Prediabetes can be correlated to the 20 types of pramehaas described in classical Ayurvedic texts. Prediabetes is well recognized in Ayurveda. Prediabetes causes, treatments, and remedies have been mentioned in these texts as well.
The US Department of Health and Human Services and the American Diabetes Association (ADA) coined the term “prediabetes”more than a decade ago on March 27, 2002.
Prediabetes is a state in which some but not all of the diagnostic criteria for diabetes are met. It is often described as the ‘gray area’ between normal blood sugar and diabetic levels.
Globally, numerous terms have been coined to describe this condition like borderline diabetes, chemical diabetes, ‘touch of diabetes’ and many others.
In the early stages of the disorder, glucose tolerance remains near normal, despite insulin resistance, because the pancreatic beta cells compensate by increasing insulin output.
As insulin resistance and compensatory hyperinsulinemia progress, the pancreatic islets in certain individuals are unable to sustain the hyperinsulinemia.1
Prediabetes develops when your body begins to have trouble using the hormone insulin. Insulin is necessary to transport glucose.
In pre-diabetes, your body either doesn’t make enough insulin or it doesn’t use it well (that’s called insulin resistance). These are the risk factors related to the development of type 2 diabetes.
Weight:If you’re overweight (have a body mass index—a BMI—of higher than 25), you’re at high risk for developing prediabetes. Especially if you carry a lot of extra weight around your belly, you may develop prediabetes. The extra fat cells can cause your body to become more insulin resistant.
Lack Of Physical Activity: This often goes hand-in-hand with being overweight. If you aren’t physically active, you’re more likely to develop prediabetes. This is one of the major causes of prediabetes.
Family History:Prediabetes can be caused by hereditary factors. If someone in your close family has (or had) it, you are more likely to develop it.
Ethnicity:Certain ethnic groups are more likely to develop prediabetes, including African-Americans, Hispanic Americans, Native Americans, and Asian Americans.
Age:The older you are, the more at risk you are for developing prediabetes. At age 45, your risk starts to rise, and after age 65, your risk increases exponentially.
Gestational Diabetes:If you developed diabetes while you were pregnant, that increases your risk for developing prediabetes later on.
Other Health Problems: High blood pressure (hypertension) and high cholesterol (“Bad” LDL cholesterol) increase your risk of getting type 2 diabetes.
Polycystic ovary syndrome (PCOS) also raises the risk and possible cause for prediabetes because it’s related to insulin resistance.
Prediabetes can be called a “pre-diagnosis” of diabetes. It’s when your blood glucose level is higher than normal, but it’s not high enough to be considered diabetes.
Prediabetes can be correlated with the 20 types of pramehaas described in classical Ayurvedic texts. It can be a warning sign that you are prone to develop type 2 diabetes (Madhumeha) if you don’t make some dietary and lifestyle changes.
However, at this stage, it is possible to prevent prediabetes from turning into type 2 diabetes. Eating healthy food, losing weight, and being physically active can help you bring your blood glucose levels back to normal.
Diabetes develops very gradually, so when you’re in the prediabetes stage, your blood glucose level is higher than it should be. While you may not notice any significant symptoms, you may notice the following.
Before moving onto the treatment of prediabetes, one must first understand what causes prediabetes. Prediabetes and diabetes mellitus causes are comparable to the disease entity of pramehaand madhumeha respectively.
A vivid description of these two conditions can be found in Ayurvedic classical texts. The major categories for the etiological factors (nidan) or prediabetes causes are the following.
The classical Ayurvedic texts also describe the pathogenesis (Samprapti) of prediabetes (prameha) in an extremely advanced manner, involving the three doshas – Vata, Pitta, and Kapha. Kapha is predominant here.
The body’s ten Doshas or Dhatus(body tissues) which get vitiated in pramehaor pre-diabetes are as follows.2
In conventional medicine, it is believed that a high-calorie diet, sedentary habits, and stressors (physical, mental, social, etc.) play an important role in the etiopathogenesis of prediabetes. Its actual cause, however, is still unknown.
A side-by-side positive familial history, overweight, and obesity are the basic risk factors for insulin resistance and for the development of prediabetes and eventually type 2 diabetes mellitus.
Ancient scholars of Ayurveda shared a similar opinion. Here’s a quote from Chikitsa Sthana.
Asyasukham svapna sukham dadhini gramyaodakanooparasah payansi. I.
Navannapanam gudavaikritam ca prameha hetuh kaphakéchcha sarvam . II.3
The predisposing factors and causes for prediabetes as mentioned in the classical Ayurvedic texts are a sedentary lifestyle, excessive indulgence in the meat of animals of tropical, marshy and wetland areas along with over-consumption of immature grains, milk, milk products and sweets made of sugar and jaggery.
