
Monitoring: Fasting blood sugar, post-prandial sugar, HbA1c, routine investigations.
🔹 Ayurvedic Management of Prameha / Madhumeha
Nidana Parivarjana (Avoidance of Causes):
“सर्वदा सर्वभावनामं सामन्यमं वृद्धिकारणामं।
ह्राषहेतुरविषेश्च प्रवृतिरुभयस्य तु। [7]”
Similarity increases, dissimilarity decreases. Overindulgence in Kapha-like foods/lifestyle worsens diabetes, while opposite measures reduce it.
“यै हेर्तुभियै प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्या।
हेतोरसेवा विहिता यथैव जातस्य भवेचिकित्सा।। [8]”
Avoidance of causative factors itself is treatment, just as active therapy is needed after disease onset.
Diet (Āhāra): Barley, green gram, bitter gourd, amla, old rice. Avoid sweets, fried foods, curd.
Lifestyle (Vihāra): Exercise, yoga (Sūrya Namaskar, Prāṇāyāma, Kapālabhāti), avoid day sleep.
Herbs & Formulations:
Gudmar (Gymnema sylvestre) – delays glucose absorption, stimulates insulin, regulates cholesterol.[9]
Daruharidra (Berberis aristata) – reduces oxidative stress, safe, effective in diabetes.[10]
Jamun seeds (Syzygium cumini) – lowers glucose and cholesterol.[11]
Nisha Amalaki (Turmeric + Amla) – antioxidant, anti-inflammatory.
Shilajit & Triphala – rejuvenative, regulate metabolism.
Formulations: Chandraprabha Vati, Vasant Kusumakar Ras (under supervision).
🔹 Integrative Approach
Ayurveda: Diet, lifestyle, and herbs.
Modern medicine: Diagnostics and emergency management.
Together, they:
Improve sugar control.
Delay complications.
Enhance quality of life.
🔹 Conclusion
Diabetes (Prameha) is a chronic disease with major health consequences. Modern medicine focuses on blood sugar control and complications, while Ayurveda emphasizes the root cause, lifestyle, and holistic healing.
“With proper monitoring, disciplined lifestyle, and the wisdom of Ayurveda, diabetes can be controlled and life can be lived fully.”
References
Suśruta Saṃhitā, Nidāna Sthāna, 6/4
Charaka Saṃhitā, Cikitsāsthāna 6/3
Charaka Saṃhitā, Cikitsāsthāna 6/4
Charaka Saṃhitā, Cikitsāsthāna 6/57
Charaka Saṃhitā, Nidāna Sthāna 4/47
Charaka Saṃhitā, Sūtrasthāna 1/44
Charaka Saṃhitā, Cikitsāsthāna 6/53
https://www.sciencedirect.com/science/article/abs/pii/S0378874109001317
✨ Author Profiles
Dr. Dinesh VatsFamily Physician & Integrative Medicine, Founder of VatsAyush Health Care Centre and medical content writer at drvats.com.
Dr. Shobha Bharti, B.A.M.S.Trainee in General Medicine. An Ayurvedic doctor undergoing a 2-year clinical training under Dr. Vats, actively contributing to research, case studies, and medical content writing at drvats.com.
⚠️ Disclaimer
This article is intended for educational purposes only. The information provided should not be used for self-medication. Patients are strongly advised to consult a qualified physician before starting or changing any treatment for Diabetes/Prameha.
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