The Disconnect Between Ayurvedic and Modern Medicine

  

The concept and practice of Ayurveda is extremely interesting especially compared to the practice of western or modern medicine. Ayurveda takes an entirely different approach than western medicine as it focuses on health holistically through a balance of mind, body, and spirit. Modern Medicine is not as concerned about promoting overall health, but rather addressing a problem once it has already manifested itself. Modern medicine offers a large variety of medications to improve symptoms and prevent further issues whereas Ayurveda has increased focus on diet and lifestyle to prevent disease. Both methods of addressing health are vital in the prevention and treatment of disease, but I believe there is a disconnect between them in our healthcare system.

I think one of the reasons that Ayurveda has not gained as much popularity in western healthcare is because of the high-pressure, instant gratification lifestyle that has been adopted. Most people would agree that disease prevention is a much better method of curing disease, but environmental factors outweigh the more long-term cure. For example, western cultures pursuit of instant gratification in the form of overeating, lack of exercise, substance abuse, and lack of sleep, override a healthy lifestyle. A variety of diseases in the heart, kidney, liver, and brain have resulted which require western medicine to find a cure. In the article “Why traditional Chinese and Indian ayurvedic medicine can’t compete with Western drugs” this same concept is discussed and other factors contributing to the disconnect. It also talks about how western medicine is a “profit-driven health care industry.” In the end, it comes down to money. Ayurvedic medicine doesn’t have the demand for, “expensive equipment, pills or lucrative research grants.” Traditional medicine practitioners are poorly paid because their treatment is inexpensive and doesn’t require costly, extensive research to find a cure. How can any money be made when the doctor prescribes that you stop smoking and cut back on sugar? With no medicine prescribed, there is very little money to be made. So, in reality, the lack of an Ayurvedic approach to health care is a vicious cycle that will be hard to break. I think the most important thing to remember is that both approaches to healthcare are extremely important and both offer incredible insight into preventing, treating, and curing disease. In combination, they have the power to improve medical care through a holistic, evidence-based medical system.

Ayurvedic medicine has many applications to common diseases that are prevalent today. One of these diseases is diabetes. There are an estimated 87 million Americans with prediabetes, out of those 30-50% will go on to develop Type II diabetes. 80% of those people will have non-alcoholic fatty liver disease. The issue not only lies with getting type II diabetes but also developing insulin resistance. According to the article, “Prevalence of the Metabolic Syndrome in the United States,” published in 2015, one in three Americans have insulin resistance.  Insulin resistance is triggered by a variety of factors including weight, age, genetics, sedentary lifestyle, and smoking. Insulin resistance not only leads to type II diabetes, but also cardiovascular disease, stroke, and cancer. The good news is that many of these diseases can be avoided through lifestyle changes.

The reason ayurvedic medicine is highly applicable to diabetes is because diabetes is a classic example of an imbalance in the body. Since the body cannot assimilate glucose into the cells, it tries to compensate through other pathways which cause many downstream problems. This results in an imbalance in the body’s main autonomic mechanisms. Common factors that increase the chances of diabetes include high triglycerides, low HDLs, high blood pressure, high blood sugar, and high fasting blood sugar. All of these factors are linked to diet and exercise. I was interested in learning about how obesity specifically contributes to diabetes on a cellular level. I researched this question and found the article, “What causes Insulin Resistance Underlying Obesity.” The article highlighted the most recent findings correlating obesity with insulin resistance. The main conclusions were that visceral obesity is the main driver for insulin resistance. It is related to insulin resistance as excess lipids accumulate in the liver. This is due to excess fatty acids from visceral adipose tissue which drain into the portal vein. The lipid accumulation results in impaired insulin signaling through cell autonomic mechanisms and through the creation of inflammation which produces inflammatory cytokines. Subsequently, insulin action is impaired. The article then describes how future therapies could prevent the buildup of visceral fat by directing the fat to the subcutaneous fat storage. This could be done through the control of the extracellular matrix and capillary expansion. Although, in reality, the best therapy to prevent visceral fat is simply diet and exercise. This article is another example of how western medicine is focused on curative care.  

