Prameha Chikitsa - Diabetes Management

Premeha - Diabetes 

In this Acharya (the scholar who wrote Ayurvedic texts) explain how to deal with disease related with over nutrition and sedentary life which leads to metabolic disease, kidney failure, neuropathy and retinopathy. Etc,

Premeha literally means excessive flow "nutrients/essence" through urine. The flow of unusual nutrients like glucose, blood nutrients, etc. through urine is considered as Premeha. Similarly, the excessive flow of water is also called Diabetes Insipidus. It can be noted that there can be common root to the functions related to kidneys in both diabetes mellites (sugar) and insipidus (water). It is known fact that the late-stage complications of diabetes are mostly kidney related.  

The premeha is divided into three broad categories based of Dosha predominance for easy understanding and classification in common clinical approach. 

Kapha prameha - Early stage of diabetes which is controllable with diet and lifestyle changes. The following symptoms do coexist or similar with symptoms of Kaphaja prameha 

    Overweight/Mild hypoglycemia- BMI generally above 25 Kg/m2

    High cholesterol - Triglyceride (above 200 mg/DL), LDL

    Insulin resistance 

    Hypertension -Blood pressure above 140/90 mm of Hg

    Poly urea - Urinating more than 3 time in 3 hours.

    Glycosuria

Pitha Prameha - Can be classified as the middle stage of diabetes, need medication along with diet and lifestyles. This is a phase in which inflammatory changes mainly happens. 

    Hyperglycemia

    Retinopathy

    Initial stage of nephropathy

    Loss of weight stage of diabetes

    Diabetic ulcer first stage.

    Somogyi effect of diabetes.

Vata Prameha - Third stage of diabetes mellitus with more complication, mostly need proper inpatient treatments, diet, medication also lifestyle corrections. In this stage, most of the irreversible stages happens, then the focus of the treatment is to reduce the degenerative changes. 

    Neuropathy

    Sever stage of nephropathy

    Cachexia

    Cardiorespiratory complications

    Gangrene and its complications

The treatment approach to manage sugar level is decided based on the pattern of blood sugar level spike. That is, when do you notice the spikes and reduction in relation to the diet, activity and medication. We need to understand the dynamics involved in the blood sugar levels in each individual. 

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