Diabetes mellitus madhumeha and it’s types

Diabetes Mellitus (Madhumeha) is a metabolic disease in which the person has high blood glucose over a prolonged period. Ayurveda identified Madhumeha as a disease which is very difficult to cure (Anushangi). It is described that high calorie diet and sedentary habit are important causative factors Diabetes mellitus.

I. Types

The different types of Diabetes Mellitus and their symptoms/presentations are as follows-

Type-1 Diabetes mellitus

This type of diabetes is due to destruction of insulin hormone producing cells in the body. The following symptoms are seen:

1. This diabetes will require insulin for survival.
2. This diabetes usually affects children and young adults.
3. The presentation is acute and often mistaken for acute infective illness in children with symptoms of fever, pain abdomen, excessive urination and weight loss.

Type-2 Diabetes mellitus

This is commonly seen in adults with the following symptoms-

1. Excessive urination, excessive hunger and weight loss.
2. There may be increase in infections like skin infections, itching in genital organs in women.
3. Sometimes there may be no symptom but on blood test for some other illness or screening, high plasma glucose level is found.

II. Prodromal symptoms

The onset of diabetes is recognized by the following early symptoms which call for adoption of early preventive measures:

• Burning sensation in hands / feet
• Oiliness on face
• Heaviness in body
• Sweetness and whitishness of urine.
• Laziness
• Polydipsia (increase of thirst)
• Bad breath
• Plaques on teeth
• Excessive growth of nails
• Polyurea (increased frequency of urination) and dirty urine.

These are main early symptoms of Madhumeha

III. Diagnosis

The diagnosis of Diabetes Mellitus depends upon the presentation as mentioned above. However, diagnosis will be made by measurement of the plasma glucose. The following tests are required to be done:

1. Blood test to determine plasma glucose level.
2. Urine should be examined for glucose, protein, ketone bodies and microscopic examination done for presence of pus cells.

Further, the following tests need to be done to assess target organ involvement and degree of control of diabetes through treatment:

1. Glycosylated haemoglobin (HbA1C)- for assessing the degree of control and monitoring treatment.
2. Fasting lipid profile (total cholesterol, triglycerides, Low density lipoprotein and high density lipoprotein).
3. Serum electrolytes.
4. Blood urea and serum creatinine.
5. Microalbumin and creatinine clearance.
6. Electrocardiography.
7. X-ray chest postero- anterior view.
8. Fundus examination.

IV. Complications of Diabetes mellitus

The complications of Diabetes are:

• Involvement of major blood vessels causing heart diseases.
• The involvement of small blood vessels causes diabetic complications in the retina of eyes, kidneys and neurons.
• The patients of diabetes are more prone to infections.

V. Referral Criteria

• Diabetes with pregnancy.
• Diabetes with complications (Diabetic foot, coronary artery disease, diabetic nephropathy, diabetic neuropathy, diabetic retinopathy) and renal failure.
• If not managed by oral Ayurvedic drugs and lifestyle modifications.
• Patients with severe infection, marked weight loss and breathlessness.