Diabetes and Ayurveda Medicine

When it comes to metabolic pathways, I think of how wonderful and intricate our bodies are. There are so many processes and functions that occur just within a cell. Everything is connected in some way which makes sense why all of our body systems rely on one another to function properly. When there is an imbalance in our metabolic pathways it creates changes in our bodies that impact homeostasis. Abnormal chemical reactions can disrupt the body's metabolism, which affects how well the body can break down large molecules and how efficiently they can produce energy. These changes could be detrimental to our health and overall well-being. There is a possibility for long-term effects such as chronic diseases. For centuries, western medicine or mainstream medicine has been able to treat symptoms and diseases using drugs, radiation, or surgery. However, not all biomedicine is effective and people seek out other forms of medicine. Ayurveda is one of them. Ayurveda has been known to treat different illnesses and diseases such as diabetes.

Diabetes is the most common metabolic disease. It is a disease that allows blood glucose to accumulate in the blood. It impacts many different hormones and organs such as the pancreas, that are supposed to help the body regulate blood glucose levels. When a person consumes food, glucose is released from metabolism, however, the pancreas is not capable of producing enough insulin to keep a balance. Insulin is a hormone that helps control the amount of sugar in the bloodstream by storing it as energy for later use. If glucose is not being properly metabolized, then hyperglycemia can occur in the bloodstream. Hyperglycemia has many harmful effects such as increased blood pressure, abnormal levels of minor proteins, increased neonatal morbidity and mortality, etc. Overall, diabetes can greatly impact the body’s balance and cause future long-term problems. 

There are two types of diabetes. Type I diabetes happens when the immune system attacks and destroys beta cells in the pancreas that produce insulin. Type I diabetes is usually more prevalent in children and young adults, however people of older age can get the disease. There are many risk factors that could potentially cause Type I diabetes. For example, drugs, viruses, infections, and autoimmune diseases. Hereditary predisposition could also be a shocking factor because you are more likely to get the disease if you are of a specific race or ethnic background.  Unfortunately, most cases of Type I diabetes are non-preventable.

When it comes to Type II diabetes there are two types of risk factors. The first one we can’t modify because it involves our inherited genes. Having a specific race or having a family history of diabetes increases your chances of developing diabetes. The second factor is modifiable and can help bring balance back to the body if fixed. This includes having an imbalance in the food we consume. For example, food that can cause high body weight or fat, high blood pressure, and high cholesterol could impact and increase the likeliness of getting diabetes. Not doing enough physical activity can also play a big role. Over the past decade, obesity rates among adults in the U.S have increased. This does not surprise me because the U.S is not the best country for healthy food choices. We have a lot of fast food chains and put healthy food at higher prices than unhealthy fatty foods. Physical inactivity is a large contributor to Type II diabetes because people can become overweight and obese and have many health issues due to it. It is hard to keep a healthy balance without exercising regularly unless we are constantly eating the right foods.

According to the John Hopkins Medicine website, Ayurveda is a natural system of medicine that originated in India more than 3,000 years ago. The term Ayurveda comes from the Sanskrit word Ayur which means life and Veda which means science or knowledge. So Ayurveda can translate to the knowledge of life. Ayurda is based on the idea that a disease can occur due to an imbalance or stress in a person's consciousness, body constitution, life forces, or the environment around them. I like how it focuses on all three aspects because they all make an impact on our health and well-being. Ayurveda encourages people to adopt certain lifestyle interventions and natural therapies to gain a rebalance between their body, mind, spirit, and environment. It is a very natural way to approach certain diseases and illnesses. 

Ayurveda treatment starts with an internal purification process. This means the body must be cleansed from any impurities or disease-causing agents. This is done through a process called metabolic fire or Agni in Sanskrit. Agni can turn food into consciousness and can rule over metabolism everywhere in the body. It can also supervise the exchange of nutrients at the cellular level. According to the article, “An Introduction to Ayurvedic Cleansing,” Agni is the number one defense system against diseases, and if we don’t use it, it could have a bad impact on our overall health. Once the body is cleansed, Ayurveda is followed by a special diet and herbal remedies. For example, eating whole foods like fruits, vegetables, and grains. There are also herbal supplements that can be taken to improve health. If needed, massage therapy, yoga, and meditation could also play a role in the healing process of the illness or disease.

Just like western medicine, Ayurveda has the goal to reduce symptoms and increase disease resistance. However, it goes into more depth to eliminate the body’s impurities, reduce worry, and increase harmony in life. Ayurveda is very popular and is considered a form of medical care in other countries. It can help classify diseases according to their origin whether it be physical, psychological, or spiritual. Interestingly, spirituality is a huge component, and it makes sense because our minds are really strong, and can certainly impact how we perceive our illness. Ayurveda practitioners can help treat some diseases such as anxiety, asthma, digestive problems, high blood pressure, rheumatoid arthritis, diabetes, and more with specific therapies and herbal medicine. This is an interesting approach to healing our bodies, and it can work if our mind and body allow it. Growing up in El Salvador, I would hear of “good witches” or “healers” that could give you certain herbs to cure illnesses. Many people believe in these healers because it seems that their medicine work at least most of the time, however, our minds also play a big role. Sometimes we get sick because our mind and body want to believe that we are sick.   

When it comes to using the Ayurveda medicine system, we have to analyze how diabetes is impacting our body’s balance. Because our body is connected in so many ways, diabetes can affect many parts of the body. For example, high blood glucose can damage eye blood vessels which can long-term cause glaucoma, cataracts, and other issues with your eyes. Because diabetes can lead to high blood pressure, it can increase the risk of coronary heart disease and damage small blood vessels which can later reduce the lack of blood flow. Diabetes can also impact the brain by increasing the risk of a stroke or cerebrovascular disease. Diabetes increases fatty deposits or clots in blood vessels that narrow the path of blood to the brain which can lead to a stroke. One disease can make a huge impact on our entire body. It also controls how we handle ourselves in our environment and lifestyle. What choices should we make to keep a balanced body? Diabetes influences people to change their lifestyle by picking healthier food choices and being more cautious of the environment surrounding them. People can search to do more therapy to not only try to keep balance in their body but also their external forces and even spiritual feelings. 

There are different Ayurvedic approaches to help manage diabetes. According to the article, “Ayurveda and Diabetes: Everything That You Must Know,” the author mentions that using Ayurveda herbs, making dietary changes, lifestyle changes, and detox therapies can all help with diabetes. The article gives different types of foods that can be included in your diet and which ones to avoid. Ayurveda medicine also has home remedies which can be very helpful to people who cannot afford to go to a doctor/physician. Using the Ayurveda approach can be a new way to gradually change the disease. It looks at different reasons for what can trigger the disease, and it has potential healthcare measures to treat the disease. 

In conclusion, diabetes is a metabolic disease that changes many aspects of someone’s life. From the body to the spirit, to the social environment. People tend to focus more on the body of a person without thinking of the external factors that may be causing the illness. Some people cannot afford to buy healthier food items or go to a gym. People may not know the short and long-term effects of constantly making poor lifestyle choices. Some people have inherited the disease, which is not their fault. Ayurda allows for more explanation of those external factors. Of course, no medical system is perfect however, everyone finds something that works for them. If this method can help you increase your well-being and manage a better lifestyle then why not try it? 

