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How to keep Diabetes within managing limits
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DIABETES
CONTROL
in Your Hand
Dr. A.K. Sethi(M.B.B.S. F.C.C.P)
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DISCLAIMER
While every attempt has been made to provide accurate and timely information in this book, neither the author nor the publisher assumes any responsibility for errors, unintended omissions or commissions detected therein. The author and publisher make no representation or warranty with respect to the comprehensiveness or completeness of the contents provided.
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Diabetes is a dreaded disease which is known to mankind from time immemorial. In India there are about 35 million people who are suffering from diabetes. This accounts for about 25% of total diabetic patients in the world. Majority (90%) of these individuals suffer from type 2 diabetes which is usually detected accidently or in advanced stage. The World Health Organisation (WHO) has estimated that by the year 2025, the population of diabetic people in the world would reach 300 millions (presently 150 millions) and in India 57 millions. WHO has declared India as the Diabetes capital of the world.
Majority of Indian individuals suffer from the misconception that diabetes is due to excess intake of “Sweet Items” and will be “Cured” if they stop their intake. Moreover, diabetes is a disease which can be controlled but rarely cured by modern medicines. It has been observed that many diabetic patients improve dramatically when they combine Ayurveda, Naturopathy, Yoga, Magnetotherapy, Acupressure, Colour Therapy, Music Therapy and Feng-Shui with allopathic medicines.
In order to provide all this information for a layman, I have ventured to write this book and hope the readers will find it very useful and enjoyable to read.
At the outset I must thank Shri Ram Avtar Gupta, the Managing Director of Pustak Mahal who has given me the opportunity to write this book for laymen on an ailment which is widely prevalent around the globe. I am grateful to the patients who came to our clinic for treatment of Diabetes and benefited from the alternative forms of treatment provided to them. I am indebted to Shri R.L. Jaggi, retired Senior Accounts Officer (Northern Railways) who has been successfully practising in Chromotherapy and had provided me with abundant literature on different systems of Alternative Medicine. (Dr.) Swami Ananta Bharati, Chairman and Founder of Swami Keshwananda Yoga Institute has thoroughly guided me and taught me the art of Yoga, Pranayama and Meditation. Shri N.S. Dabas, an eminent astrologer and Vastu Shastri who is a staunch believer, follower and practitioner of Magnetotherapy has also assisted me in these fields. Dr. Ruma Banerjee, a practising physiotherapist and Naturopath has guided me in her field of practice.
My wife Dr. Sunanda Sethi, an Ayurvedacharya and a Traditional Reiki Master has been a source of inspiration. I thank my children Rupal and Mitali without whose cooperation this book would not have been completed.
—Dr. A.K. Sethi
Preface
Acknowledgement
1. What is Diabetes?
Structure and Function of Pancreas
Basic Cause of Diabetes
Ayurvedic Concept of Diabetes
2. Types of Diabetes
Insulin Dependent Diabetes or Type 1 Diabetes
Non-Insulin Dependent Diabetes or Type 2 Diabetes
Diabetes due to Diseases of the Pancreas
Diabetes due to Malnutrition
Diabetes due to Other Hormones
Diabetes due to Medicines and Toxic Chemicals
Diabetes due to Liver Diseases
Diabetes in Pregnancy
Types of Diabetes According to Ayurveda
3. What Causes Diabetes?
Age
Sex
Diet and Nutrition
Lifestyle
Infections
Medicines and Toxic Substances
Stress Factors
Inheritance
Causes of Diabetes According to Ayurveda
4. Signs and Symptoms of Diabetes
5. Complications of Diabetes
Why Diabetes is Considered a Dreaded Disease
When do Complications of Diabetes Occur
Hypoglycemia or Low Blood Sugar
Features of Low-Blood Sugar
Ketoacidosis
Diabetes and Heart Disease
Diabetes and Kidney Disorders
Complications of the Eye in Diabetes
Complications of the Nerves in Diabetes
Infections
Gangrene of Foot
Digestive System Disorders
6. Diagnosis of Diabetes
Criteria for Suspicion of Diabetes
Urine Examination
Blood Tests for Sugar (Glucose) Estimation
Glucose Tolerance Test (G.T.T.)
