Available Online at http://www.recentscientific.com International Journal of CODEN: IJRSFP (USA) Recent Scientific

International Journal of Recent Scientific Research Research Vol. 11, Issue, 02(A), pp. 37208-37210, February, 2020 ISSN: 0976-3031 DOI: 10.24327/IJRSR Research Article

CONCEPT OF AND LIFE STYLE MODIFICATI0NS IN UNCONTROLLED DIABETES

Dr.Padmini, Dr. Shaila Borannavar, Dr Ananta S Desai and Dr Ahalya Sharma

Department of PG Studies in Panchakarma SJIIM, Bengaluru

DOI: http://dx.doi.org/10.24327/ijrsr.2020.1102.5068

ARTICLE INFO ABSTRACT

Article History: Diabetes mellitus is a chronic metabolic disorder that affects majority of population. Type -2 diabetes mellitus possesses a major risk factors for various other diseases.DM has grown to such a Received 13th November, 2019 th status of global epidemic, the prevalence of DM is increasing day to day due to change in lifestyle Received in revised form 11 activities, stressful life, etc. As per the estimate of WHO, atleast 171 million people presently suffer December, 2019 from DM and this number is expected to rise to 366 million by the year 2030.Uncontrolled diabetes Accepted 8th January, 2019 th is a blood sugar level are above recommended targets ranges including HbA1c level above 7.0%. Published online 28 February, 2020 Uncontrolled diabetes can lead to major complications such as heart attack, stroke, eye disease, kidney disease, nerve disease of if left untreated. literature describes about the prevention, Key Words: prognosis, complication and management of DM. Panchakarma is an integral part of ayurvedic

Diabetes mellitus, Madhumeha, Shodhana, treatment, it is designed to eliminate vitiated through the nearest route and maintain a state of Life style modifications. its equilibrium.DM is correlated to madhumeha. Treatment mainly involves panchakarma, dietary modifications and life style changes for healthy life, exercise, , and which in turn play a major part in prevention and management of uncontrolled diabetes which is very much necessary in present era.

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INTRODUCTION Approach of Treatment

Uncontrolled diabetes is blood sugar level are above Sthula Pramehi (caused due to over nutrition) - Avaranajanya recommended target ranges including an HbA1c level above samprapti - Apatarpana chikitsa Krusha Pramehi (caused due 7.0%. to under nutrition) - Dhatukshyajanya samprapti - Santarpana chikitsa It can lead to major complications such as heart attack, stroke, eye disease, kidney disease, nerve disease and infection if left Chikitsa under the Heading of untreated. In ayurveda it is corelated as madhumeha, which is 1. Nidana parivarjana mainly need shodhana therapy, panchkarma is specialised 2. Shodhana / Apatarpana chikitsa modality of ayurveda, which eliminates excess from the 3. Santarpana chikitsa body. Ayurveda is the only science which has incorporated 4. Aavastika chikitsa different detoxification methods in daily routine. This works 5. Bahirparimarjana chikitsa as preventive as well as curative. The term ayurveda means 6. Shaman chikitsa – a) Dosha pratyanika b) Vyadhi science of life which has prescribed healthy lifestyle. pratyanika Vagbhatachary has explained this life style in his ancient 7. chikitsa compendia Astanga hrudaya and Sangraha by a separate 8. Pathyaapathya chapter called Nidana Parivarjana Review of Literature The information about the concept of st shodhana in madhumeha and its importance is mentioned in In all disease 1 line of treatment is avoiding the causative Ayurvedic Samhita Granthas. The detailed study of shodhana factor. Here it specially it mention because Prameha is a and life style modification had been reviewed for collection of chirakalanubandhi vyadhi it seems to be important step to study material. avoid all such factors which causes further increase of Dosha and there by increase the Vyadhi.

*Corresponding author: Dr.Padmini Department of PG Studies in Panchakarma SJIIM, Bengaluru Dr.Padmini et al., Concept of Shodhana and Life Style Modificati0ns in Uncontrolled Diabetes

