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.