Prameha in terms of Diabetes Mellitus, Metabolic syndrome and ...

THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE D**i/i*%iii/ A *"fi**I*\ +Volume 17, Number 6. 2011, pp. 491-496 riGVIGW MiUClGSMary Ann Liebert, Inc.DOI: 10.1089/acm.2010 0396Prameha in Ayurveda:Correlation with Obesity, Metabolic Syndrome,and Diabetes Mellitus.Part 1-Etiology, Classification, and PathogenesisHari Sharma, MD, DABP, FCAP, FRCPC. DABHM,' and H.M. Chandola, MD (Ay), PhD?AbstractBackground: Obesity, metabolic syndrome, and diabetes meilitus are increasing in epidemic proportions globally. Prameha is a syndrome described in the ancient Ayurvedic texts that includes clinical conditions involved inobesity, prediabetes, diabetes mellitus, and metabolic syndrome.Materials and methods: Integrating the theory and modalities of Ayurveda in the management of these disordersmay prove to be beneficial. Kven though Prameha is a Yridoshaja Vyadhi (a disease involving all three of thepsychophysiologic principles known as Doshas [i.e., Vatu, Pitta, and Kapliaj), it is basically a disease with Kaphapredominance.Results: There are 20 subtypes of Prameha due to the interaction of the three Doshas and 10 Diiblu/us (disturbedfunctioning of the principles that support the various bodily tissues); several of these subtypes have sweeturine, whereas some of them have different coloration of the urine, highlighting the inflammatory conditionsinvolved in the metabolic syndrome. This disease has close ties to Sthauhja (i.e., obesity). With regard todiabetes mellitus, Sahaja Prameha and jatah Prnmchi correlate with type 1 diabetes; Apaihyanimittaja Pramehacorrelates with type 2 diabetes. Madhumeha is a subtype of Vtittija Prameita (Prameha with Vata predominance)that can occur as the terminal stage of type 2 diabetes (in which insulin is required), or as type 1 diabetesbeginning in early childhood. The latter is defined as jatali Pramehi Madltutnehino in Charaka Samhita, one of theclassical Ayurvedic texts.Conclusions: Various dietary, lifestyle, and psychologic factors are involved in the etiology of Prameha, particularlyin relation to disturbances in fat and carbohydrate metabolism. The ancient Ayurvedic knowledge regardingPramehn can be utiliz.ed to expand the current understanding of obesity, metabolic syndrome, and diabetes.Introduction Etiological Classification of PramehaO , ,. , , .... Nidana is the branch of Ayurveda that addresses theHtsiTY, mei Asouc SYN0ROM1-, and diabetes mellitus arc .. ... _. . - n ,increasing in epidemic...proportions.globally., , ,.Ai/urveda. , etioloevc , &'or,,disease., .,I..he.etiology. . byc.of Prameha is discussed' @in., e L i f. . , j. f ... r% , Sushruta Samhita, which identifies two types of Prameha:describes a set or cmnplex clinical disorders with Irequcnt . .. ,1 @,t -t-, --,11 .-f -H - -]|| >d Pnmidhi wh'-h ^al"Va' which is hereditary, and Apathyammtttaja, which ba "wrmn nm un ion, lo (i i\ y . J( , , . ,and dUibcte nu-llitus.'int^ratins Hu- theury .md ,@,dalitics ^"o"0S"' mi''""1"18 """"''"7 ^ """ d"C ' S1"@ticof Ayurveda in the management of these disorders may proveto be beneficial (see Sharma and Chandola, Ayurvedic Con- ^ , . @ l, ,. , @ ,. ,c,,, . \ . , ,. .., ,' . -. , .. ... Sahaja Prameha/Jatah Pramehi (Hereditary)cept of Obesity, Metabolic Syndrome, and Diabetes Mellitus' ' yiin this issue, pp. 000-000). The etiology, classification, path- In Ayurveda, the words Sahajti and jatah indicate geneticogenesis, and m(inag*?ment of Rnunchu are discussed at length predisposition in the pathophysiology of disease. Broadly, inand in detail in the Ayurvedic texts. hereditary diseases there may be two contributing factors:'Center for Integr.itivu Mi-dicim- .md Di-partmont of Pathology. CoHe^e of Modicine, '11iet,)]uo Suite University, Culunilnib, OH.2Institute for Tost Graduate Teaching & Research in Ayurveda, Gujarat Ayurved University, Jamnajiar, India.'