All these increase the properties of Kapha dosha. Following such a diet and lifestyle constantly for a period of time leads to the accumulation of excess Kapha dosha in the body.
In the primary stage, the body tries to resist this but in due course, the strength of the body diminishes and the excess Kapha starts to show its effects on the body.
Ayurvedic texts Sushruta Samhita reflect two major types of prameha.4
Out of these possible causes of prediabetes, Sahaja is caused due to bija dosha (defects in the seeds of the mother and father). In this case, the patient is emaciated, eats very little, thirsty and has a Vata dosha predominance.
Apathyanimittaja prameha(acquired diabetes) has a close resemblance with the contemporary concepts of prediabetes and type 2 diabetes mellitus.
Generally, patients of prameha have an excess accumulation of Kapha dosha.
On this basis, Ayurveda describes Sthula Pramehi, which clearly corresponds to the currently recognized concepts of being overweight and obese and its role as a predisposing feature of diabetes mellitus.
Scholar Charaka has described the predominance of Kapha dosha in pramehaas bahudrava where bahumeans excess and drava means liquidity.
Drava refers to the liquidity of Kapha dosha, which is abnormally high in quantity and has pervaded every part of the body.5
Generally, patients of prameha have an excess accumulation of Kapha dosha (water and earth elements) in their body which leads to a diminished digestive fire.
The scholars say that in this condition, whatever is consumed in one’s diet is converted into urine and fat only.
To get rid of this and to enhance the tejo mahabhuta(fire element) and to diminish the excess moisture and fat in the body, the patients should be treated with purificatory therapies (shodhan chikitsa)and those who are weak should be treated with palliative therapies (samana chikitsa).6
According to the Ayurvedic scholar Sushruta, madhura ahara(sweets and desserts), when taken in excess coupled with daytime sleeping and a sedentary lifestyle, may convert into fat due to metabolic blocks (ama rasa).
Sweets contribute to the adiposity of the body leading to weight gain.7
The recently formulated concept of metabolic syndrome in obese patients was already recognized in Ayurveda thousands of years ago. In metabolic syndrome, most of the consumed carbohydrates turn into fatty acids.
Weight gain in prediabetic patients has been theorized to be associated with hyperinsulinemia and increased level of free fatty acids (FFA’s).
Due to the increased FFA level in the serum, the glucose entry into the cells is hampered, resulting in insulin resistance and finally diabetes.
The relationship of Amawith psychological factors, as stated in Charaka Samhita, is the evidence of the relationship of prameha with mental stress. Ama in Ayurveda is defined as metabolic waste.
Recently, the idea of the significance of meda (adipose tissue) as the principal dhatu(body tissue) involved has been confirmed in western medicine where the central obesity and dyslipidemia are being considered as the main components of this disease.
The concept of metabolic syndrome also seems to have been conceived in Ayurveda. Many Ayurvedic texts emphasize the fact that while all three doshas are involved in this disease, the vitiation of the Kapha dosha is the main contributing factor.
If you’d like to learn more about the Ayurvedic approach towards treating metabolic syndrome, check out Todd Caldecott’s course below.
The involvement of a wide range of dushyashas a special significance because such a pathogenic feature of the disease indicates that pramehain relation to prediabetes is a systemic disease involving the whole body.
Prediabetes and type 2 DM (Diabetes Mellitus) are largely preventable diseases. According to Sushruta, overindulgence in the following lifestyle factors may result in prediabetes. Possible prediabetes causes include the following lifestyle patterns.
Ayurveda shows its observational prowess by furnishing prodromal features of prameha,which covers the pre-diabetic stage or early clinical manifestation of diabetes mellitus.
This is crucial in choosing the best possible treatments for prediabetes. Purvarupas(prodromal symptoms) are valuable signs and symptoms to predict the disease in its early stage and to check its progression and complications.
Prodromal symptoms, according to the great scholars of Ayurveda Charaka, Sushruta, Vagbhata and Madhav Kar, are as follows.
According To Etiological Classification: Sahaja (hereditary/congenital); another one is apathyanimittaja(acquired by incompatible diet and lifestyle patterns)
Classification As Per Body Constitution
Classification As Per Prognostic Classification
Kaphaja Type: prediabetes and early stage of type 2 DM (diabetes mellitus)
Pittaja Types: acute stage of type 2 DM
Vataja Types: advanced stage of type 2 DM or genetic/hereditary form of DM
Ayurveda describes a set of complex clinical disorders, collectively called prameha, that are characterized by frequent abnormal micturition.