Importance of Shodhana swedana some are localised and some are contraindicated during the shodhana karma. Ushna jala snana can be advised. Bahudosha vyadhi - quantitatively the vikruta dosha (kapha) and vikruta dushyas (kapha vargiya dushyas) are high and Vamana qualitatively the combination of kapha and medas (due to Madana Phala - Amashaya sthitha kapha and pitta - M.P guna, karma samanya) is very difficult to disintegrate. choorna+jeemutakaadhi qwatha Santarpana janya vyadhi where the main pathology is kleda - Balvat Sleshma - M.P Vati - M.P Shodhana / Apatarpana choorna+Kovidaraadhi kashya Dhamargava - Amashya sthitha kapha and vata Treatment plan for Pramehi differs from all other diseases by - Manasika vikara - D kalka+Jatyadhi kasaya categorizing the patients into - stula and karshya. (ex. Rajani, Jati, Vacha, Shweta punarnava, Kasamarda) stula: Balavan- Samshodhana Kutaja karshya: paridurbala- Brimhana Kritavedhana Ikshavaku - I bija kalka+mamasa rasa (Na Cha Daurbalyam After रोग एवं रोग परा-(दोष, दयू , बल, काल, कृ त, अनल, Ashnute) वय) adopt the treatment Role of Vamana Karma Shodhana Brihmanam All these drugs are having kapha hara, ushna, tikshna, 1. VAMANA vyavayi, vikasi guna in predominant. Help in elimination of 2. VIRECHANA excessive kleda.1d After vamana karma bahudrava shlesma is 3. ASTHAPANA BASTI removed, Helps in stimulation of dhatvagni (vamite vardate 4. RAKTA MOKSHANA vanhi) thereby help in formation of prakruta meda dhatu Buddhi prasad balam indriyanam dhatu sthiratva3a Sneha Purva Rukshana Chikitsa Virechana • In kapha and pittaja prameha before snehana, rukshana is indicated • As Madhumeha is considered as durvirechya, • Mamsala purusha - upachita mamsa • Teekshna virechana should be administered • Medasvi purusha • According to Sushrutha, • Bhuri sleshma - kapha predominat purusha • Jayapalabeeja, Arkaksheera • Vishamagni purusha • Manibhadraguda,Abhayadimodaka • Snehochita - sneha satmya • Probably Virechana lowering down the hepatic glucose • Rational - To avoid the sneha vyapad lakshanas during production and by promoting insulin secretion helps to the shodhananga sheha paana control blood sugar.

Rookshana Basti Chikitsa

Bahya If basti is administered without removing the kleda, dosha get Nishi jagarana aggravated further and vitiate mamsa and rakta dhatu which Ghada vyayama cause the shopha and produce various upadravas.2b Ghada udwartana Basti - Rasnadi niruha basti,Saindhavadi niruha basti, Abhyantara Vidangadi niruha basti Khali, pinyaka ,takra, madhudaka Panchatikta prasrutika basti, Somavalkala basti, Mustadi Triphala, Musta, Kustadi choora, trayoshanadi mantha, yapana basti, Madhu tailika basti vyoshdya saktu. The Shodana Dravya Help in Removing the Avarana of Purva Karma for Shodhana Kapha and Meda Dhatu.

Deepana and pachana Mode of Action of Shodhana in Madhumeha Rational - Help in absorption of shodhananga Sneha. SNEHANA During snehapaana only koshta snigdhta is In samprapti of Madhumeha dominance of kleda, meda, needed. kaphadosha are involved. Shodhana procedure explained in madhumeha improves and stabilizes , and reduces the Common grita are - Dhanwantaram ghrita excess of kapha, meda,and kleda. Vamana and virechana Trikantakadya grita procedure specifically removes the kapha and kleda from the Vatsyamantaka grita shareera there by removing the sanga and help in samprampti Kalyanaka grita vighatana. Vamana karma by reducing kapha and medha helps Trikantakadya taila to minimize insulin resistance, where as virechana by lowering Sarshapa taila down the hepatic glucose production and by promoting insulin Atasi tail secretion helps to control blood sugar. Basti clears the Swedana Karma Avarana of vata and normalizes the functions of vyana and Don’t go for Agni swedana, always prefer Anagni swedana. apana . Among 10 type- usna sadana and guru pravarana can be Life Style Changes adopted to get the sarvanga swedana effect, in remaining

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Food according to dosha, Diet is a basic part of management Have a walk in every case. Treatment cannot be effective unless adequate ( Low caloric as much as diet) possible attention is given to ensuring appropriate nutrition. Dietary Shook dhanya Travelling on treatment should aim at- Ensuring weight control, providing Shimbi dhanya elephants ( high caloric diet ) Ekastana asana, nutritional requirements. Allowing good glycaemic control Shaka vargas Different Milk,ghee, oils, curd, Sugar, Divaswapna, with blood glucose levels as close to normal as possible. Phala vargas plays and Different types of rice Dhoomapana, Mamsavarga games preparations, anupa gramya Sweda, Avoid the sugar- sweetened drinks. Udaka varga Roaming in and audaka mamsa, Raktamokshana,