                                                                References

Ayurveda. (2019, December 02). Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/ayurveda#:~:text=Ayurveda treatment starts with a primary basis of ayurvedic medicine

Ayurveda. (n.d.). Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ayurveda

Ayurveda and Diabetes: Everything That You Must Know! (n.d.). Retrieved from https://www.keralaayurveda.biz/blog/ayurveda-for-diabetes-guide-to-wellness#:~:text=In Ayurveda, diabetes is referred, referred to as Kapha Prameha

An Introduction to Ayurvedic Cleansing. (n.d.). Retrieved from https://www.banyanbotanicals.com/info/ayurvedic-living/living-ayurveda/cleansing/an-introduction-to-ayurvedic-cleansing/

Type 1 Diabetes: Causes, Symptoms, Complications & Treatment. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes#:~:text=Type 1 diabetes develops when lack (deficiency) of insulin

What Is Type 1 Diabetes? (2022, March 11). Retrieved from https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

Ayurveda and Diabetes

    I first delved into what the definition of Ayurveda was. The word's derivation is interesting, ayur (life) and veda (science or knowledge), basically meaning the science of life. It has historical roots in India from more than 3,000 years ago. Ayurveda is based on the idea that disease or sickness is because of an imbalance in consciousness and promotes regaining a personal balance within the body through special diets, herbal remedies, massages or other therapy, and meditation.

I think it is interesting that Ayurveda healthcare providers can’t be licensed in the United States, with no certification or training with National standards. Many articles I found cautioned exclusive use because there isn't licensing, it could negatively interact with western medicine's effects, and the FDA doesn't regulate Ayurvedic products because they are considered dietary supplements thus not needing the rigorous screenings that traditional drugs go through for approval. An article from John Hopkins University said that “While Ayurveda can have positive effects when used as a complementary therapy in combination with standard, conventional medical care, it should not replace standard, conventional medical care, especially when treating serious conditions” (2019). 

It is important to think about how some aspects of Ayurveda are expressed in western culture. One of its main core principles is the necessity of balance, and we are taught the importance of a healthy and balanced diet, regular exercise, and enough sleep to maintain our body’s health. This will strengthen our immune system and prevent health problems from what imbalances can do to us. Imbalance is found everywhere; sedentary lifestyles and bad food choices are a couple of examples. Ayurveda emphasizes the prevention of disease and health promotion, so parts of it just go by another name.

Considering if type 1 diabetes can be safely managed with only aspects and treatments from Ayurveda, my initial thought is no, because of the need to accurately measure blood glucose levels. I cannot think of a way to do that by natural means. The secretions of the pancreas (or lack thereof) need to be very precise in order to keep levels in homeostatic equilibrium. Ayurvedic treatments are not sufficient or at least to the level that western medicine can provide for the treatment of diabetes. Improper maintenance can lead to hyperglycemia, and so many adverse effects can result from that. I don't think it would be worth it to consider ayurvedic treatments based on the science and treatments available to us. 

As the quote above from John Hopkins University states, using Ayurveda as a complementary therapy could be useful to someone battling type 2 Diabetes. A study conducted by the University of Nottingham found that some Ayurvedic treatments are effective in maintaining blood sugar levels. The systematic review included 219 articles with 199 randomized control trials. The researchers have developed a clinical guideline for managing type 2 diabetes by Ayurvedic Practitioners and recommend that high-quality randomized control should be done to further test the applications (Henderson, 2022). 

A monumental issue right now is the rising costs of treatments and hospitalizations for people with diabetes. The average hospital stay for a patient with diabetes is a full day longer than other patients. The American Diabetes Association also detailed this startling statistic:

Findings on hospital populations convey not only an issue around the high costs of diabetes management but also glaring examples of health inequity. For example, while most amputations—which are most frequently associated with the diabetes population and result in extreme direct and indirect costs to patients—are preventable with specialized care, they occur 10 times more often in lower-income populations, where specialists may be less available or hospital staff less well trained to refer these individuals to needed preventive care.

Ayurveda should be explored as an approach to assist in preventative care treatments for those with type 2 diabetes. From what I have read it would be useful to some in treating this very serious health problem and could also help in maintaining their body and extending longevity, as well as helping some overcome the disease. This will ultimately lower the costs associated with diabetes since these amputations will become less frequent and education of proper health practices can reduce the strain of health care providers in these areas of lower income. 

American Diabetes Association. (n.d.). The costs of hospitalization for people with diabetes. The Costs of Hospitalization for People with Diabetes | ADA. from https://diabetes.org/advocacy/costs-hospitalization-people-diabetes?utm_source=diabetes-care-cost&utm_medium=website&utm_content=learn-more-4-btn&utm_campaign=ADV&s_src=online&s_subsrc=costs-hospitalization-people-diabetes 

Chattopadhyay, K., Wang, H., Kaur, J., Nalbant, G., Almaqhawi, A., Kundakci, B., Panniyammakal, J., Heinrich, M., Lewis, S. A., Greenfield, S. M., Tandon, N., Biswas, T. K., Kinra, S., & Leonardi-Bee, J. (2022). Effectiveness and safety of ayurvedic medicines in type 2 diabetes mellitus management: A systematic review and meta-analysis. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.821810 

 Henderson, E. (2022, June 8). Ayurvedic medicine is effective in blood sugar control in patients with type 2 diabetes, study finds. News Medical. Retrieved September 30, 2022, from https://www.news-medical.net/news/20220608/Ayurvedic-medicine-is-effective-in-blood-sugar-control-in-patients-with-type-2-diabetes-study-finds.aspx#:~:text=by%203%20people-,Ayurvedic%20medicine%20is%20effective%20in%20blood%20sugar%20control%20in,type%202%20diabetes%2C%20study%20finds&text=A%20new%20study%2C%20led%20by,patients%20with%20type%202%20diabetes. 

John Hopkins University. (2019, December 2). Ayurveda. Johns Hopkins Medicine. Retrieved September 30, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/ayurveda#:~:text=Ayurveda%2C%20a%20natural%20system%20of,translates%20to%20knowledge%20of%20life. 

Ayurveda and Diabetes

 Ayurveda is a natural medicine, or maybe more of eastern medicine. I think of it as non-allopathic medicine. It literally means when translated to sanskrit life knowledge or science. Ayur means life and veda means life or knowledge. The idea behind it is that imbalance in the body creates disease and balance prevents it. It is a concept that promotes the idea that a balanced lifestyle can be used as a preventative medicine. Ayurvedic medicine uses many natural products and practices like herbs and meditation to treat imbalances between the life forces and body. The primary focus is interconnectedness and balance between the two.

    Ayurvedic medicine or people that practice it are not licensed to do so in the United States. It is considered equal to western medicine in India though. There are some instances where ayurvedic medicine has shown to be complementary to western medicine but the substances used in ayurvedic medicine are considered dietary supplements not drugs. Due to this classification they can be agonists or antagonists of traditional drugs used in western medicine. This makes it very important that you tell your physician if any ayurvedic interventions are being used. Healthcare professionals should still be in charge of diagnostics and western medicine techniques should not be replaced by ayurvedic techniques. 

There are different small studies showing effectiveness of ayurvedic medicine in osteoarthritis, rheumatoid arthritis, type II diabetes, and ulcerative colitis. To conduct these studie they compared the pain relief ayurvedic technique provided against the traditional treatment. There were comparably similar results for both routes for people with osteoarthritis in their knees. Results were similar for the rheumatoid arthritis study. The diabetes trial was said to be helpful but later researchers decided it was inconclusive. In the ulcerative colitis study turmeric was used and said to be “helpful” but not much evidence to prove anything. These studies show that there is potential for ayurvedic medicine in pain relief for specific diagnoses although they don't prove to be better than already used techniques by traditional health care professionals. Potentially useful techniques may not be fully safe though there is evidence showing people practicing these techniques have significantly higher levels of lead in their blood. As well as half the people testing high for lead also tested high for mercury and rarely there are instances of arsenic poisoning that are attributed to ayurvedic medicine. 

