Both Ayurveda and modern medicine agree that type 2 diabetes mellitus (DM) is a multifaceted disease that affects many organs, tissues, and channels of the body including the cardiovascular, urinary, nervous and immune systems. In Sanskrit, diabetes is called prameha, or frequent urination, because this is one of many symptoms that can be observed by those with this condition. Historically, type 2 DM was considered to be mainly adult on-set, however, according to the CDC, we are currently seeing increased risk of type 2 DM among young children and teenagers. I will try not to shroud this topic in complex Ayurvedic or medical language, but rather use simple terms and core concepts to convey the practical approaches that can be taken by those wanting to manage or reverse this condition.
Some Basic Ayurvedic Concepts
In Ayurveda, there are three bodily humors (doshas) that maintain the normal function of the body and mind and, when disturbed, contribute to the disease process. These three doshas are known as vata (energy of movement), pitta (energy of transformation), and kapha (energy of structure, lubrication and fluidity). Kapha imbalance can be a primary factor in the development of type 2 DM when left unmanaged.
Kapha Imbalance and Diabetes
Let’s first get a basic understanding of kapha dosha before venturing into how kapha contributes to diabetes and other related complications.} Kapha is made up primarily of the earth and water element and is the structural and lubricating energy of the body. Kapha has heavy, slow, cool, oily, liquid, smooth, dense, soft, static, sticky, viscous, cloudy, slimy, hard, and gross qualities. Kapha dosha governs the formation and tone of all the bodily tissues, organs and channels. It lubricates, protects, and gives shape and support. It’s associated with ojas, the vital essence of the body that supports vitality and immunity. Out of balance, kapha causes disorders such as obesity, diabetes,, hypertension, edema, asthma, tumors, lethargy, heart disease, and a wide variety of congestive conditions.
In modern medicine, metabolic syndrome is a condition that can lead to type 2 DM and acute cardiovascular conditions. Metabolic syndrome symptoms are high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. These same factors are also frequently observed with the increase of kapha dosha.
In Ayurveda, there are twenty classifications for diabetes that relate to the qualities of the three doshas, but for the sake of this article, let’s focus our attention on type 2 diabetes (kaphaja prameha). If our daily diet consists of foods that share the same qualities as kapha, such as excess carbohydrates, refined grains and sugars, alcohol, and other highly processed and denatured foods, this will eventually increase kapha, which can cause excess accumulation of un-eliminated metabolic wastes and body fat. This can also put more stress upon our internal organs such as the liver, spleen, pancreas, kidneys, and the entire gastrointestinal tract.
In type 2 DM, we also disturb the natural function of our pancreas, known in Ayurveda as kloma. Kloma agni (pancreatic fire), can be viewed as the flame of intelligence that is present as insulin, which assists in the conversion of glucose into energy within the cells. It is also present as pancreatic enzymes, which help with the breakdown of proteins and fats. If we take excessive amounts of rice, bread, sugary treats, alcohol, and poor quality refined fats on a daily basis, we can begin to put on excess weight, feel lethargic, and even develop false cravings for more sweets and other substances that will compound the problem. For instance, eating excess sweets or excessive carbohydrate intake in general, strengthens the desire for sweets. This creates a snowball effect, which acts like our intuition driving in reverse. This increased sweet taste in the body drives kapha aggravation in the form of increased body fat, which can, over time, prevent insulin from carrying glucose into the cell. Even 5 to 10 pounds of excess body fat can trigger this in the right circumstances. In this case, the pancreas works harder to accomplish its job by secreting more insulin than was needed before. When the bloodstream has too much insulin, too often, cells become desensitized to insulin and insulin resistance develops. The pancreas continues to produce insulin in hopes it will carry the excess sugar into the cells for use, but with little effect. If this continues, the fire within the pancreas, present in the beta cells, begins to tire from working overtime and eventually becomes insufficient.
The Multifaceted Cause of Diabetes and Metabolic Syndrome
In our modern world, we can obtain almost everything we need with the push of a button, a trip to the supermarket, or take-out food delivery, and we can go anywhere we want by hopping into our car, rather than walking or riding a bicycle. Until fairly recently, most humans needed to work much harder physically to procure the most basic necessities and to travel from place-to-place. As we have become more and more inactive as a society, we have seen a rise in diabetes and other conditions, including obesity, auto-immune diseases, osteoporosis, heart disease, and more. These conditions are multifaceted and, to a large degree, relate to our lack of connection to life at a core level and touch almost every aspect of human life in the modern world: mental, emotional, and physical.
