PRAMEHA: AYURVEDIC PATHOGENESIS, METABOLIC CORRELATION WITH DIABETES MELLITUS, AND EVIDENCE-BASED MANAGEMENT

Abstract

Prameha is a major Ayurvedic disease complex characterized by excessive and altered
urination, metabolic imbalance, and progressive involvement of Kapha, Meda, Mamsa, Kleda,
Ojas and Mutravaha Srotas. Although Madhumeha is often compared with diabetes mellitus,
the classical concept of Prameha is broader and includes multiple phenotypes that differ in
Dosha dominance, tissue status, body habitus and prognosis. This structured review synthesizes
classical Ayurvedic descriptions with contemporary evidence on type 2 diabetes, insulin
resistance and selected Ayurveda-based clinical interventions. The review was developed from
the supplied Prameha material, classical compendia, peer-reviewed Ayurveda studies and
authoritative diabetes sources. The Ayurvedic Samprapti is dominated initially by Santarpana,
Agnimandya, Kapha-Meda-Kleda excess and Srotorodha, while chronic or advanced disease
may progress toward Vata aggravation, Dhatu Kshaya and Ojas depletion. Modern type 2
diabetes similarly involves insulin resistance, ectopic adiposity, beta-cell dysfunction and
chronic hyperglycaemia, but these biomedical mechanisms should be treated as a clinical
correlation rather than a literal translation of Ayurvedic constructs. Published clinical studies of
Saptarangyadi Ghanavati, Rishyagandha, Nyagrodhadi Ghanavati, Vamana followed by
Darvyadi Kwatha, and integrated Ayurveda-lifestyle programmes report improvements in
symptoms and selected glycaemic outcomes; however, small samples, open-label designs,
heterogeneous formulations and multicomponent interventions limit causal certainty. The most
defensible contemporary approach is individualized, stage-sensitive Ayurveda used with
objective glucose monitoring, pharmaceutical quality control, lifestyle correction and
appropriate coordination with conventional medical care. (Sharma and Chandola, 2011b)