While this is one of the oldest techniques to treat disease there are five known principles. Those being vayu, jala, aakash, prithvi, and teja. Also known as air, water, space/ether, earth, and fire. In addition to these five principles there are three humors called the tridoshas; Vata dosha, Pitta dosha, and Kapha dosha. They are believed to control the human body's physiological functions. As well as the tridoshas there are subdoshas as well. Each controlling different parts of the body and important functions for basic health. Balance of these three tridoshas would be healthy and anything causing imbalance could result in disease. Ayurveda also believes in seven types of tissues, the Sapha Datus. They work together to create the balance that is health. 

In conclusion, Ayurveda is an ancient form of non-allopathic medicine. This consists of many principles that are believed to create the perfect balance that result in a healthy individual. There is not great scientific evidence of the effectiveness or safety of these techniques but they are based on using natural elements and practices such as herbs, meditation, yoga, and soil. There are studies with qualitative data saying some techniques reduced pain in specific diagnoses previously stated. There is quantitative data showing high amounts of metals that may be damaging in the blood stream of patients who practice these techniques.  Ayurveda is focused on the balances and imbalances between the body and life. Although this is a sacred practice in India and maybe other eastern cultures it's not a licensed therapy in the US today. 

What is diabetes? A disease that comes from an imbalance in glucose levels, there are different causes and treatments as well as different types of diabetes. The most common types are type 1 and type 2. Type 2 is more prevalent than type 1 but both have different onsets. Different factors play into each type differently but both result in imbalanced glucose levels. 

Type 1 diabetes usually has a sudden onset and occurs mostly in  young children. It can occur in all ages but much more common in adolescents. Insulin levels are usually absent or decreased compared to normal and these patients are often insulin dependent. Meaning they will need to inject synthetic insulin to maintain regular bodily functions. Usually patients with type 1 will be thinner and are at a higher risk for ketoacidosis. 

Type 2 diabetes is more common. It is usually present in obsese adults and in contrast to type 1 has a more gradual onset. Mostly in adults rather than pediatrics which is opposite of type 1 as well and they also have a lower risk for ketoacidosis. Their insulin levels may be decreased, increased, or even normal. This is much more common in the United states. 90-95% of the diabetics are type 2 this could correlate with the obesity levels in the states. 

There are many causes of type 1 diabetes such as hereditary predisposition. Environmental factors can also be a cause of T1 as well as damaged or removed pancreas. There are many other causes as well. The treatments are taking insulin and managing blood glucose levels. There are different ways this can be done as well. You can do this manually and in intervals measure your blood glucose and take the right amount of insulin through a calculation that mostly needs to be done before eating. Another way is to have this done automatically you can get two devices that you insert into your kin as ports and they check your blood glucose and then another device to inject the insulin accordingly. There's currently no cure for type 1 diabete. 

Type 2 diabetes can be a result of many things controllable and noncontrollable. Controllable factors are level of physical activity, high body fat or weight, high blood pressure, high cholesterol. Uncontrollable factors include gestational diabetes, race/ethnicity, age over 45 years, family history of diabetes. The two most common causes are obesity and inactive lifestyle. Type 2 diabetes management usually involves weight loss, healthy eating, regular exercise and things along those lines. There is no cure for T2 as of right now. 

Gestational diabetes is diabetes that is onset or first diagnosed during pregnancy. This type of diabetes changes how your cells use glucose. In most circumstances functions return back to normal after delivery but it does put you at higher risk for type 2 diabetes. There are people that become permanently diabetic from gestational diabetes as well. This disease is scary because it can affect the health of the mother and her baby but can be managed by controlling blood pressure, eating healthy, and the use of some medications. It is unsure the cause of gestational diabetes but it has been hypothesized that it can be due to a hormonal shift that happens during pregnancy and the great impact multiple hormones have on regulating blood glucose levels. One of the major effects this can have on your baby is it can be born hypoglycemic which may lead to it having seizures. Another result can be a stillbirth so it is extremely important to visit your doctor before getting pregnant to understand your risk of getting gestational diabetes. There are not very many symptoms that can indicate this sometimes frequent urination but frequent urination is common for pregnant people. 

Outside of diabetes there are multiple physical inactivity related causes of deaths that take many lives in the United States every year. These diseases include heart disease, malignant neoplasms, cerebrovascular diseases, and essential hypertension and hypertensive renal disease. All of these were in the top 15 leading causes of death in 2013. Obesity severely slows metabolism which increases risk for imbalances in the body. If we are looking at the standard of ayurveda these imbalances are what cause the disease.

Diabetes is a very costly disease they actually spend more than double what other patients spend annually on average. Costs have increased and are continually rising in the United states. In 2012 it was estimated that the cost of diabetes was 245 billion dollars. Not only is diabetes expensive on its own, the effects of diabetes lead to costly medical care as well.  Hypoglycemia that requires hospitalization on average costs 16,000 + dollars every time it occurs. Of course this is sometimes avoidable by proper management but is sometimes very hard to control. The most expensive procedure that diabetes can induce is renal disease which is about 71,000 dollars. This doesn't even take into consideration the disability and sometimes inability to work due to diabetes or obesity. 

The economic costs of diabetes can be detrimental to diabetic patients. The price of insulin right now can range from 300-1000 dollars for a one month supply. Insulin is not the only thing diabetics need but due to the insane cost that has risen 54% 2014-2019 is very dangerous. One effect of these high prices can be insulin rationing due to the inability to have enough to adequately manage the disease. Inadequacy to manage diabetes can be fatal for patients or lead to things such as diabetic comas which as stated above cost even more per every event. 

In conclusion, Ayurveda is an ancient form of non-allopathic medicine. This consists of many principles that are believed to create the perfect balance that result in a healthy individual. Diabetes would be an example where an imbalance in the body results in a disease or illness. Diabetes has an imbalance in blood glucose levels. There is not great scientific evidence of the effectiveness or safety of these techniques but they are based on using natural elements and practices such as herbs, meditation, yoga, and soil. There are studies with qualitative data saying some techniques reduced pain in specific diagnoses previously stated. There is quantitative data showing high amounts of metals that may be damaging in the blood stream of patients who practice these techniques.  Ayurveda is focused on the balances and imbalances between the body and life. Although this is a sacred practice in India and maybe other eastern cultures it's not a licensed therapy in the US today. 

Diabetes Through the Lens of Ayurveda

  Biological systems naturally strive to reach a state of equilibrium, whether it be at the cellular or organism level. When the body’s delicate balance is disrupted the consequences to health can be hugely damaging and in many cases fatal. The detriments of unbalance in the body is the primary idea behind the Indian healing concept Ayurveda which emerged over 3,000 years ago.

    Ayurveda is a holistic form of medicine that attempts to repair and maintain the precarious equilibrium between the mind, body, and spirit. Practitioners of this system believe that when this balance is interrupted, sickness and disease are the natural result. Disease prevention and treatment through balancing of these three systems is the ultimate goal of Ayurveda.

As with any form of alternative medicine, there are a multitude of associated pros and cons. Many diseases go far beyond the scope of holistic medicinal practices and few ailments should be treated with this method alone. But, the underlying principle of Ayurveda certainly has some points that can be beneficial to consider when trying to better understand both the causes and results of disease. 

There are countless diseases that exhibit the concept of Ayurveda in terms of disbalance causing disease, but one of the most prevalent in America today is diabetes. Diabetes is actually a group of diseases, but they have one critical factor in common: an excess amount of glucose in blood. In America alone it is estimated that 37.3 million, roughly 1 in 10, people suffer from diabetes, and these trends show no sign of leveling. One study projected that if this number continues to increase at its current rate 1 in 3 Americans will be diabetic by the year 2050 making this a public health issue of dangerous proportions.

