Introduction: Diabetes is a metabolic disorder and a chronic health condition in which the body’s sugar metabolism is disturbed. Diabetes occurs when body cells are not able to take up the glucose to utilize as an energy source resulting in the high level of glucose in the  bloodstream. The food we eat breaks down in the digestion process into complex to simple sugars (glucose). This glucose is taken up by the cells to use as energy. The uptake of glucose into the cells is aided by the hormone secreted by the pancreas called insulin. Insulin acts as a key to unlock the cells. There are two conditions for diabetes to occur :

• Pancreas are not making enough insulin
• Pancreas makes enough insulin but the body’s insulin uptake is hampered (insulin resistance)

Types and causes of Diabetes :

Type 1 Diabetes : Type 1 or insulin dependent diabetes is an autoimmune condition in which the body’s own cells attack insulin producing cells in pancreas. It usually occurs in children and young adults. Heredity may play a role in this.

Type 2 Diabetes : Type 2 or non insulin dependent diabetes is a purely metabolic disorder.in which either the pancreas doesn’t produce enough insulin or the body cells do not respond to the insulin (resistance) resulting in the high sugar in the bloodstream. It usually occurs in middle aged and older people.

“आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|

नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||”

In ayurveda diabetes is known to be “prameha or madhumeha”. Acharya Charaka above has explained so well that a person can have prameha if he is overly indulge in the sedentary lifestyle habits that are excess sleep, prolonged sitting (lack of physical exercise), eating curd or meat or milk and its products or freshly harvested grains or jaggery and all the things that aggravates Kapha dosha in the body.

Sign and symptoms :

“स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च|

हृन्नेत्रजिह्वाश्रवणोपदेहो घनाङ्गता केशनखातिवृद्धिः||

शीतप्रियत्वं गलतालुशोषो माधुर्यमास्ये करपाददाहः|

भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||”

  

• Weakness or fatigue ( शिथिलाङ्गता )
• Numbness or tingling sensation in the hands and feet ( करपाददाहः)
• Dry mouth (गलतालुशोषो)
• Increased thirst (तृष्णा)
• frequent urination  and sensation while urinating (मूत्रेऽभिधावन्ति पिपीलिकाश्च)
• Blurred vision (नेत्र उपदेहो)
• Frequent urinary infections
• Weight loss

Why is diabetes one of the major causes of  blurry vision and blindness ?

As in diabetes there is excess of sugar into the bloodstream that can lead to damage to the blood vessels and nerves throughout the body including the eyes. That is the main reason for blurry vision, floaters, faded colors, sensitivity to light and blindness. These are collectively known as diabteic retinopathy.

Blurry vision means it becomes difficult to see fine detailings. Sometimes very low glucose can also lead to blurry vision. The high blood sugar leads to changes in the retinal blood vessels. Either there is leakage of blood vessels or the abnormal new growth of the new blood vessels. Leaking of the retinal blood vessels into the lens of the eye makes the lens swell up and changes its shape leading to blurred or distorted vision. Blurry vision can be stopped with the proper treatment  at the early stages of the diabetic retinopathy.

Diabetic retinopathy has four stages are as follows:

• Stage 1: Mild nonproliferative diabetic retinopathy
• Stage 2: Moderate nonproliferative diabetic retinopathy
• Stage 3: Severe nonproliferative diabetic retinopathy
• Stage 4: Proliferative diabetic retinopathy

Diabetes is one of the leading causes of blindness. In advanced stages or proliferative diabetic retinopathy damaged blood vessels cut off and the blood vessels formed are fragile, easily ruptures and leaks and fill the center of the eye. Gradually the scar tissues are formed from the growth of new blood vessels leading to detach of the retina from the back of the eye. Detachment of retina and fluid buildup in the eye damages the major nerve in the eye which is responsible for the vision that is the optic nerve resulting in glaucoma and complete vision loss (blindness).