Decreases the saturated fats and trans fatty acids which are the Kritanna varga different ikshurasa,Pistanna,Navanna Mutravega dharana Madhu, hingu, places increasing the risk.Increases the polyunsaturated and Saindhava, Using monounsaturated fat which are decreasing the risk. Avoid the Maricha, umbrella lots of white rice Lashuna Following Sadvrutta Exercises- Physical activity promotes weight reduction and improves insulin sensitivity,thus lowering the blood glucose CONCLUSION levels. Ayurvedic treatment differs from person to person. It is one Lack of exercise is believed to cause 7% of casess. among the Mahagada having poor prognosis, incurability and development of complications hence early diagnosis and Yogas Proper treatment will give better results. Ahara is one among 1.Dhanurasana, the trayoupasthamba which supports the body. So proper 2. Paschimotthasana, 3.Padaangustasana, 4.Bhujangasan consumption of food by following proper pathya and apathya 5.Sarvangasana ,6.Ardha-matsyendrasana, is beneficial in preventing the disease madhumeha. 7.Halasana, 8.yoga mudrasana, 9.supta Vajrasana. Panchakarma plays a vital role in preventing the disease (rutu 10.Chakrasana, 11.Shalabhasana shodhana) and to support the line of treatment in avoiding the complications. Shodhana helps in removing the kledatwa Benefits: lowering stress levels, Improving emotional well which is the main culprit in vyadhi samprapti and hence is of being prime importance. The rational use of shodhana not only Improving strength and balance, Improving heart health protects from the disease but also helps ilive a longer life there by achieving Hitayu and Sukhayu.Life style modifications Yoga mudras6 also plays a vital role in uncontrolled diabetes .The ayurvedic 1.Surya mudra 2.Linga mudra approach gives hopes to diabetics.

3. mudra, 4.Apana mudra 5.Gyana mudra References

1. Agnivesha, samhita , redacted by charaka and Dridabala, Ayurvedadipika commentary of Chakrapanidatta, edited by Trikamaji yadavji, Varanasi, Chaukhambha surabharati prakashana a. Sutra sthanam ch.17/78-79 - Keeyantha Shirasiyam adhyayam- Avaranjanya madhumeha

Dinacharya b. Nidana sthanam ch.4- Prameha nidanam C. Chikitsa sthanam ch.6 - Prameha chikitsitham Aurveda as science of life is a part of culcture of indian 2. Kaviraj Ambika Dutta Shastri (editor). Sushruta Samhita of lifestyle. Wake up early exercise, bath, head massage all these Sushruta, Reprint2015 edition, Varanasi; Choukambha Sanskrit Sansthan. 2015:76 were included in indian life style. Pathogenesis of lifestyle th disorders are mainly vitiated kapha dosha, dushita a. Nidana sthanam 6 chapter (Prameha nidanam) - the term rasadhatu,agnidusti, and amapradosha. Pathogenesis occuring ‘kshaudra meha’ is used. b. The body constitution and symptoms related to Sahaja due to western life style can be prevented by fallowing 3b prameha and Apathya nimittaja prameha are mentioned in ayurveda dinacharya. th prameha chikitsa 11 chapter. They as fallows c. The decoctions according to each type of prameha is mentioned 1. Danta dhavana 2.Jihva nirlekhana d. Prameha pidaka and Madhumeha chikitsa are mentioned 3. Anjana 4.Navana nasya in 12th and 13th chapter of chikitsa sthana respectively. 5. Gandusha 6.Dhooma nasya 3. T. Sreekumar MD ( AYU ) , Phd English translater and commentator, editor K. Kavitha AStanga hrudaya sutrastana- 7. 8.Vyayama nd 9. Mardana 10.snana 15/21-22 ; 2 edition 2008 a. Categorized the disease under the heading ‘Mutra Atipravrttija Dinacharya which is ayurveda life style includes Shodhana Rogam’ nd tratments which may prevent lifestyle diseases. b. Sutra stana 2 chapter ( Dinacharya Adhyaya ) 4. http://www.diabetes.co.uk./lifestye.com Pathya Apathya 5. http://www.diabetes.co.uk/yoga-asanas.com Ahara Vihara Ahara Vihara 6. http://spiritualpunditz.com 7. http://www.webmd.com/diabetes mellitus

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