Looking at this disease through the lense of Ayurveda we see that the initial imbalance of diabetes is high blood sugar. One of the most critical responsibilities of the pancreas is maintenance of blood glucose levels. This is accomplished through production and secretion of insulin and glucagon in beta and alpha cells respectively. These two hormones act as antagonists to one another as they carefully balance glucose levels in response to the presence or lack thereof of sugar. When blood glucose levels fall glucagon is secreted and can raise the blood sugar through a number of metabolic pathways including gluconeogenesis. Once adequate amounts of glucose have been released into the blood a feedback loop signals for secretion to end. Insulin is the counterbalance for this hormone. Its primary purpose is the lowering of blood sugar through enabling glucose uptake into cells. 

Type 1 and 2 diabetes both result from this imbalance though the mechanism is very different. Type 1 diabetes can result from a number of factors, but it often occurs when the immune system attacks the beta cells of the pancreas in an autoimmune response. This damage results in beta cells being unable to produce adequate amounts of insulin to meet the body’s needs creating a relative imbalance between glucagon and insulin secretion. Type 2 diabetes is the result of two issues regarding insulin: inadequate production and processing. Overnutrition requires the body to secrete higher levels of insulin in response to elevated levels of blood sugar. Over time the body’s cells experience stress as a result of this enhanced insulin secretion and begin to exhibit reduced responses to the hormone. This is known as insulin resistance. Insulin resistance interferes with uptake of glucose into the cells causing blood sugar levels to rise. This stress to the cells can cause glucagon secretion to occur prompting further release of glucose into the blood where it can no longer be processed effectively. As a result of these stresses to the body the pancreas can experience damage resulting in lowered production of insulin. 

The body’s systems are all tied together through a multitude of pathways. This means that imbalance in one system catalyzes unbalance in others, so the effects of high blood sugar are felt far beyond the pancreas. One major risk of untreated diabetes is the development of ketoacidosis. Over time the cells become exhausted in the absence of glucose, and in response the body begins to break down its fat reserves at a rapid rate creating a buildup of ketones in the blood. Under normal conditions these ketones can be processed and balance can be restored, but in excess they cause the concentration of hydrogen ions in the blood to increase, lowering the pH in turn. This causes a condition known as diabetic ketoacidosis which has a rapid onset and can be fatal without proper medical care. Potential complications associated with this condition include swelling of the brain, fluid within the lungs, and organ failure. 

Diabetic ketoacidosis is only one of the many health issues that can result from diabetes. Increased risk of stroke, heart disease, gangrene in the extremities, and neuropathy are also present on the long list of complications associated with the imbalances caused by the disease. But, a lack of balance in the body is not contained  exclusively to the organism it affects. If we expand the ideas of Ayurveda beyond just health we can see how one seemingly small imbalance can create a domino effect far greater than its initial cause. Untreated high blood sugar does not only harm the stability of countless organs and organ systems, but also society and the economy.

“Economic Costs of Diabetes in the U.S. in 2012” was written and published by the American Diabetes Association to examine exactly how much economic burden was associated with this common disease. The ADA found that in 2012 alone diabetes cost Americans $245 billion between direct medical costs such as injectable insulin and reduced productivity in the form of absenteeism, presenteeism, disability, and premature death. These costs are not only shouldered by the individuals diagnosed with diabetes and their families but by society as a whole. 

Many risk factors for developing diabetes are unavoidable. Genetics undeniably play a role in development of both types of diabetes, and risk for type 2 diabetes increases with factors beyond the control of individuals such as age. Diseases such as PCOS and even pregnancy can contribute. These imbalances within the body cannot be balanced directly. But, many cases of type 2 diabetes development can be attributed to lifestyle. Poor diet and lack of physical activity are the initial destabilizers that contribute massively to this pandemic through resulting obesity. Individuals who develop diabetes from “avoidable” risk factors often face heavy stigmatization, but to fully understand this issue we must first understand the role that physical and social environments being in imbalance have on poor lifestyle. 

Many studies have found a high level of correlation between diabetes and low income levels. This correlation is due to a number of factors. Some of these include low income communities being more at risk for qualifying as food deserts where access to high quality, healthy food is low or priced exorbitantly when available. Education quality is also often lower in these areas which results in many not fully understanding the importance of nutrition and exercise, and reduced access to neighborhood resources that encourage physical activity also plays a role. All of these imbalances in a social environment put individuals at greater risk of poor health. Making changes that benefit the overall health of low income communities would not entirely eliminate type 2 diabetes, but it would drastically improve the number of individuals being diagnosed with this disease. In turn this would directly ease the societal burdens of diabetes. 

One of the primary takeaways that can be gained from study into Ayurveda is that disbalance of systems, whether it be in the body or society, results in negative effects. We cannot look at a topic as complicated as diabetes from only one vantage point. We must instead consider the immense interconnectedness of countless factors including preventative care, disease-associated complications, public health education, poverty, etc. to understand the true impacts of what can begin as high blood sugar initially. Diabetes is a disorder that should be treated with scientifically-based Western medicine, but the causes and resulting complications should be examined with Ayurveda in mind to truly comprehend the dangers of allowing unbalances in any system to go unchecked.

Ayurveda and Diabetes

 

Ayurveda and Diabetes

              Diabetes is a massive widespread disease that affects many people throughout the world. 415 million people in the world are dealing with diabetes and that number is steadily increasing. 37.3 million Americans are diagnosed with diabetes, and around 1 in 5 people don’t know they have it. As many people are able to live normally with diabetes, for a lot of people it can cause some major health problems that impact their daily lives. Diabetes affects how your body either makes or uses insulin, which is vital for converting sugar into the energy our bodies need to function. Type II diabetes is more common than type I, as type I is genetic, and type II is associated with obesity and can be prevented. Ayurveda, a type of approach to medicine that involves the whole body instead of just the parts, can be applied to diabetes patients to be able to deal with their condition and live a happy, healthier life.

              Ayurveda originated in India over 3,000 years ago and the name comes from Sanskrit. Ayur means life, and veda means knowledge. So ayurveda literally means the knowledge of life. Ayurveda can be used to help with diabetes by establishing a connection between the whole body and the mind instead of just one part of the body. Many of the treatments include using herbs, different diets, and lifestyle changes. This isn’t vastly different from what a traditional doctor would tell you to do outside of their medical practice on your own. A lot of ayurveda seems to be pretty intuitional, just keeping your body healthy and doing what you can to lessen the symptoms of the disease. Little changes like increasing exercise, choosing healthier more balanced meals and snacks, and even dealing with stress in a productive way can have a huge impact on your overall health and wellbeing. Like with anything, little changes overtime help achieve greater things than trying to do it all at once.

              Of course, ayurveda isn’t just limited to treat diabetes, it can be used to treat many chronic illnesses where patients can’t seem to find relief any other way. When I first heard about the idea of ayurveda, I was honestly a little skeptical. I fully believe in the importance of establishing a good connection with the mind and body and doing as much as you can to keep your body healthy. However, I also believe in science and medicine and the power to heal through medication. Fully relying on ayurveda I think can only solve half of the problem in most cases. With diseases that literally have life saving medications, just treating with ayurveda probably isn’t going to help you out as well. I think the best approach is to combine the two, to treat diseases with medicine but also with ayurvedic approaches. I think then can we see a huge impact of the two working together to solve what’s going on at the source while simultaneously helping the body as a whole.

              Applying this idea to diabetes, taking insulin is an essential treatment for type I, but can also be accompanied with regular exercise and healthy eating. For type II, it is imperative to maintain a healthy lifestyle to lessen the effects of diabetes on the body, as well as treating conditions that may have risen from diabetes through medications. I think ayurveda is most important when it comes to preventing diseases, as it can help establish that good connection with the mind and body and have better habits overall. Ultimately, combining the idea of ayurveda along with seeing a doctor to help relieve particular symptoms can be very beneficial and I think the most productive way to manage disease.