Risk factors:

• Prolonged diabetes and poor control over it
• High blood pressure
• Altered lipid profile
• Use of tobacco, smoking or alcohol

Management of diabetes:

 

“स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|

सम्बृंहणं तत्र कृशस्य कार्यं संशोधनं दोषबलाधिकस्य||”

 

Principle for the management of the prameha (diabetes) as discussed by our acharya is basically classified into two categories:

• Patients who\ are strong and obese: Elimination therapy or detoxification (शोधन:)
• Patients who are weak and emaciated: nourishing therapy (बृहन्)

Pathya or Diet to be Followed-

The Dietetics for Diabetes one should follow-

1. Vegetables

• Broccoli
• Bitter Gourd
• Carrots
• Green Leafy Vegetables
• Peppers
• Tomatoes
• Capsicum
• Raddish
• Limit starchy or avoid food items like potatoes, corn, and green peas

2. Fruits  

Fruit containing natural sugar so can intake fruit low in glycemic index

• Oranges
• Avocado
• Melon
• Berries
• Guava
• Apples
• Kiwi fruit
• Peaches
• Jamun
• Amla (Indian Gooseberry)

3. Grains

Take at least half of your grains for the day should be whole grains

•  Wheat
• Rice
• Whole grain oats
• Cornmeal
• Barley
• Quinoa

4. protein

• Lean meat
• Chicken or turkey without the skin
• Fish
• Eggs
• Nuts and peanuts
• Dried beans and certain peas, such as chickpeas and split peas
• Meat substitutes like tofu

5. Dairy- nonfat or low fat

• milk or lactose-free milk if you have lactose intolerance
• yogurt
• cheese

6. Others

Neem Leaves, Aloe Vera, Basil, Flax Seeds, Fenugreek seeds, Turmeric etc.

Choose Heart-healthy fats, which is provided from the food items like-

• Canola and olive oils- These are liquid at room temperature.
• Nuts and seeds
• Heart-healthy fish such as salmon, tuna, and mackerel
• Avocado

Apathya or Diet to be Avoided-

The person with Diabetes Mellitus should avoid/limit the following-

• Sugar– Sugar and sweetened beverages can elevate the blood glucose levels and should be avoided.
• Tran’s fats- Artificial Trans fats found in packaged food items like- peanut butter, spreads and frozen dinner are extremely unhealthy.
• High carbs food items- White bread, rice and pasta should be avoided.
• Fruit-flavored yogurt- You can use plain curd/Yogurt instead of fruit flavored curd
• Sweetened breakfast cereals- Ignore the health claims in the boxes because most cereals are highly processed and contain more amounts of Carbs.
• Flavored coffee drinks- It can be regarded as a liquid dessert and should be avoided.
• Honey, agave nectar, and maple syrup- these may increase blood sugar levels, insulin and inflammatory markers.
• Dried fruit- when a fruit is dried this process results in loss of water content and leading to higher concentration of nutrients.
• Packaged Food items- They are highly processed foods made from refined flour, and further raises your blood sugar level
• Fruit juices– It may affect your blood glucose level and packaged fruit juices should be avoided.

Limit or Avoid food items- 

• Fried foods and other food items which are high in saturated fat and Trans fat.
• Low sodium diet or limit the salt intake
• One should limit sweets, baked goods, sweet candy, and ice cream
• Sugar added beverages like juice, regular soda , sports or energy drinks

NOTE: 

• In place of sweetened beverages one should drink water. Sugar substitutes like Stevia leaves; coconut sugar etc. can be used in your coffee or tea.
• Alcohol should be used in moderate amounts, not more than a drink in a day as it can make your blood glucose level drop too low.
• Avoid use of butter, cream,  stick margarine etc. instead of these you can switch to oils for cooking food.

Vihara or Lifestyle Changes-

Physical activity plays an important role in nowadays life. If you are active then only you will be able to perform your daily activities in a more efficient way.

Benefits of Physical activity-

• It helps to Lower the blood glucose levels
• Beneficial in lowering the blood pressure
• It improves blood flow across your body
• Weight loss- It helps to burn extra calories and maintain good weight.
• It helps to improve your mood
• Helps in balancing and improve memory in older adults
• Better sleep

NOTE: 

• Add extra activity to your daily routine for Ex. – Use stairs instead of using the elevator, Plan for the Outing with your family or friends, walking in the park, bike riding etc.
• Do Aerobic Exercises and can also do strength training to build muscle and do stretching exercises

CAC Special DIABETES CARE PRODUCTS-

• DAIBO CARE KADHA
• DAIBO CARE TABLET
• VASANT KUSMAKAR RASA
• ASHWAGANDHA TABLETS