From the ‘Desk of Doctor’ at JKYog Naturopathy Hospital in Banara, Cuttack, Odisha, comes an insightful overview of diabetes mellitus and its natural management. This article explains the types of diabetes, their causes, and the role of lifestyle factors in managing the condition. It highlights key naturopathy treatments such as cold hip baths, Gastro Hepatic Pack (GH Pack), mud packs to the abdomen, and cold abdominal compresses, which provide effective methods for regulating blood sugar levels.
The article also emphasises the importance of specific yoga asanas like Dhanurasana, Matsyendrasana, Mandukasana, Bhujangasana, Setubandhasana, and Pawanmuktasana to help prevent and manage diabetes. At JKYog Naturopathy Hospital, we specialise in integrating diet therapy, naturopathy, and yoga to holistically treat diabetes and promote overall health and well-being.
What is Diabetes?
Diabetes mellitus, often referred to as diabetes, is a condition in which a person has a high blood sugar (glucose) level due to the body either not producing enough or body cells not adequately responding to insulin. Insulin is a hormone produced in the pancreas that enables body cells to absorb glucose to turn it into energy. In diabetes, the body either fails to respond to its own insulin appropriately, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.
Classifications of Diabetes
There are many types of diabetes, the most common of which are:
- Type 1 Diabetes or IDDM (Insulin-dependent diabetes mellitus)
- This results from the body’s failure to produce and requires the person to inject insulin.
- Type 1 diabetes mellitus is characterized by the loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas, leading to insulin deficiency.
- In this condition, the body is unable to produce insulin. Insulin is a hormone produced by the pancreas, a gland that is in the abdomen. Insulin is a hormone that controls the use of different fuels for energy. It is especially important because it allows the body to use glucose (simple sugar) instead of fats. When there is no insulin, the body cannot use or store the glucose that comes from food, and this causes the blood sugar levels to become very high. Instead, the body uses fat as a source of fuel, which gives rise to some of the acute complications of diabetes mellitus. The pancreas undergoes an autoimmune attack by the body itself and is rendered incapable of making insulin.
- Type 2 Diabetes or NIDDM (Non – insulin-dependent diabetes mellitus)
- Results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. Type 2 diabetes is the most common form of diabetes.
- Gestational Diabetes
Diabetes can occur temporarily during pregnancy. Significant hormonal changes during pregnancy can elevate blood sugar in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born.
Other forms of diabetes mellitus include:
- Congenital diabetes is due to genetic defects in insulin secretion.
- Cystic fibrosis-related diabetes.
- Steroid diabetes induced by high doses of glucocorticoids.
- Several forms of monogenic diabetes.
Causative Factors of Diabetes
- Family history, diet and environmental factors are risk factors for type 1 diabetes.
- Risk factors for type 2 diabetes include family history, increasing age, obesity, physical inactivity and a history of gestational diabetes.
Pathophysiology of Diabetes
Insulin is the principal hormone that regulates glucose uptake from the blood into most cells (primarily muscle and fat cells, but not central nervous system cells). Therefore, insulin deficiency or its receptors’ insensitivity plays a central role in all forms of diabetes mellitus.
Humans are capable of digesting some carbohydrates, in particular, those most common in food; starch and some disaccharides, such as sucrose, are converted within a few hours to simpler forms, most notably the monosaccharide glucose, the principal carbohydrate energy source used by the body. The most significant exceptions are fructose, most disaccharides (except sucrose and, in some people, lactose) and all more complex polysaccharides, with the outstanding exceptions of starch. The rest are passed on for processing by gut flora, largely in the colon. Insulin is released into the blood by the beta cells found in the islets of Langerhans in the pancreas in response to rising blood glucose levels, typically after eating. Insulin is used by about two-thirds of the body’s cells to absorb glucose from the blood for fuel, conversion to other needed molecules, or storage.
Insulin is also the principal control signal for the conversion of glucose to glycogen for internal storage in liver and muscle cells. Lowered glucose levels result both in the reduced release of insulin from the beta cells and in the reverse conversion of glycogen to glucose when glucose levels fall. This is mainly controlled by the hormone glucagon, which acts in the opposite manner as insulin. Glucose, thus forcibly produced from internal liver cell stores (as glycogen), re-enters the bloodstream; muscle cells lack the necessary export mechanism. Normally, liver cells do this when the level of insulin is low (which normally correlates with low levels of blood glucose).
Higher insulin levels increase some anabolic (building up) processes such as cell growth and duplication, protein synthesis and fat storage. Insulin (or its lack) is the principal signal in converting many of the bidirectional processes of metabolism from a catabolic to an anabolic direction and vice versa. In particular, a low insulin level is the trigger for entering or leaving ketosis (the fat burning metabolic phase).