 

Sources:

Ayurveda and diabetes: Everything that you must know! Ayurveda for Diabetes: Types, Symptoms and Home Remedies. (2022, June 23). Retrieved September 30, 2022, from https://www.keralaayurveda.biz/blog/ayurveda-for-diabetes-guide-to-wellness#:~:text=In%20Ayurveda%2C%20diabetes%20is%20referred,referred%20to%20as%20Kapha%20Prameha.

Centers for Disease Control and Prevention. (2022, January 24). The facts, stats, and impacts of diabetes. Centers for Disease Control and Prevention. Retrieved September 30, 2022, from https://www.cdc.gov/diabetes/library/spotlights/diabetes-facts-stats.html#:~:text=37.3%20million%20Americans%E2%80%94about%201,t%20know%20they%20have%20it.

Diabetes our Metabolic Disorder

 Our metabolic pathway is astoundingly complex, many different pathways working together to have our metabolism working systematically. When working in proper order it provides our organism the energy needed. When laid out on a screen it seems easy for something to go wrong. When something changes in the environment often the metabolism will also change. Some instances this is positive, on other occasions it is the opposite and sometimes deadly. Organisms faced with predators often enter into a spontaneous fight or flight response. Oxygen consumption skyrockets and with it the metabolic rate increases. When the presence of the predator is constant the opposite reaction takes place, metabolic rates decrease [2]. Both responses of the prey could mean the difference between life and death.

In humans having properly functioning metabolic pathways are equally important. Many people are faced with a metabolic disorder, diabetes. Diabetes doesn’t just affect the insulin level of a person it leads to other unwanted issues. One in particular being peripheral artery disease, PAD [3]. PAD is the beginning step to many more issues, some can be poor blood circulation to the lower extremities. If untreated it may lead to visible conditions of disease ravaging the body. Known as critical limb ischemia, CLI, usually affects the lower extremities of the body and in many cases amputation is needed. Again, improper insulin levels are not limited to CLI, it can also cause increased heart problems, nerve damage and many a list that can extend a mile long, if formatted correctly. Those who live with diabetes but lack treatment would surely have a decreased life span.

Almost everyone in a first world country knows someone who has diabetes. This is due to many factors, including poor diets, more sedentary lifestyles and late intervention, in most cases the islet cell mass is only 25 percent of the original cell mass. If culture itself makes us “prime breeding grounds” for diabetes what is the solution?

Discussions between myself and a group of peers lead to the future possibility of growing a  new pancreas which would be the ideal cure for diabetes. While that is not yet an option for all who deal with diabetes. Current treatments of insulin pumps and when needed special clothing for those who had PAD will have to suffice. But this disease can no longer be only viewed as the individual's problem when it has effects on the whole human race. Consistently diabetes and inactivity are the top killers of people in the United States. However, because the apple doesn’t fall far from the tree, obesity tends to run in families. Not genetically but because the habits of the parents pass onto their children. By following Ayurveda this may be possible. Ayurveda includes the healthcare practice of treating the whole body instead of only the symptomatic regions. Completed in a 4 part process of cleansing, reducing the intensity of the disease, rejuvenation, and mental nurturing and spiritual healing [1]. 

Cleansing may consist of higher health standards among the many organizations that give quick access to food. Reduction would consist of teaching and encouraging a healthier lifestyle, which could be combined with rejuvenation. A shift in our culture in promoting healthy bodies, not the current trend that “all bodies are beautiful.” Then mental nurturing and healing of mental disorders would help people be able to function and become healthier. Through the combination of modern medicine advancement and Ayurveda we can overcome our metabolic disease.

Citations:

1. Jayasundar, R. (2010). Ayurveda: a distinctive approach to health and disease. Current Science, 908-914.

2. Steiner UK, Van Buskirk J (2009) Predator-Induced Changes in Metabolism Cannot Explain the Growth/Predation Risk Tradeoff. PLoS ONE 4(7): e6160. https://doi.org/10.1371/journal.pone.0006160 

3. Thiruvoipati T, Kielhorn CE, Armstrong EJ. Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes. World J Diabetes. 2015 Jul 10;6(7):961-9. doi: 10.4239/wjd.v6.i7.961. PMID: 26185603; PMCID: PMC4499529

Ayurveda and diabetes

    Ayurveda is a natural form of medicine that was found in India. It’s used as more of a lifestyle medicine than a prescription. Ayurveda is used as a therapy to regain balance in life. This can be between the body, mind, spirit and the environment around the person. The natural therapy begins with a purification process that may include massages, yoga, a specific diet and meditation. Exercise and diet are especially important in maintaining a balanced and healthy life. This method is used in hopes to resist the chance of disease. It’s also used to reduce symptoms of sickness or disease a person might have as well as add harmony to their life. This is very similar to the term biologist know as homeostasis in the body, constantly trying reach an equilibrium. 

    Diabetes is a great example of what happens when the balance in the body is disconnected. There are multiple types of diabetes, each having their own imbalance in the body with sugar levels. There are 2 types of diabetes, type 1 and type 2. Type 1 occurs suddenly at mostly young ages but can occur at any age. It tends to occur in the more thin or normal body habitus. Endogenous insulin can be low or absent in type 1 and ketoacidosis is common as well as autoantibodies are usually present. Type 2 gradually occurs in adults and tends to be the opposite than Type 1. It is often common in the obese body habitus and ketoacidosis is rare. Autoantibodies are absent in type 2 along with normal, decreased or increased endogenous insulin levels.

    Beta cells have a lot to do with diabetes and the organs affected. The pathways are all connected to the beta cells in the pancreas. The pancreatic beta cells are producing insulin and from there contribute to the pathways. From the final common denominator from insulin, there are a couple different pathways that can occur. It can cause hyperglycemia through 3 different pathways. The first is the incretin effect that causes hyperglycemia and the kidney increases glucose reabsorption. The second is the alpha cells are defected resulting in production of glucagon leading to hyperglycemia. The last pathway resulting in hyperglycemia is the final common denominator producing amylin. From here there are 2 pathways able to reach hyperglycemia. The first being going straight from amylin production to hyperglycemia. The second way, the amylin leads to increased rate of glucose absorption in the stomach and small intestine the causes hyperglycemia. 

    The pancreatic beta cells also affect the brain, colon and immune system. The insulin final common denominator can affect the brain by increasing appetite, decreasing the dopamine surge, and increasing sympathetic tone. The final common denominator can affect the colon and biome due to the abnormal microbiota and the possible decrease of GLP-1 secretion. Its effect on the immune system is immune dysregulation and inflammation. The final common denominator can lead to insulin resistance. Insulin resistance can affect the liver, muscles and adipose. It increases glucose production in the liver, decreases peripheral muscle uptake in the muscles and increases lipolysis in adipose tissue. There are a lot of ways diabetes affects other organs and pathways and most times can result in health issues. 

    In 2013, diabetes was the 7th leading cause of death. There are a couple different factors that play into diabetes being so high on the cost for the person living with the disease. The direct factors are more correlated to the economy and dealing with money. The cost for diabetes is 2.3 times higher than other patients. The cost has increased by 41% costing billions of dollars to those who suffer from the disease. A person being hospitalized for hyperglycemia is charged more than $16,000. All treatments for the damage diabetes can do to the patient ranges from $2,000-$40,000. The indirect costs are more due to the inability to move, work or being disabled.

    A study in 2012 found that the estimated cost for diabetes was $245 billion dollars. Most of this price comes from medical costs from in-patient hospitalization. In five years, the price was increased by 41% for treatment of diabetes. Although there is already a burden of having to live with a disease, there is now also the burden of costs for treatment added on to that. The consequences are very high and draining on the body then added cost make it very difficult and expensive to live with diabetes.

