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

594glibenclamide or metformin significantly enhanced rhability to Jower glucose and improve the lipid profile, co:pared to administering the drugs alone.''"1 Shilajit atlemuit^treptozotocin-induced hyperglycemia in rats and reducthe decrease in superoxide dismutase activity in pancreaislet cells. It was postulated that Shilajit acts as a free-radkscavenger."Oiaraka Samhita recommends Madlm-asnva, a polyhertfermented preparation, for patients with Pramcha. Hypoglcemic effects in animal models have been noted for somethe ingredients of Mudluoasava, including Tcjapatra [Cim;momum Umiak (Bueh.-Ham.) T. Nees & Eberm.J, Pushkarmu(hiuJa racemosa Hook. f.), and Chirauata (Kiratatikta, Swerichirata).l3lV5'm'wl As discussed previously, in a pilot stucon patients with diabetes, S. chirata produced a significaidecrease in fasting and postprandial blood glucose levels.A pilot study on Tcjapatra showed insulin-releasing activila? well as a decrease in fasting and postprandial blood gUcose levels in patients with diabetes.102'103Mamejjaka {Eritcoslema Uttoralc Blume) is used as a sing]herb and also as part of an antidiabetic mixture.KH Inclinical study on patients with type 2 diabetes, E lit lorn,reduced blood glucose and prevented the progression cdiabetic complications. There was significant improvemerin the lipid profile, blood pressure, and kidney function.10" jsignificantly reduced blood glucose and lipid peroxides i.rats with alloxan-induced diabetes, and increased superoxiddismutase, catalase, and glutafchione peroxidase.106 In sludieon rats with sbeptozotocin-indueed type 1 diabetes, C. littarak significantly reduced glucose, cholesterol, and triglyc^ride levels,10' and ameliorated diabetic nephropathy. Sei'un:reatinine and urea were signiricantly decreased, mid glomerular function improved.1 * In rats'fed a hypercfiolestci"Dlemic diet, E. Uttoralc decreased serum cholesterolxiglycerides, LDL, VLDL, liver and kidney diolesteroJ levdsind lipid pera.xidation levels. There was an increase in HDLmd an increase in reduced glutatJiione levels.10?A pilot study on an herbal mixture am tabling TejapatnCinnamomum tamala), Pushkarmula (Jnula racemosa), h/nimejjak:,E. littoruk), Mesliaskrhig; (Gytnneiiw sylvustre), and Jaitibu (Syyghuitaivunf) seeds with Kctravrtlnka (bitter gourd; bitteinelon; Montordica chanmtia) juice, administered at a dose oJig twice a day before meals, decreased fasting and postnundialblood glucose le\els in patients with diabetes (Singht al., 1992; see Box 1). Avurtaki {Cassia auriculata Linn.) and'lethika {Trigondla foenum-gmecum) as single herbs and deoctionof Nimbn {Azadiradila indies A. Juss.; Nsj/jO have alsoSHARMA AND CHANDOLAemonstrated blood glucose-lowering action (Marwah et al.,990; see Box 1). In a dinical study on patients with type 2iabetes, Neem shewed significant hj'poglycemic activity.110i rabbits witli alloxan-mduced diabetes, the hypoglycemictfect of Neeiit was comparable to that of glibunelamide.111The herbs Cokshura (Tribuluz terrestris Linn.),112 Asana"teracarpiis mavtuyuun Roxb.),6i Kulatha [Vigrm unguicuhta-bin.) VValp.], and Saptapama [Alstonia scholaris (Linn.) R.Br.]re also beneficial in treating Prameha. These herbs can besed in different combinations, depending on the Doshicivolvemcnt and severity of the illness. An herbal mixtureimprised of one part each of Ktirnvdhikn (bitter gourd: bitter.elon; M. chanvitia), Jambu (S. cwn'mi), Gummr (Meshae-hringi,. svlviisire), and Awra (Mangifera iudica Linn.), taken alongith Shilajit, was investigated in a cibiical study on 805 patientswith diabetes. The results showed a statistical!}' si;nificnnt reduction in fasting and postprandial blood glucosalong with clinical improvement (website of India's CentrCouncil for Research in Ayurveda and Siddha; see Box IVijayit&iradi Kiuatha, Nishakatnkadi Kumtha,u? KatakagadmuKioatha, Saptaranguadi Vati, and Chandraprabha Vati acefew oUVr polyherbal combinations that have an antidiabet:effect. Given the abundance of Ajairvedic herbs that are useto treat Pramcha, further research and clinical trial? in thfield may determine which are most effective in managindiabetes mellitus.Management of complicationsPatients with diabetes are at high risk for a number of con:jliostiond. Ayurvedic herbs that target specific organ functionire helpful in managing these disorders. A large bod)' of research has been conducted cm these herbs. For cardiovasciilaimplications, Arjuna {Tennmalia arjunn Linn.),113'116 GugguhConimtphora wighsi't (Am.) Bhandari],11' Pttslikiinnula (hurfa in@cmosa),ll'~u9 and Kushiha [Snussurea lappa (Decne.) C.Baailicj'120'121 can be utilized. Bitva [Aeglc marmclos (Linn.) Corricrr.],1^'1"3 Kutaju [Holarrhena antidyscutericn (Roxb. ox FlemingVail, ox A. DC.],12*125 and Haritaki'{Tennmalia chebuh)126-@ arcLelpful in managing diabetic cntcropatrry. For diabetic nc-@liropathy, Pimamaz>a (Boorliai'ia diffusn Linn.),126'1'9 GokshwiTribulus h'rrestris)^^'1'^' and Varuna {Cratacva nuivala Buch.-fam.)'W35 are useful. Knpiknc.chu [Muaina pruriais (Linn.)Cl,13^178 Ashwngmdha (Withaiw sarrmifera)@ SltPeta Mush'1rf/wjntvjs aiiscertdens Roxb.) (Deka et al, 2004; see Box 1),shwunha (Ficus rdigiosa Linn.) (Virani et a]., 2009; see Box 1),ltd Jntiphxla {Mymlica fragrant Houtt.) (Deka et af,, 2004; seeox 1) can be utilized lor erectile dysfunction. For diabeticriunipathy, Dashnmuh Kwalha (Dwjvedi, 1986; see Box 1) and(jgy/i/-based formulations are helpful. For diabetic retinopaiy,Saptiinirita Lntlut fUpadhyaya and Singh, 1993; see Box I)140id Mnhatriphrtla Ghiita (Gupta Diu-gesh, 2IJ09; see Box 1) are@commended. Lucal and internal administration of MaliaanjishthadsKtvathn (Anil Kumar, 1985; see Box 1) and Kaishorugguhi (Shringi, 1996; Hota, 1997; see Box 1) can be utilized furirioiLS skin manifestations. For cerebral diseases such as deefitiaand Alzlieimer disease, Shankhapnshpi (Convolvulusuriaiulis),71-^41^42 Mnndukaparni [CentcHti asiatiat (Linn.)rb-1,1*3""5 Brtthwi (B. monnieri),73U6M7 Vitcha {Acorns cnlnu$)/^M9fyoHshwati (Celastruf pauiculatus Willd.),150']51 andiduchi (Titiospora cordifolin)152'1'' are recommended,inclusionsIn At/nrveda, Prameha is described as a set of complexnical disorders characterized by frequent abnormal micriu'on,with tlie etiology involving genetic predisposition as;]| as improper diet and lifestyle. The role oi stress andesity in its pathogenesis it, also elaborately discussed in the'iirvedic texts. The clinical conditions described in Pniniehnve much in common with those