Many of our ancestors had to farm and raise at least some of their own food. Today, many of us spend more time indoors, rather than outside in the open air, under the sun, moon, and stars. Our work may demand that we spend more time sitting than standing and walking. This disconnect has led to a life within four walls, driving from place to place, more social isolation, and ultimately a greater lack of connection with our traditions, nature, and with one another. Social media and online culture has all but cemented this into our daily lives as well as our future generations. In short, our modern lifestyle has the potential to easily create imbalances to kapha dosha.
How to Get Back Into Balance
Treating diabetes or any other condition with Ayurveda doesn’t require that we reject our modern world, but rather that we develop a better relationship with the world and ourselves. Ayurveda encourages the cultivation of healthy habits and daily routines in order to tip the scales of health in our favor. This takes effort, especially at first, but eventually we build momentum and start to crave more of what we need and less of what we don’t. Slow changes are typically the best way to integrate new patterns into our lives, rather than biting off more than we can chew and then losing steam and giving up altogether.
How to Managing Diabetes with Ayurveda
When working with our patients to get started on an Ayurvedic herbal regime, we first tailor all recommendations to address their individual needs. It is not as simple as identifying a person’s Ayurvedic constitution or taking random supplements that are labeled with the promise of lowering blood sugar or losing weight. For example, herbs such a neem, turmeric, or shardunika (gymnema sylvestre) may be effective to lower blood sugar, but may need to be balanced with other herbs, depending on the individual’s constitutional needs or other complications. In Ayurveda, herbal formulations are frequently adjusted, based on the changes that occur in a person’s body, over the course of treatment.
There are also many herbs and classical formulations that can assist in supporting the pancreas and other organs and systems in the body affected by diabetes. But in my experience, the cornerstone to a successful treatment is the one-on-one relationship with an Ayurvedic physician or practitioner, who can help guide the process in an individualized, meaningful, and prioritized way.
It is crucial when starting on an herbal treatment that the herbs are balanced for your constitutional needs. Certain herbs that are used to treat kapha imbalances may have reducing effects on the bodily tissues and might only be appropriate in certain amounts or only for some individuals. A skilled clinical herbalist can help to balance the various effects of these herbs in custom formulations, so they can be taken on a long-term basis without creating imbalance. At our clinic we adjust herbal formulations with the season and as changes occur within the body over time. As a person changes, so do the herbs and recommendations.
Diet and Lifestyle for the Management and Prevention of type 2 Diabetes Mellitus
When working with diabetes in Ayurveda, a strong emphasis is placed on eating a balanced diet. This varies to a degree with each person, but the main aspect is making sure that there is a wide variety of fresh organic vegetables and healthy sources of protein and fats, while limiting or modulating carbohydrate intake based on a person’s blood sugar levels and ability to remain on a program. When working with patients, I have witnessed remarkable changes when the dietary guidelines are followed at least 80+ percent of the time and the recommended herbs are taken daily. Furthermore, when a healthy diabetic-friendly diet is put in place, herbal treatments work well and can dramatically help to speed up the healing process.
Since what we eat often relates to how we feel on an emotional level, we offer support in ways to develop healthy awareness around true cravings and false hunger. Staying active both mentally and physically, in ways that are life affirming and wholesome at a holistic level is key. This is a journey that requires commitment and recommitment and is one of the most rewarding over time.
We also help to strategize and recommend exercise routines, and get a plan in place to keep the body moving in a healthy way, one that is suitable for each person’s needs and abilities. Since many people are required to work sedentary jobs, developing strategies to integrate movement, walks, short workout routines, yoga and chair yoga sessions before, during, or after the workday is helpful. Working with a practitioner not only helps to develop a treatment plan with you, but also encourages these changes and helps them to become a more lasting part of your life.
Our cleansing and rejuvenation programs such as the Guided Ayurvedic Home Cleanse or Panchakarma can also be helpful at certain phases of treatment, once a solid foundation of diet and lifestyle is obtained and maintained for a period of time. These cleansing processes are designed to remove deep-seated toxins from the system and greatly accelerate the healing process.
For more information about our Ayurvedic services, please feel free to reach out via email or by phone.