    Although diabetes is very expensive directly and indirectly, it is also very taxing socially. Many focuses with treatments are related to diet and exercise. Patients with diabetes are being monitored with activity and diet because this can impact their daily lives and how they feel day by day. Their physical and social environments are also observed to have poor living conditions and income and education all play a role in overall health. This can be where Ayurveda comes in to play. Finding a balance in life with food and health and become a treatment option. Although treatment like insulin is very high in cost, a balance in life can be easy to obtain. Taking time for yourself can be nearly free, because swapping out food choices and going on walks for exercise are not very costly. People being labeled to have diabetes can also be difficult on the patient, especially at a very young age. There are consequences that come with poor social factors. In poor conditions, obesity can run in the family. It can be more susceptible for newborns to be born with diabetes as well. It can also lead to a person being high stress, higher chance for depression and anxiety and mental health issues. People suffering with diabetes are often times categorized and known to be “the person with diabetes.” A friend of mine had type 1 diabetes, and since elementary school he was always known as the “diabetes kid.” Our classmates at this time had no clue what that was at the time, but the name stuck from there on out.

    Although Ayurveda isn’t an exact solution, it is a form of treatment that more people should be aware of. A balance of life is just as important as medication prescribed because it can keep people in better condition. I didn’t believe that it was a true solution, but a balanced life helps maintain a healthier lifestyle. For many people, getting a better balance of their environment, mind and body can make all the difference. In some cases, like diabetes, it has to make all the difference. When all that is available is limited treatments, the patients have to find ways to have a healthy balance. Ayurveda should be taught and practiced more to try for a healthier, well-balanced lifestyle and purification of sickness. Healing and balancing may at times be more beneficial than trying 3 different prescriptions as a treatment.

The Avatar, Ayurveda, and Disease.

Water. Earth. Fire. Air. Space? Almost a perfectly executed introductory scene of Avatar the Last Airbender. The ancient Ayurveda medicine and its practices base itself on the proclaimed truth that all the universe originates from these 5 elements. Each of these elements represents balance beyond its physical meaning, and each is associated with its own qualities, foods, senses, emotions, and Chakras. What better way to learn about the balance between these elements than to learn from he who mastered all of them: Avatar Aang. I consider Avatar the Last Airbender not only a great show but a decent depiction of some of these values and beliefs which I intend to explore. In fact, one of its episodes features a guru from whom the Avatar learns about the Chakras of the body and how to open them. Disease can be considered in the context of the principles of Ayurveda to be an imbalance of many sorts, and I intend to explore the imbalance relative to these Chakras.

Chakras are explained to be “wheels” of energy within us. They are not physical; they are not anatomical like our organs and systems. Again, they are “pools of energy” which are opened and closed by maintaining and expressing certain emotions. Having them open equates to having a balanced self and yields power and health.

The first Chakra is Muladhara, the Root Chakra. Located at the base of the spine, it is associated with safety and survival. It is connected with the Earth. This Chakra is antagonized by feelings of fear. Opening this wheel requires one to acknowledge their own fears, but not letting them overwhelm you. The second Chakra: Swadhisthana, associated with Water. It represents sensuality and pleasure. It is opposed by guilt. Guilt can be a powerful burden and a poison to our own self. Next, the Fire Chakra, Manipura. It is in the stomach and represents courage and willpower and opposes shame. Anahata, the Heart Chakra is love. It’s blocked by grief. Vishuddhi¸ the Throat Chakra is opened by trust. Ajna is opened by intuition. Sahasra¸ represents mortal transcendence and divinity.

In terms of contemporary Western medicine, all of this information can quickly fade into irrelevance. Surely, “opening” all these Chakras cannot scientifically be proven to be the cure for any disease, but the significance of a healthy mind has been increasingly tied to a healthy body. Especially in today’s prevalence of depression and anxiety, it has been observed how an unhealthy mind can quickly affect the rest of the body and its health. The effects of stress are known to be detrimental, and the physiological consequences of excessive distress are detrimental to the body, even leading to increased risks of disease. So, while we may not understand the mechanisms yet, it’s plausible that other emotions and manifestations of the brain have a greater effect on the body than we currently understand. Just as a conscious thought in our mind provokes a muscle contraction through a physiological cascade, and just as a distressed mind and its associated hormones take an effect upon the body, so can other emotions positively and negatively play a large role in the balance of the bodily systems.

In regard to a specific disease like diabetes, these practices may not be a cure, but it’s curious to wonder about the efficacy of prevention that they provide. Important to remember is that Ayurveda is much more than Chakras. The balance of diet plays a great role. And the excess or lack of certain foods would definitely contribute greatly to the incidence of a disease like diabetes. Still, I think that the mind must be a significant factor in this and any other disease. A balance of the mind can prevent excessive stress. I think researchers must not be far from discovering just how important mental health is in regard to the overall health of our body. And when, or if, they do, we’ll know that the ancient practitioners of Ayurveda were on to something thousands of years ago.

Ayurveda in Medicine: The Imbalance that is Diabetes

     Almost everyone with a scientific background is familiar with the term of homeostasis, and its importance to the body. This mechanism is vital to life, as all living organisms try to reach a balanced, stable state whilst their environment constantly changes (either drastically or minimally). When we talk about homeostasis, we generally think about pH levels, body temperature, fluid balances, etc. which are maintained via physiological processes and pathways. The many different systems in our body are constantly adapting their processes to keep us alive in the various different activities, hardships/injuries, and environments that we find ourselves in. While this state of the physical body being in balance, as a whole is, very important, what if there was more to our well-being than this… and that introduces the concept of Ayurveda.

Ayurveda isn’t a commonly heard word in the Western world, as this word originated thousands of years ago in India. With the Western and Eastern worlds differing in many categories, it is no surprise that many haven’t heard this word, however, it has incredible meaning when broken down into its root words. According to PubMed, in Sanskrit, “Ayur” means life and “veda” means knowledge, so Ayurveda literally means the knowledge of life. The concept of ayurveda is one of Eastern medicine, with a much more holistic approach to the treatment of one’s health. As such, ayurvedic medicine is the practice of balancing one’s mind, body, and spirit to promote good health and wellness. 

That being said, Ayurveda can almost be considered a step back from homeostasis, as it encompasses the entire body and not just the physical processes and components. Humans are more than just an intricate compilation of incredible organs, complex biochemical processes, etc.… our conscious mind with our intelligence, personality, and reasoning combined with our bodies makes each and every individual unique. We all have unique beliefs, ideals, and standards that make us different from one another… but each body has its own unique differences, and flaws, that make us physically different as well. As such, each individual cannot be treated in the same, generic ways for physical, mental, and spiritual matters. The more that we read about Ayurveda and other Eastern medical practices, the more we begin to see major differences in the ways that medicine is conducted in the Western world (for the most part) as compared to the Eastern world.

It is a common stereotype that the general course of medicine in the West is that of treating symptoms, rather than treating patients. This is not always the case in Western medicine, because there are those healthcare providers and individuals who treat in a holistic manner rather than as a general compilation of symptoms and stereotype. In holistic medicine and practices, like ayurveda, the goal is to find the root of what may be causing a person symptoms “X, Y, and Z”, rather than just trying to fix the patient’s symptoms. Now, there isn’t anything wrong with conventional medicine and all that comes with every growing modern medicine… but it has its places, with its ups and downs.

For example, a patient may be suffering from recurrent headaches and goes to see a healthcare provider who prescribes them ibuprofen, or other common medications, in order to help with their symptoms. This may alleviate the symptoms temporarily, but once the ibuprofen has metabolized, the headache returns. Rather than attempting to give the patient the next pain medication on the list, the provider may take a step back, evaluate the patient’s history, and realize that there are stressors in their life that are causing the headaches. With this newfound discovery, the healthcare provider could offer the patient resources to help alleviate stress in their life rather than try another medication to “get them by” for some time. 