If the amount of insulin available is insufficient, if cells respond poorly to the effects of insulin (insulin insensitivity or resistance), or if the insulin itself is defective, then glucose will not have its usual effect so glucose will not be absorbed properly by those body cells that require it, nor will it be stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis and other metabolic derangements, such as acidosis.
Signs and Symptoms of Diabetes
- Polyuria (frequent urination)
- Polydipsia (increased thirst)
- Polyphagia (increased hunger)
Mechanism of Diabetes
When the glucose concentration in the blood is raised beyond its renal threshold (about 10 mmol/l, although this may be altered in certain conditions, such as pregnancy), reabsorption of glucose in the proximal renal tubule is incomplete, and part of the glucose remains in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits the reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst (polydipsia).
Complications of Diabetes
- Acute complications
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- Diabetic ketoacidosis
- Hypoglycemia
- Diabetic coma
- Chronic complication
- Diabetic cardiomyopathy – damage to the heart, leading to diastolic dysfunction and, eventually, heart failure.
- Diabetic nephropathy – damage to the kidney, which can lead to chronic renal failure.
- Diabetic neuropathy – abnormal and decreased sensation.
- Diabetic retinopathy – growth of friable and poor-quality new blood vessels in the retina as well as macular oedema, which can lead to severe vision loss or blindness.
- Diabetic foot – often due to a combination of sensory neuropathy (numbness or insensitivity) and vascular damage, increased rates of skin ulcers and infection and in serious cases, necrosis and gangrene.
Management of Diabetes
Dietary Modifications
- Low glycemic index diet- the glycemic index (GI) is a scale that ranks a carbohydrate-containing food or drink by how much it raises blood sugar levels after it is eaten or drank. The glycemic index ranks food on a scale from 0 to 100. There are three GI categories:
- Low GI Diet < 55
- Medium GI Diet 56 – 59
- High GI Diet >70
- Low glycemic index diet like apple, pineapple, orange, kiwi, brown rice, kidney beans, bitter gourd, bottle gourd, okra etc. A low glycemic index diet decreases the risk of type 2 diabetes and its complications, decreases the risk of heart disease and stroke and maintains weight.
- Protein intake can range between 10-15% of total energy (0.8-1 g/kg of desirable body weight). Requirements increase for children and during pregnancy.
- Carbohydrates provide 50-60% of the total caloric content of the diet. Although it has been traditionally recommended that carbohydrates be complex and high in fibre, more emphasis should be placed on the total amount of carbohydrates consumed than the source of carbohydrates.
- Excessive salt intake is to be avoided. It should be particularly restricted in people with hypertension and those with nephropathy.
- Alcohol tends to increase the risk of hypoglycemia in those taking antidiabetic drugs and should be particularly avoided in those with lipid abnormalities and patients with neuropathy.
Diet in nutshell
- Bitter gourd juice on alternate days is advised. The dilution fraction should be 50ml of real juice with 150ml of water.
- Powdered fenugreek seeds (Methi) with a glass of buttermilk alternate with bitter gourd juice.
- Increased intake of green leafy vegetables like Palak, Methi, Drumstick leaves, etc is advised. Onions and Garlic have demonstrated blood sugar-lowering action in several studies.
- Intake of fruits like jamun, guava, pomegranate, etc. is advised.
Naturopathy Treatments for Diabetes Management
A combination of diet therapy, lifestyle intervention and the following naturopathy treatments has been found to be helpful in managing diabetes mellitus.
- Cold Hip Baths, taken for 15 to 20 minutes every day, have been found highly beneficial in the management of diabetes mellitus.
- Gastrohepatic pack (GH Pack) for 30 to 45 mins. Once a day is advised. This is a special pack in which a hot fermentation bag is placed over the abdominal region, and an ice bag is placed at the corresponding lumbar region. This has been shown to have an excellent effect on reducing blood sugar levels.
- Apply a mud pack to the abdomen twice a day for 20 minutes. This has been found to be helpful in managing blood sugar levels.
- Cold abdominal compress for 30 mins a day.
- Partial massage on the abdomen for 10 mins.
Yoga Techniques for Diabetes Management
Several yoga techniques have been found beneficial in the treatment of diabetes, reducing its complications and also preventing diabetes.
- Dhanurasana
- Matsyendrasana
- Mandukasana
- Bhujangasana
- Setubandhasana
- Pawanmuktasana
Article by: Dr. Geetika Sonwani
Resident Medical Officer (RMO)
JKYNHRC
Book an appointment with Dr Geetika, email to info@natural-cure.org or Whatsapp at +91 8249882301