Dextrometer/Glucometer
Glycosylated Haemoglobin
7. Treatment of Diabetes
The Objectives of Treatment of Diabetes
Treatment Protocol
Changes in the Lifestyle
Dietary Management
The Features of a Diabetic Diet
Menu for Diabetics
Types of Diabetic Diet
Role of Physical Exercise
Benefits of Exercise
Types of Exercises
Frequency and Timing of Exercise
Role of Yoga
Yogasanas
Yogic Kriyas
Pranayama
Stages of Pranayama
Rules for Pranayama
Benefits of Pranayama
Pranayama Useful for Treatment of Diabetes
Meditation
Basic Procedure of Meditation
Auto-Suggestion and Resolution
Naturopathy or Nature Cure
Hydrotherapy
Mud Therapy
Massage
Medical Treatment (Allopathic)
Ayurvedic Treatment of Diabetes
Home Remedies for Treatment of Diabetes
Magnetotherapy
Acupressure and Refexology
Colour Therapy
Music Therapy
Feng Shui
8. What Does the Future Hold for Diabetes?
Better Diagnostic Facilities
Better Treatment Modalities
9. Answers to Your Queries
10. Role of Commonly Available Ayurvedic Medicines
Diabetes or Diabetes Mellitus is a disease in which the patient D passes increased quantity of urine. Diabetes is derived from two Greek Words “dia” which means “through” and “betes” which means, “to pass”. “Mellitus” is another Greek word, which means “sweet”. In this disease the patient passes large quantities of urine containing a sweet substance, namely glucose. It is either due to lack of production of a hormone called insulin in the pancreas or due to the inefficient action of insulin.
Pancreas is an important structure found in the abdomen, which plays a major role in the causation of Diabetes Mellitus. Pancreas is a soft, fat gland, which is 15-20 cm long, 3-5 cm broad, 2-4 cm thick and 80-90 gm in weight. It is situated in the posterior part of abdominal cavity just behind the stomach. Pancreas consists of three parts—the head, the body and the tail.
Fig. 1.1: Pancreas & surrounding organs
The head is enclosed in a C-shaped concave structure, the duodenum that lies between the lower end of stomach and the upper end of small intestine. The tail ends in a firm organ, the spleen that is located in the left upper portion of abdominal cavity. The portion between the head and the tail is the body.
Functionally the pancreas consists of two parts:
About 99% of the pancreas consists of the digestive part. It comprises a large number of cells which produce the digestive enzymes which are important for the digestion of proteins, carbohydrates and fats in the food we eat.
About l-2% of the weight of the pancreas constitutes the hormonal part. A hormone is a chemical substance which is produced by an organ or a gland and sent to another part of the body through the blood where it increases the functional activity of that part. The hormonal part of the pancreas consists of large clusters of cells called the islets of Langerhans, named after the discoverer Paul Langerhan who discovered them in 1869. There are about two million islets in the pancreas. The islets consist of 4 types of cells:
A or alpha cells produce the hormone glucagon.
B or beta cells produce the hormone insulin.
D or delta cells produce the hormone somatostatin.
F cells produce pancreatic polypeptide.
Insulin is the most important hormone whose deficiency is responsible for producing the disease Diabetes Mellitus.
Diabetes is mainly due to two causes:
Reduced production of Insulin.
Reduced efficacy/effectiveness of Insulin.
In order to understand the Ayurvedic concept of Diabetes we must first understand the 3 bodily elements, which are responsible for sustaining the living body in their normal state.
These 3 elements are:
“Dosha”
“Dhatu”
“Mala”
Any imbalance in the 3 elements produces disease or ill health.
“Doshas” govern the physical and chemical functions of the body. They are of 3 types:
“Vata”
“Pitta”
“Kapha”
1. “Vata” is responsible for active movements of different organs and parts of our body.
There are 5 types of Vata:
Prana refers to functions of the brain and nervous system i.e. sensations of smell, taste, touch, hearing and vision, movements of upper and lower limbs, rectum and sex organs and breath.
Udana refers to movements of the chest, diaphragm and voice box. It controls movements of breathing out, sneezing and speech.
Samana refers to movements of the intestine along with digestion and absorption of food substances.
Apana refers to the movements of the bladder, rectum, uterus and is important for passing urine, stools, menstrual fluids, semen and foetus (delivery).
Vyana is concerned with movements of all kinds of both voluntary and involuntary muscles. It is responsible for movements of the heart e.g. blood vessels, lymph (special white fluid present in different parts of the body) glands and glands which produce hormones.
The diseases caused by the disorder of Vata are as follows:
Asthma
Epilepsy (fts) and other mental disorders
Urticaria (a skin disease)
Viral fever (due to temperature changes)
Anaemia (lack of iron in blood)
Obesity (Increased weight gain)
Diabetes
Diarrhoea or constipation
Reduced functions of thyroid and adrenal glands
2. “Pitta” is responsible for the chemical reactions that take place in our body. It is of 5 types:
Pachaka is due to digestive enzymes and other chemicals in the body, which control the digestion and absorption of food substances.
Ranjaka is responsible for haemoglobin (the iron-containing pigment in blood) production.
Alochaka is responsible for the biochemical activity of the eye, which is responsible for perception of vision.
Sadaka is responsible for normal functions of the mind.