The clinical conditions associated with pramehacorrelate in many ways with obesity, metabolic syndrome, and diabetes mellitus.8
The etiology, classification, pathogenesis, treatment, and management of pramehaare discussed at length and in detail in the Ayurvedic texts.
The Ayurvedic prevention, treatment, and management of prediabetes depend on a number of factors. Here’s what Ayurveda recommends for the treatment of prediabetes.
The consumption of food and drinks which diminish urine and fat, do not cause weight gain, increase appetite, digestion, and strength of the body is recommended. This is sufficient to prevent its progression to Madhumeha or type 2 diabetes mellitus.6
Recent evidence suggests that consuming a heart-healthy diet, losing excess weight, staying active and adopting mental relaxation, one can reverse the progression of prediabetes to type 2 diabetes mellitus.
It is believed that prediabetes is likely to turn into full-blown diabetes within 5 to 10 years. By exercising regularly and losing weight, the risk of diabetes can be lowered by 60 %.
The management of prediabetes emphasizes dietary and lifestyle recommendations, herbal, herbo-mineral, and mineral preparations.
In this context, Ayurveda emphasizes the role of environmental factors, daily routines, seasonal changes, lifestyle patterns, diet, regular exercise and rasayana for maintaining good health in general.
The management of prediabetes (prameha) emphasizes dietary and lifestyle recommendations, herbal, herbo-mineral, and mineral preparations in accordance with the etiopathology and psychosomatic constitution.
Charaka and Sushruta have strongly emphasized the first and foremost principle of prevention, as well as the treatment of any disease, is to protect oneself from the causative factors.
At present, the goal of prediabetic treatment is not only to normalize the blood glucose level within its normal range but also to improve the status of the ojasand agni, and to improve the quality of life.
Experiences: How I Healed My Diabetes With Ayurveda
Abstinence from certain causes is firmly advocated in Ayurveda for the management and treatment of prediabetes.
Prediabetes is a clinical entity in which lifestyle modification can reverse prediabetes and check its further progression to type 2 diabetes mellitus.
Food enriched with any type of fermented material, excessive water intake, milk, oil, ghee, sugarcane and its products, newly cultivated grains, soups, and meat of aquatic and near-aquatic animals should be avoided by patients of prediabetes (prameha).
The treatment and management of prediabetes are heavily dependent on one’s diet. Diet is the first-line of defense against prediabetes.
Barley (Yava), old shali, shashtika (a variety of rice), pulses like split chickpeas (chanaka), split pigeon peas (adhaki), green gram (mudga) and horse gram (kulattha) are advised by Sushruta for prameha.
In this context, Sushruta wants to convey the role of consuming less carbohydrate-rich foods for the treatment and management of prediabetes or prameha.
The quantity and quality of the diet should be decided based on agni bala(digestive power) and the prana(vital energy).
Physical activity is the lifestyle factor most consistently reported to improve insulin resistance. Insulin moves sugar from the bloodstream into the cell where it is burned for energy.
Exercise promotes sugar burning in the cell, the same as insulin. Exercise has such a strong impact on blood sugar that it can improve prediabetes even without making other lifestyle changes.
The American Diabetes Association recommends exercising for at least 30 minutes a day, five days a week, for a total of 150 minutes or more. Interestingly, even Sushruta recommended exercise and diet for the management of pediabetes or prameha
Meditative yoga asanas(poses) such as savasana, padmasana, siddhasana, vajrasana are considered to be beneficial for mental relaxation and ultimately, the treatment and management of prediabetes.
Anuloma-vilomaand Bhramari Pranayama are also helpful for managing psychological stress. Yama and Niyama are to be performed daily.
Asanas like Mayurasana, Bhujangasana, Paschimottanasana, Gomukhasana, Halasana and others are helpful by promoting peripheral glucose utilization and by improving insulin.
In Ayurvedic classical texts, a number of herbal and herbo-mineral combinations are advocated for the treatment of pramehain general.
After undergoing proper purification, the patient should be administered one of the following recipes.
Prediabetes has been a well known clinical entity for ages. The features described in Ayurvedic classics seem very contemporary and logical.
Ayurveda considers that lifestyle errors play a major role in the diathesis of prediabetes or prameha.
Scholars and researchers of biomedical sciences have recently conceived the idea of Medas as the principal Dushya of Ayurveda. They opine that central obesity and deranged lipid metabolism are considered the main pathogenic component of the basic matrix of prediabetes and type 2 diabetes mellitus.7
Please do not try to self-diagnose prediabetes. Consult your primary care doctor right away if you start noticing symptoms. Consult your Ayurvedic practitioner before trying the remedies and herbs mentioned here.
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