Ayurveda and Diabetes

    The word Ayurveda is derived from Sanskrit. The Ayur means life and Veda means knowledge. Ayurveda is a knowledge of life and a quest for balance. Disease is the result of an imbalance in consciousness. This knowledge of life helps to maintain or regain balance through lifestyle management and the use of traditional eastern medicine. In other words, it is a natural or holistic approach to overall health. The treatment aims to reduce symptoms by eliminating impurities and increasing disease resistance and harmony in one’s life. Much of the treatment focuses on certain practices and habits like sleep schedules and exercise, but also incorporates food as a preventative and symptomatic treatment to ailments. These foods are mostly plants, but animal products can also be used along with metals and minerals. Taking a closer look at diet, exercise, and lifestyle will help to live ayurvedic principles. Many Indians practice these principles and have for hundreds of years. Ayurveda is even taught as a recognized form of medicine in India. One of the central tenets that is taught is the existence of three doshas, or energies, that are formed from the elements and influence bodily functions. The doshas are known as Vata, Pitta, and Kapha. Imbalances between these doshas can lead to disease. There are certain steps to regain balance when one of these doshas is out of balance. Depending on the specific need, changes in diet, exercise, or sleep may be necessary to rebalance.

One of the benefits of Ayurveda is how individualized it can be. Concepts from papers and videos illustrate that since treatment from Ayurveda will be based on how one feels, the imbalance can be self-corrected, without help from another person. This is a benefit because the symptoms and treatment will coincide perfectly since the data comes from one source. This is one of the arguments in favor of ayurvedic medicine versus western medicine. Traditionally, western medicine has one type of drug that is used by everyone as a treatment. At first glance, this is not a specialized form of care.  However, much of the western medicine we use is also specialized in its own way. Digestive problems do not warrant an x-ray of a foot. Similarly, antibiotic medication is not prescribed as a treatment for hypertension. Individualization in western medicine is apparent in special screenings where DNA samples are analyzed to see which medications will work best for the tested metabolism. This is a personalized form of treatment despite being a type of Western Medicine. While there is a distinction between individualized care in both Ayurveda and western medicine, it appears that western medicine can be specialized when done correctly. Ayurveda has an advantage in its emphasis on self-awareness, by encouraging proactive treatment with diet and lifestyle instead of going to see a doctor. Many patients that come to the doctor’s office do not need treatment because there is nothing wrong with them, or serious enough that it requires treatment from a medical professional. In some cases, more effective treatment would be for the patient to first treat themselves with simple practices stemming from Ayurveda. If those are ineffective, then a visit to the doctor’s office or the emergency department is warranted.

There is a connection between our bodies and the environment. Over the past year I have made conscious efforts to change a lot of my habits to improve my overall well-being. I have noticed a definite difference due to these efforts. Many of these changes were to my sleep schedule, diet, and amount and types of exercise. Taking proper care of the body allows for a higher level of performance. Placing our bodies in environments where they can succeed can help our overall health. This requires the proper fuel, rest, and activities. We can improve physically, mentally, and emotionally by changes that build into habits. Even small adjustments have measurable effects on overall health and performance. In simple terms, the environment that our bodies are in will affect the body for good or bad. Intentional efforts to surround our bodies with good will directly improve our health.  Surrounding it with bad will have the opposite result. There are benefits to health that will come from implementing ayurvedic principles that will improve diet, sleep, exercise, and overall health.

Through work at a family medical practice over the last year, I have learned many things about preventative and overall health. We often think of prescription medicine and vaccinations when we picture a doctor’s office but there is just as much treatment that is patient-driven. We all have the capacity to do good things for ourselves. The efforts that patients can make to improve their health will have a great effect on their bodies and well-being. Efforts such as diet, sleep, and exercise are the first that come to mind.  One of the most impressive things that I have learned is the effect of obesity on overall health. It has caused me to rethink my approach to health, diet, and exercise. This is an example of something within my control and so I have made a lot of changes in my lifestyle. I have had the opportunity to speak to many of the providers about treatment for those who struggle with obesity. My position also allows me to read through chart notes and see the recommendations that providers give to patients to help them to manage their conditions and symptoms. I have been shocked to see how many of these recommendations from medical professionals are forgotten or disregarded by patients. The same pattern of disobedience occurs with diabetic patients, many of whom have a comorbidity of diabetes and obesity. They have the chance to help or hurt themselves by following or not following recommendations by doctors. Due to the extensive research we have on diabetes, these recommendations will help patients to maintain balance in their lives. However, very few of these suggestions are followed and overall health declines as a result.

Diabetes is a classic example of a metabolic imbalance that can have devastating effects on health. Everyone knows someone with diabetes and that number continues to increase. This could be your grandparents, parents, siblings or cousins, and even your friends. This growing prevalence has prompted some to refer to diabetes as a pandemic and epidemic. Some of the research that I conducted theorized that the real reason for the pandemic status was the lack of physical activity. Our activity level has a dramatic effect on our health and can be linked to diabetes. Those who do not get enough exercise are at a higher risk of developing diabetes. Exercise is even recommended by doctors to help manage diabetes. Physical activity has a direct connection to overall health. Additionally, diabetes affects economies, sociality, and the environment.