While this is just a generic, basic example, it demonstrates how just a slight change in our mindset about diseases that terrorize the body may come about and be treated. The viewpoint of ayurveda and holistic medicine is very important because each of us is different and will react to medications and treatments completely different than another person may. With this basic example in mind, one of the largest, most widespread disruptors of Ayurveda in terms of diseases is that of diabetes mellitus.

This disease occurs when the body cannot manage its level of blood glucose (often called blood sugar), which disrupts many processes. When the body is unable to manage its glucose levels independently, this often results in hyperglycemia, or an elevated blood glucose level. Complications that arise due to hyperglycemia include: an increase in blood pressure, impairment of immune system phagocytosis, neuropathy (nerve damage), and many changes to the body’s response to hemorrhage (to name a few). 

There are two different varieties of diabetes mellitus: type 1 diabetes and type 2 diabetes. There are many differences between the two diseases, however, of the biggest is that type 1 diabetes is a genetic, organ-specific autoimmune disease and type 2 diabetes is life-style related disease which can be prevented. Type 1 is usually a sudden onset of the disease, generally occurring at a young age. Type 2, on the other hand, is usually a gradual onset of the disease and generally occurs in adults. In type 1 diabetes, endogenous insulin is reduced or even absent and in type 2 diabetes, endogenous insulin remains around normal (potentially with some increase or decrease).

Diabetes has many impacts on almost every organ of the body. For example, in type 1 diabetes, there is a decrease in beta-cell function/mass and insulin production (all happening in the pancreas). For the brain, diabetes causes an increased appetite, lessened dopamine surge in the morning, and an increase in sympathetic tone. In the colon, specifically our microbiome, abnormal microbiota (and abnormal function of the microflora) can occur. In the stomach/small intestine, we find an elevated glucose absorption, and, in the kidneys, we see increased glucose reabsorption. In the liver, diabetes causes increased gluconeogenesis, in the muscle we see decreased peripheral uptake of glucose, and in the adipose connective tissue we see increased lipolysis. With diabetes (both type 1 and type 2, but sometimes in different ways) impacting our homeostatic balance, it truly is a serious disease.  This is where Ayurveda begins to come into play in terms of diabetes mellitus, and with so many physical and physiological impacts occurring, one’s mind and spirit also get impacted.

Type 1 diabetes mellitus’ is generally caused by a genetic factor, however, there are also a handful of other situations that it can arise. These include damage or removal of the pancreas, environmental factors, drugs/chemicals/toxins, endocrine diseases, and some viruses/infections. Regardless of the cause, type 1 diabetes results from the damage and death of beta-cells in the pancreas. Think of the beta-cells as factories that produce, store, and ship out the hormone insulin. This hormone is vital to the body in combating hyperglycemia, as it signals a pathway in which cells uptake the sugar from the bloodstream, using it for energy. In the majority of type 1 diabetic cases, the body initiates an autoimmune response, fighting and killing its own beta-cells in the pancreas. As such, hyperglycemia sets in because the insulin factories have been shut down. In order to combat this, one must take insulin from an exogenous source, introducing it to the body so that blood glucose can be taken into the cells. We see many individuals daily who struggle with this disease that we don’t even know have it. When this disease is appropriately managed and cared for, we see them living normal lives. These individuals generally have insulin injections or insulin pumps that help them manage their blood glucose levels.

Type 2 diabetes mellitus’, on the other hand, is not the cause of damage to the beta-cells in the pancreas. Instead, this form of the disease is caused by the body’s cells not responding to insulin (which is called insulin resistance). Because of this, the pancreas produces more insulin in an attempt to get the cells to respond. Over time, the pancreas cannot keep up with the increasing demand of insulin, and type 2 diabetes sets in. The reason that type 2 diabetes is linked to an individual's lifestyle and diet is because when one eats too much glucose, and/or doesn’t exercise to burn the glucose in the cells, blood glucose levels begin to rise. After prolonged elevation, we see insulin resistance set in and blood glucose continuing to rise. Type 2 diabetes is generally accompanied by a large, or obese, body habitus (while type 1 is generally accompanied by a thin or “normal” body habitus). This is one of the biggest issues that we see in the United States of America, as many individuals eat glucose-rich diets, don’t exercise, and do not tend to take the steps necessary to treat their elevating blood glucose levels. Some type 2 diabetics even have to use exogenous insulin, as well as changes to their lifestyle.

While hypoglycemia isn’t the most expected thing to see in a diabetic patient, it can occur. Hypoglycemia is the opposite of hyperglycemia, meaning that it is a result of low levels of blood glucose. Hypoglycemia is generally the result of treating hyperglycemia, and generally an “over-treatment” (in diabetic individuals). I work in the emergency department here in Cedar City and have seen quite a few cases of diabetic hypoglycemia. In most of these cases, the patient either miscalculated the amount of insulin needed or accidentally gave themselves too much insulin. In these patients, I have seen confusion, loss of consciousness, nausea/vomiting, dry mucous membranes, diaphoresis, etc. Generally, hypoglycemia is treated by introducing glucose into the individual’s system, and I have definitely given out a handful of juice boxes to those who are conscious and able to drink. In non-diabetic individuals, hypoglycemia can be a result of decreased food intake. 

On the opposite side of the blood glucose spectrum, when hyperglycemia becomes too high, we see diabetic ketoacidosis. This occurs because the body’s cells are not getting glucose for fuel, so the liver breaks down stored fats in order to produce energy. While in short bursts when needed this isn’t bad, over a prolonged period this can become dangerous. A side product of this fat metabolism is an acid called ketones, which, over an extended period of time build up in the bloodstream to a dangerous level. At this point, the body’s pH is thrown off and requires immediate treatment. In the emergency department when we see patients in DKA, I have found that we generally give fluids, electrolytes, and provide insulin, in an attempt to lower the patient’s blood glucose levels.

With that understanding of diabetes mellitus, we can see just how the use of medications is very important to managing this disease. However, maintaining an Ayurvedic balance of physical, mental, and spiritual well-being has a large role in preventing type II diabetes mellitus. And regardless of the type of diabetes that an individual has, the economic costs, maintenance, etc. can weigh heavy on one’s mind and throw off one’s mental balance. As individuals ensure that they are taking care of themselves in a holistic manner, especially those with impactful diseases, they will not only see a positive increase in their physical health, but also their mental, emotional, and spiritual health.

                                                                        

                                                                       References

Ayurveda. Johns Hopkins Medicine. (2019, December 2). Retrieved September 8, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/ayurveda#:~:text=Ayurveda%2C%20a%20natural%20system%20of,translates%20to%20knowledge%20of%20life.

How long do insulin vials last & how many you need per month? 4Allfamily. (2022, August 9). Retrieved September 30, 2022, from https://4allfamily.com/blogs/diabetes/how-long-does-a-vial-of-insulin-last

Lad V. (1995). An introduction to Ayurveda. Alternative therapies in health and medicine, 1(3), 57–63. https://pubmed.ncbi.nlm.nih.gov/9419799/#:~:text=Ayurveda%20is%20a%20Sanskrit%20word,became%20the%20science%20of%20life.