Besides the many physical costs of diabetes, there are also many economic costs and social costs. In the article, “Economic Costs of Diabetes in the U.S. in 2012” the large burden of diabetes costs is studied in depth. The article estimated that diabetes cost the U.S. economy 245 billion dollars in 2012 with 22.3 million people diagnosed with diabetes. This number is substantially higher compared to the number of people in 2007 with diabetes (17.5 million). The article attributes this large increase in diabetes to changing demographics including an increase in the risk factors for diabetes including obesity, decreasing mortality, and improvements in detecting diabetes. Since this article is seven years old, I thought I would see what the numbers for diabetes are now. I was blown away to find out that in 2018 there were 34.2 million people with diabetes according to the CDC. According to the Diabetes Research Foundation, diabetes cost the U.S. 327 billion dollars in 2017. Also, diabetes was the seventh leading cause of death in the United States in 2017 with 83,564 deaths attributed directly to diabetes and 270,702 deaths which were related to diabetes. I thought these numbers would be interesting to compare to the Covid-19 deaths in the U.S. There have been 218,648 deaths from the Coronavirus. So obviously diabetes is still a major problem which not only kills many people but also costs the economy billions of dollars.  “Economic Costs of Diabetes in the U.S. in 2012,” also noted that the 245 billion dollars was not accounting for those who had undiagnosed diabetes or those with prediabetes. Also, the costs of diabetes are ultimately passed along to society through higher insurance premiums and taxes, reduced earnings, and reducing the standard of living. Finally, the CDC estimated that diagnosed diabetes will double between 2010 and 2050. Not only does diabetes cost the health care system billions, but it also costs thousands of lives.

Along with all of the physical and economic costs of diabetes, there are also social consequences. Individuals with diabetes can have more aggression and stress, depression, anxiety, and also increased issues when drinking alcohol. With all of the numbers of costs and deaths of diabetes, I think it’s interesting that both Type I and Type II can be managed by diet and exercise as well as medication. But still, thousands of people are diagnosed with Type II diabetes every year (1.4 million every year) when diet and exercise can prevent it.

References

Hong, N. W. (2018, July 20). Why TCM and Indian medicine can't compete with Western drugs.  Retrieved October 10, 2020, from https://www.scmp.com/lifestyle/health-beauty/article/2107357/why-traditional-chinese-and-indian-ayurvedic-medicine-cant

Targeting Insulin Resistance: The Ongoing Paradigm Shift in Diabetes Prevention. American Journal of Managed Care. April 11, 2013. http://www.ajmc.com/journals/evidence-based-diabetes-management/2013/2013-1-vol19-sp2/targeting-insulin-resistance-the-ongoing-paradigm-shift-in-diabetes-prevention

 Aguilar M . Prevalence of the Metabolic Syndrome in the United States, 2003-2012. JAMA, 2015; 313 (19): 1973 http://jamanetwork.com/journals/jama/fullarticle/2293286

 Hardy, O. T., Czech, M. P., & Corvera, S. (2012). What causes the insulin resistance underlying obesity?. Current opinion in endocrinology, diabetes, and obesity, 19(2), 81–87.

https://doi.org/10.1097/MED.0b013e3283514e13

American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012. (2013). DiabetesCare, 36(4), 1033-1046. doi:10.2337/dc12-2625

National Diabetes Statistics Report, 2020. (2020, August 28). Retrieved October 10, 2020, from https://www.cdc.gov/diabetes/date/statistics-report/index.html

  United States. (n.d.). Retrieved October 10, 2020, from https://www.worldometers.info/coronavirus/country/us/

U.S. Department of Health and Human Service. Press Release. (2010, October 22). Retrieved October 10, 2020, from https://www.cdc.gov/media/pressrel/2010/r101022.html

National Institute of Mental Health. Chronic Illness & Mental Health. (n.d.). Retrieved October 10, 2020, from https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml

Diabetes, Alcohol, and Social Drinking. (2017, November 9). Retrieved from https://www.healthline.com/health/type-2-diabetes/facts-diabetes-alcohol