Diabetes occurs when our bodies can no longer regulate blood sugar. Much of the food we eat is composed of glucose, which is the preferred source of sugar for cells. Glucose is released into the blood as food is broken down. When glucose levels in the blood rise, a signal is sent to the pancreas to release insulin. Insulin is a hormone, or protein, that acts as a chemical messenger to control bodily processes. It is produced by beta-cells in the pancreas and acts as a messenger that allows glucose to enter the cells instead of remaining in the bloodstream. The uptake of glucose into cells lowers blood sugar and provides energy for the cells. An additional hormone called glucagon is antagonistic to insulin. While insulin release is stimulated by high blood sugar, glucagon release is stimulated by low blood sugar. This partnership ensures that our blood sugar does not get too high or too low, but maintains homeostasis. The actions of these hormones help us remain balanced. This balance ties into Ayurveda, where the body functions best when it is balanced. The human body seeks balance without conscious thought. Diabetes introduces imbalance by disrupting the central role of insulin in controlling blood sugars in the body, among other effects elsewhere. Diabetes causes unregulated blood sugar by making insulin less effective or producing lower amounts of insulin. The beta cells that produce insulin are either attacked by the immune system or begin to fatigue and die from overwork. Logically, this affects blood sugar levels and leads to a condition known as hyperglycemia, or high blood sugar. In other words, glucose cannot be taken into the cells and broken down but stays in the blood where it continues to circulate throughout the body. Long-term circulation of glucose can lead to health problems.

It is important to briefly note that there are a few types of diabetes. Type 1 is due to an autoimmune deficiency and usually develops earlier in the lifespan. Type 2 is the type that is most well-known and is diagnosed in adults. The other two types are gestational diabetes, which occurs during pregnancy, and prediabetes, which signifies an increased risk of developing diabetes. All types have subtle differences but the underlying issue of high blood sugar is the same. Recall that the continued circulation of blood will lead to further health issues. All types of diabetes have aspects that are within and without the patient’s control.

The effects of diabetes can be curbed by active efforts to live a healthier life. Those who do not make these efforts are at risk of a host of health issues. The long-term effects are significantly more damaging to the many tissues and systems in your body. These issues include: increased glucose production in the liver, increased glucose reabsorption in kidneys, decreased peripheral muscle, increased lipolysis, increased rate of absorption of glucose in the stomach and small intestine, changed microbiota in the colon, and increased appetite and sympathetic tone in the brain, along with decreased dopamine surge in the morning. These are just some of the problems caused because diabetes can also affect your eyes, raising the probability of developing retinopathy, cataracts, and glaucoma. Risk is also increased of developing kidney disease, nerve damage, peripheral arterial disease, high blood pressure, heart disease, stroke, cognitive impairment, and decreased function in the immune system. The addition of any of these health issues becomes a challenge for the patient on top of diabetes. Diabetes can reach many parts of the body and induce negative consequences on overall health. This health challenge extends to family members, friends, communities, and countries as they try to combat this disease. 

Additionally, there is the economic effect of diabetes. The American Diabetes Association published a paper about the cost of diabetes. Their cost estimates placed diabetes at around $245 billion in 2012, which was up 41% from 2007. If a five-year period yields a 41% increase a ten-year jump will surely have a similar result. Diagnosis of diabetes has become more common and more costly. Part of the cost comes directly from supplies and treatment but a large chunk is due to lost labor and disability. At the time of the study, 7% of the US population had received a diagnosis of diabetes. These people pay 2.3 times more money for medical treatment than those people without diabetes. The extra costs are often related to additional diabetic treatment that is beyond what is required for those without diabetes.

As previously mentioned, I have been exposed to a lot of treatment of patients with diabetes through work at a family clinic. I have seen how much diabetic medications cost and how time-consuming treatment of patients can be. The majority of these patients fall within the middle-aged to the older population and the majority are type 2 diabetics. We ask them to come in every 3 months to check on their hemoglobin A1c, which is the average of your blood sugar over the last 90 days. Many insurances also require A1c tests as proof of treatment. This is a critical test that allows for proper treatment going forward. These visits follow a template that includes questions about diet, exercise, most recent diabetic eye and foot exams, history of chronic kidney disease, medications, and recent labs, tailored to the needs of each patient. Because all of these patients are different, some are compliant with the instructions they get from the primary care providers and others who do not follow the instructions. Most regularly take their medications, whether that is pills or injections, but they struggle with aspects that require more effort, such as improving their diet and exercise habits. This calls back to the pandemic of inactivity mentioned in the first paragraph. Indifference for these patients is costly, whether that be through exercise or diet. This can cause their A1c to spike to dangerous levels, prompting the diagnosis of uncontrolled diabetes mellitus and increasing the risk of the side effects of diabetes. Others have learned to manage their condition effectively and now have controlled diabetes. Unfortunately, patients tend to take the easiest route, or the path that requires no extra effort. Very few patients are motivated enough to implement the changes in their lives that will have the best effects on their health. I think that this is part of the reason why diabetes is so common around the world. There are too many people who shirk responsibility for their health and end up with problems that result from poor exercise and diet habits. This is part of why the diabetes pandemic is such a strain on public health and the economy.

This paper has allowed me to see some of the connections between Ayurveda and medicine. I had not previously thought about the body's own ability to maintain balance as a form of Ayurveda, but the body certainly knows life and a quest to maintain balance and homeostasis. I appreciate that my research and thoughts show that western medicine can be specialized and tailored to the needs of the patient, despite our discussion in the classroom. We can see that through adequate treatment to treat the symptoms at hand. Patient responsibility is paramount, especially in following instructions from doctors and being proactive in personal treatment to treat symptoms and improve health.