Miller, K. (2021, March 20). What is ayurveda? treatments, massage, diet, and more. WebMD. Retrieved September 8, 2022, from https://www.webmd.com/balance/guide/ayurvedic-treatments 

U.S. Department of Health and Human Services. (n.d.). Ayurvedic medicine: In depth. National Center for Complementary and Integrative Health. Retrieved September 8, 2022, from https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth

Ayurveda, Metabolism, and Diabetes

Ayurveda is a natural, holistic, and spiritual approach to treating disease. It is centered around the idea that body, mind, and spirit are all linked. Imbalances in one of these areas can cause problems in the others. Ayurveda treatments involve herbal remedies, lifestyle changes, diet changes, etc. (John Hopkins Medicine). I find Ayurveda to be very interesting, especially considering that a lot of it can’t be directly/scientifically proven yet many find Ayurveda practices to work. I do agree that all parts of the body are interconnected with each other. Take the lungs for (a drastic) example. If the lungs were functioning deficiently, every organ, all the way down to the cellular level, would suffer because everything in the body needs oxygen. Changes in one system will usually have some effect on one or more other systems. I like that Ayurveda treats the patient as a whole instead of only focusing on one specific system. Ayurveda practices begin by assessing the individual, then working down to the system level, and when needed the organ level. Modern medical practices favor focusing on specific organs or systems instead of the body as a whole. 

I also think that there is a connection between mind and body, but only to an extent. I immediately thought of the placebo effect and how it is occasionally used by modern doctors to treat symptoms of disease. Ted Kaptchuk, professor and placebo researcher at Harvard Medical School, explained, “The placebo effect is more than positive thinking — believing a treatment or procedure will work. It's about creating a stronger connection between the brain and body and how they work together” (Harvard Health Publishing, 2021). Under the right conditions, patients have been given placebo treatments and the body was able to manage the symptoms simply because the mind believed changes were occurring. I believe the mind influences the brain and the brain influences the body. However, I do not think that the mind has an extensive influence over disease. No matter how hard my grandma wills her diabetes to go away, it won’t. Hence, the mind and body are connected only to a certain extent. 

I also discovered that in traditional Ayurveda practice, attempting to define Ayurveda in scientific terminology would be degrading to the practices. This makes me think that Ayurveda is intended to be more of a spiritual practice and not necessarily a medical one. I wonder how much spirituality can affect health. I tend to be a logical person, and I seek to understand how things work. I found that I had a harder time trying to understand Ayurveda because it isn’t based on ideas that can be directly proven. 

In relation to balance, one characteristic that all cells have in common is metabolism. Metabolism is defined as all of the chemical reactions that take place inside of one cell to maintain proper function. It is a very complex process. Because of this complexity, it has to be tightly regulated to maintain proper function and balance of not just the cell, but the organism as a whole. I connected this to genetics, more specifically the process of DNA replication. DNA replication is so tightly regulated with separate processes in place to fix any errors. Any genetic mistakes that make it through replication to the new cell can kill the cell or cause a variety of other issues (ex. cancer). DNA replication is just one process that takes place inside a cell. It is amazing that so many reactions take place inside each cell on a regular basis and it is done so successfully. This also gives an understanding as to why diseases occur. So many processes have to consistently work properly, and if even one process or reaction goes wrong issues begin to arise. 

Diabetes mellitus is an example of a metabolic disease that throws off the balance of many systems within the body. Diabetes involves issues with the pancreas, which in turn affects blood sugar levels. Blood sugar is regulated by glucagon and insulin which are both produced by pancreatic beta cells. Glycogen and glucose are interconverted by the liver. High blood sugar stimulates the pancreas to release insulin. Insulin will stimulate tissues and cells via insulin receptors to absorb glucose from the blood to lower blood sugar. Insulin also stimulates the liver to convert glucose to glycogen (a storable form of glucose). Both lower blood sugar. Low blood sugar stimulates the pancreas to release glucagon. Glucagon breaks down glycogen back into glucose. The glucose will enter the blood, raising the blood sugar. There are two common types of diabetes. Type I diabetes occurs when the pancreas can’t release insulin because the beta cells are damaged. Without insulin, cells can’t absorb glucose and they “starve in the midst of plenty of sugars”. With type II diabetes, the insulin receptors have been over stimulated, building resistance to insulin. In both cases, glucose isn’t absorbed from the blood and hyperglycemia occurs.  Hyperglycemia leads to many issues in different systems/organs. To name a few, there is greater risk for stroke, heart disease, reduced blood flow in the legs/feet which can lead to gangrene, nephropathy, neuropathy, retinopathy, cataracts, and glaucoma. Diabetes does not just cause issues with the pancreas and liver, it can cause issues in many organs. This example shows that body systems are interconnected with each other. 

A lot of research has been done on diabetes, and the statistics surrounding Type I vs Type II are very interesting. Most interestingly the statistic that for Type II diabetes, there's a 90% concordance for identical twins. Type II is gradual, mostly occurring in adults and tied to obesity. I wonder what accounts for such a high rate occurring in identical twins. Because they’re identical, I would assume that genetics is a major factor. I would imagine there would also be a social role, involving the parental care/upbringing and culture they were raised in. This would be an interesting topic to research more.

I was surprised to see that the majority of costs from diabetes comes from hospital inpatient medical care at 43%. I would’ve thought that the highest costs would be from prescription medications (which are the 2nd highest cost at 18%) because they are purchased on a regular basis. In 2012, 7% of the US population had diabetes which led to a cost of $176 billion in direct medical costs and $245 billion total, which is so shocking (American Diabetes Association, 2013). I would be very interested to see what the costs would be today considering that diabetes is more prevalent than it was 10 years ago.

Physical inactivity and obesity are also examples of interconnectedness. Physical inactivity is described as a pandemic and an epidemic. The google definitions for both are:

Pandemic: “(of a disease) prevalent over a whole country or the world.” Epidemic: “a widespread occurrence of an infectious disease in a community at a particular time.” Some may think that these terms applied to inactivity/obesity are odd, but I do agree they are useful in describing them. I would be more specific and say long term physical inactivity leads to disease. Many life threatening diseases are directly tied to physical inactivity and sedentary lifestyles, heart disease being one of them and the leading cause of death in the US. Diabetes (moreso type II) is also tied to inactivity.

 I wonder how much of a role culture and society play in this large increase of inactivity/obesity/diabetes/etc. We live in a society that is improving inclusivity and acceptance towards groups that don’t fit the “norm”, which includes those who are inactive and those with the associated diseases. This has both pros and cons. I agree that society should be accepting of all, including those with diseases. Most people do not fit the societal beauty standard, so accepting all body types and conditions is beneficial to self esteem and self worth. On the flip side, people begin to neglect their bodies and become content, not caring to worry about future sicknesses that can arise. And now that so many pharmaceutical companies are finding treatments for symptoms, people can care less about their overall well being. I believe this is a major reason why so many affiliated diseases are on the rise worldwide.

I was surprised that in only 7 years, obesity in the US drastically increased. Comparing the self reported obesity diagrams, in 2011 only 12 states had 30%-35% obesity and the rest 25%-30% or 20%-25%. Jump ahead 7 years to 2018 and 9 states are 35% and above, 22 states in the 30%-35% range, the rest in the 25%-30% range (excluding HI, CO, and DC in the 20%-25% range). That is such a large increase in just 7 years. I would be interested to see how the country is now in 2022, especially considering the covid quarantine periods where even more people were physically inactive. I think we as a society should try to find a way to convince people to be more physically active and improve overall health. 

I believe that combining Ayurveda with modern medical practices would be beneficial in treating diseases. Imbalances can affect many areas of the body, so taking the Ayurveda approach to treatment would seem best. All parts of the body are interconnected, including the mind. It is important to take into account all factors when finding solutions to diseases. Although we know much about a lot of diseases, there is a lot of research still to be done. 

Works Cited

American Diabetes Association (2013). Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care, Vol. 36, p. 1033-1046. 

Harvard Medical School (2021). The power of the placebo effect. Harvard Health Publishing.   Retrieved from health.harvard.edu

Johns Hopkins Medicine. What is Ayurveda? The Johns Hopkins University. Retrieved from hopkinsmedicine.org