Effect of individualized ayurvedic treatment in ameliorating fasting and postprandial blood glucose in patients with type 2 diabetes mellitus

Dr. Sintija Sausa

Background
There are multiple publications on preclinical and clinical studies of various single Ayurvedic herbs and their combinations in the treatment of type 2 diabetes (T2D), but there is lack of whole system retrospective and prospective studies using the customized Ayurvedic medicine, diet, and exercise.

Aim
The aim of our two studies was to comprehensively evaluate efficacy of customized Ayurvedic therapy for type 2 diabetes in various treatment subgroups.

Materials and methods
For the retrospective study a cohort of 82 patients who visited the AVCRI day care center was selected based on inclusion/exclusion criteria and completeness of data. All patients were on Ayurvedic or on combination therapy. Selected group was subjected to tools of descriptive analysis and test of significance namely paired 2-tailed t-test was performed to evaluate efficacy outcomes.

Results
In retrospective study there was a male predominance of 62.2 % (n=51), the mean age was 55.2 ±12.1 years in male and 51.5 ±11.7 years in female patients.
In the total cohort we found statistically significant changes in fasting blood glucose after 3 months of treatment  p<0.015 (2- tailed t-test)  and in post prandial blood glucose after three months (p<0.001) and after seven months (p<0.043).
After subgroup analysis based on Ayurvedic diagnosis of madhuheha ( T2D) and performing  dosha based clinical phenotypic analysis we found that 51.2 % (n=42) had  Vata imbalance with highest number of associated disorders mainly in cardiovascular and musculoskeletal system, (15.9%; n=13) had Pitta imbalance, mainly with inflammatory digestive tract disorders, and third largest group was Vata/Pitta imbalance (14.6%; n=12). Fasting blood glucose decreased statistically significantly after seven month in Pitta group (n=7; p<0.009), but increased in Vata/Pita group (n=9; p<0.015). Postprandial blood glucose level decrease was seen only in Pitta group (n=8; p<0.03) after three months.
Out of total cohort of 82, 34% (n=28, mean age 49 y.) patients were taking only Ayurvedic medicine, the rest had combined therapy of Ayurvedic medicine and oral hypoglycemic drug 40% (n=33, 56 y.), Ayurvedic medicine, oral hypoglycemic drug and insulin 17% (n=14, 56 y.) and Ayurvedic medicine and insulin 9% (n=7, 57 y.). Statistically significant improvement in fasting blood glucose was seen after three months (n=19; p<0.03) and in postprandial blood glucose after three months (n=16; p<0.001) and after seven months (n=28; p<0.013) was observed in patient group, who were only on Ayurvedic medicine, who had shorter duration of known T2D and were younger age.

Conclusions
In the total cohort of type 2 diabetes patients fasting blood glucose decreased statistically significantly after three months of treatment, whereas postprandial blood glucose decreased after three and seven month of personalized Ayurvedic therapy.
T2D patients with Vata imbalance had the longest duration of known diabetes, and they suffered predominantly from cardiovascular and musculoskeletal system disorders; patients with Pitta imbalance predominantly had inflammatory disorders of the digestive system. Statistically significant improvement in blood glucose control was achieved in patients with Pitta imbalance only.
Statistically significant improvement in blood glucose control was also observed in the subgroup of T2D patients receiving only Ayurvedic medicine, but not in patients on combined Ayurvedic and conventional treatment.

Sintija Sauša MD1,3, Somit Kumar, MD (Ayur)1,2, Valdis Pīrāgs MD, PhD1,3, P.R. Krishna Kumar, MD (Ayur)2
1
Center for Complementary Medicine, University of Latvia, Riga, Latvia, Riga, Latvia
2The Arya Vaidya Chikitsalayam and Research Institute (AVCRI), Coimbatore, India
3 Faculty of Medicine, University of Latvia, Riga, Latvia

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