Madhumeha [Diabetes mellitus] now emerging as the “king of diseases” is involving most of the population with its multi system involvement, complex metabolic abnormalities manifesting lavishly and having varied clinical presentations. Due to this metabolic disorder and the pathology set in, increased blood glucose levels ultimately lead to heart disease, stroke, kidney failure, foot ulcers and damage to eyes.
Diabetes is gaining epidemic proportions in India, with more and more younger people being diagnosed, and they may be the sole “bread earners” of the family who will have to bear not only the extra cost of managing their own disease, but also preventing its morbid complications. What we have observed about Indian type 2 diabetes is that it also affects farmers, who are non-obese, who live in open countryside, do hard physical work in fields, and eat a low fat, simple diet with fresh farm produce, a stark contrast to their city- dwelling, sedentary, processed food eating counterparts.
Global community is looking towards Indian ancient system of life science Ayurveda as an effective alternative to tackle modern day maladies. Ayurvedic management of madhumeha specially emphasizes on regulation of blood glucose concentration, maintaining ideal body weight, improvement in metabolic profile to lower the incidence of vascular diseases and diabetic complications such as neuropathy, nephropathy and retinopathy.
The Madhumeha specialty OPD, where comprehensive Diabetic management should be performed include
- Early detection and treatment of diabetes and its complications
- Education, Counselling and awareness regarding the pathophysiology and the treatment aspect
- Optimizing treatment goals
- Preventing and postponing diabetes in the nondiabetic /prediabetes population and vulnerable coming generation.
- Treatment based on to prevent the prone patients to micro vascular and macro vascular complications.
- Management of symptoms and complications with the perspective of inhibiting the expressive symptoms
- IDDM – reducing the dosage of insulin and treating it through ayurveda formulations (herbal and herbo mineral).
- NIDDM – effective formulations in madhumeha are used to treat such condition.
- Encouraging Research in Indian diabetes
Integrated approach to the disease has been well co-ordinated with supportive departments such as diabetic foot care with Dept of shalya tantra [surgery] & physiotherapy,Nephropathy with dept of urology,Opthmalmic care with Chakshushya [Opthacare OPD] nutritional support regarding healthy and balanced dietary advise through Dept of Diet and nutrition[swasthavritta and Pathyahara unit].
Thus the Madhumeha specialty OPD dedicated specially for management of Diabetes where treatment, education, awareness and research has been integrated for the welfare and effective outcome.
Our plan of care
1) Patients are educated regarding the disease, its permanent nature, and its complications. The best time to counsel as per our experience is just when diagnosis is made for at this time the patient is highly motivated and acceptance of the disease and its permanent nature is easy. This is half the battle won!
2) Physicians at diabetes OPD try to eradicate the two most “upsetting” worries in patient’s mind:
- Will I have to take injections? and
- Will I have to give up my favorite food?
Once reassured, the physician and patient “team up” against the disease and achieve set goals.
3) Early detection and treatment of complications is our forte. Every diabetic patient is encouraged to follow a “diabetes calendar.” Months are assigned for carrying out various tests which include:
- Once a year “eye check-up with fundoscopy”
- An ECG and Stress Test
- Regular assessment of feet to identify any evidence of foot ulcers
- Blood and Urine glucose testing, HbA1c testing, Renal function test, Sensory nerve testing [using 10-gram monofilament]
4) Our OPD also encompasses the all-important diet advice by the physician or dietician. Today in diabetes “staple diet,” which includes what patient has been eating since childhood is not changed (e.g. someone whose staple diet has been rice is not asked to make a complete switch to wheat!). A switch from the staple diet is devastating for the patient, and can itself become an acute “stress” leading to worsening of diabetes.
5) Our OPD also focuses on the importance of weight reduction in the obese patients and the benefits of exercise in diabetes control.
Patients of madumeha are treated by the use of classical herbal and herbomineral drugs, detoxification therapy, specialized Panchakarma treatment modalities like Udwartana [Powder massage],shirodhara[gently pouring liquids over forehead],Abhyanga[oil massage],Lepa(application of medicinal paste) etc.
Specially designed Diabetic dietary charts which are provided to every patient with edible pathyahara[Patient specific diet] by assessing patients prakrati, roga bala, rogi bala, koshta , satmya and many other important criteria. Disease specific yoga and meditation will be taught to patients for the everyday practice.
Thus, madhumeha speciality OPD specially flourished for the treatment of diabetes mellitus, providing best of its contribution to the field of ayurveda medicine and research.
- Suketha Kumari
- Dr Keertan M S