Brajaka is responsible for removing waste products in the form of sweat and enhancing the natural glow of the skin.
The diseases caused by disorders of Pitta are as follows:
Toxic fevers
Hyperacidity (Gastritis)
Vomiting
Diarrhoea
Jaundice
Anaemia (due to destruction of blood cells)
Bronchitis
Skin diseases associated with pus formation
All infections due to toxins, bacteria, viruses etc.
3. Kapha refers to promotion of growth brought about by secretions of different types of the body and organs. It is of 5 types:
Kledaka refers to secretions of the mouth, stomach and intestines, which dissolve the food and destroy bacteria.
Avalambika refers to secretions of the respiratory tract from the nose to the lungs and facilitates passing of air and flushes out foreign substances.
Bodhaka is the watery secretion of the glands around the taste buds of the tongue which help in perceiving the taste.
Tarpaka refers to the cerebrospinal fluid which is a secretion surrounding the brain and spinal cord. It provides nutrition to the brain and protects it from toxic substances.
Shleshaka is the fluid lying in the bones and joint spaces called as synovial fluid producing movements of bones and joints with ease. The watery fluid surrounding and protecting the heart, and lungs are also referred to as Shleshaka Kapha.
The diseases caused by disorders of Kapha are as follows:
Common cold.
Infection of the lungs and other parts of respiratory system.
Diarrhea due to infection.
Jaundice.
Eczema, pimples and other skin infections.
Arthritis (painful joints).
Rheumatic heart disease.
Swelling and infection of the kidneys (glomerulonephritis).
Peritonitis (swelling of abdominal cavity).
Encephalitis, meningitis and other infections of the brain.
Benign tumours of different parts of body.
Dhatu is a substance which is responsible for formation of basic structure of body. There are 7 types of dhatus i.e. lymph, blood, muscle tissue, fat tissue, bone-marrow, sperm or ovum.
Malas are waste products of various dhatus produced during the course of metabolic changes in the body. Examples of malas are sweat, urine, stool, gases, bile, ear-wax, nasal discharge, mucous secretions etc.
Thus disease is the imbalance of doshas, dhatus and malas.
Diabetes is one Type of disorder of the urinary tract in which patients pass excessive and turbid urine (PRAMEHAS).
There are 20 Types of Pramehas which are classified according to the doshas into 3 major types:
Vataja Pramehas—which are 4 in number.
Pittaja Pramehas—which are of 6 types.
Kaphaja Pramehas—which are of 10 types.
Diabetes (Madhumeha) is a type of Vataja Prameha.
Diabetes Mellitus is divided into different types, depending on the cause of disease and the situation in which it develops. Each type is distinctly different from the other by virtue of the cause of the disease, its presentation, complications, diagnosis and treatment. The different types of Diabetes Mellitus are discussed below.
This type of diabetes is commonly known to occur during early childhood and adolescence. This is sometimes also known as Juvenile Diabetes due to this reason. It can also occur in middle aged and older individuals. In this disease, the pancreas produces very little or no insulin due to which the patient has to depend on artificial source of insulin. It develops suddenly and progresses rapidly. By the time it is diagnosed the patient may have developed many complications in the body. It is not commonly present in other family members. The individuals who develop this disease are usually not obese and have a normal dietary pattern and an active lifestyle. These individuals respond only to insulin injections and if not treated properly they develop complications and outcome may sometimes be fatal. The disease is more common in Europe and America. It affects 1 in 500 children and 1 in 200 adolescents.
This type of diabetes is seen in middle-aged adults and older individuals. This disease is more common than Type 1. It develops slowly and gradually and may not be noticed for years together. It is commonly detected when a person goes for a medical check-up before joining employment or before an operation. Such individuals are obese/overweight, voracious eaters and have a sedentary life-style. Often such people have other family members especially parents, grand parents, uncles, aunts or siblings with the same disease. The disease is not as serious as Type-1, with fewer complications developing and patients respond to oral medicines, diet restriction and exercise. The major differences between the two Types of diabetes are outlined below:
Since the main cause of diabetes is the production of insulin in the pancreas, any disease affecting it will indirectly give rise to diabetes. The common disease/disorders of the pancreas are as follows:
a) Any infection of the pancreas
b) Tumour related to the pancreas
c) Any obstruction between pancreas and other organs due to stone, toxic chemicals etc.
d) Removal of pancreas by operation.
Such individuals may develop the disease at any age irrespective of their body weight, eating habits, life style and family history. They commonly require insulin injections for treatment while some may respond to oral medicines.
In developing countries like India many individuals in the adolescence and adulthood develop diabetes due to severe malnutrition. These people are commonly deprived of food in early life especially protein-rich food. Due to this they are undernourished and very lean and have very little production of insulin hormone.