Diabetes mellitus: the discussion of a widespread disease from an Ayurvedic point of view

According to WHO estimates, the number of diabetics worldwide has almost doubled from 4.7% in 1980 to 8.5% in 2014. The majority of patients suffer from type 2 diabetes. The number of type 2 diabetics increases with the extent of over-nutrition.

This results in major challenges for patients and the health care system alike. In diabetics, the complication rate for myocardial infarction, heart failure and stroke is about 2 to 3 times higher. The risk of other dangerous secondary diseases (e.g. diabetic foot syndrome, diabetic retinopathy, nephropathy and neuropathy) is also high. Diabetes mellitus is a disease that significantly limits the life expectancy and quality of life of patients. Therapy, especially of complications, is costly.

In the Ayurvedic source texts the classical clinical picture madhumeha is found as the equivalent of diabetes mellitus. Madhumeha can be translated as "excessive (honey)sweet urine flow". As in conventional medicine, Ayurveda differentiates between two subspecies: kṛśa-pramehī (corresponds to type 1 diabetes) and sthūla-pramehī (corresponds to type 2 diabetes). Both types are considered prognostically incurable, but therapeutically controllable (so-called yāpya classification).

Also from an Ayurvedic point of view, diabetes mellitus is a lifestyle disease. For the development of madhumeha, Ayurveda describes various etiological factors (hetus) from the areas of nutrition and behaviour. Also a genetic component (especially in type 1) is mentioned in the classical texts. The described causes lead to the provocation of doṣas (especially vāta and kapha), which finally, due to a disturbance of the transport spaces (srotas), locate themselves in various weakened structures (dūṣyas) of the body and damage them. Madhumeha is a multi-organ disease. In diabetes all dhātus as dūṣyas (damaged body components) are involved in the pathogenesis. Also ojas is involved. This shows the complexity of the disease.

Despite this complexity, Ayurvedic medicine offers effective, clinically proven therapy concepts for diabetes mellitus as well as for the chronic complications of the disease. Also in the field of prevention Ayurveda offers numerous simple but effective recommendations to prevent the development of diabetes mellitus. Especially for people with a family history of diabetes, following preventive recommendations is especially important.

Although Ayurveda cannot reverse an existing insulin obligation, the insulin dose can often be significantly reduced by Ayurveda therapy and a healthy lifestyle of the patient.

As proven therapy elements for diabetes, Ayurvedic medicine uses above all physical cleansing therapies (śodhana), various remedies (especially with bitter = antidiabetic taste), an individualised nutrition and order therapy, rasāyana therapies as well as techniques for mental harmonisation. For the therapy of the chronic complications of diabetes mellitus there are specific therapy procedures.

If the diabetes is very pronounced, an in-patient therapy is initially preferable. Later, or if the disease is milder, outpatient therapy is also possible.

In the workshop the above contents will be explained in more detail and further elaborated. The etiopathogenesis, symptomatology, therapy strategy as well as the therapeutic principles of diabetes mellitus from an Ayurvedic point of view will be presented. Preventive recommendations are also addressed.