Type 5-Diabetes – Ayurveda Understanding

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Type-5 diabetes is a variety of Diabetes which has got a nod from the medical system very recently and has been acknowledged as a distinct type. It is known to primarily affect the undernourished adolescents and young adults and is marked with these people having BMI lesser than 18.5 kg/m².

Etiologically and clinically it differs from Type 1 and Type 2 Diabetes. Type 1 Diabetes is an autoimmune condition whereas Type 2 Diabetes is driven by insulin resistance. On the other hand, Type 5 Diabetes arises from chronic malnutrition leading to pancreatic damage to irreversible proportions and significant reduction in insulin secretion.

Predominant symptoms and signs of Type 5 Diabetes include persistent fatigue, unintentional weight loss, recurrent infections, low body fat percentage and nutritional deficiencies. There is also absence of autoimmune markers in this condition.

Related Reading – ‘Type 5 Diabetes: Recognition, Pathophysiology and Public Health Implications’

In this article we will discuss Ayurveda Understanding of Type 5 Diabetes in a nutshell. We will also put forth the treatment principles for the same.

Type 5 Diabetes: Ayurveda Understanding

Undernourishment, Chronic Malnutrition & Krsha Pramehi – Since undernourishment or chronic malnutrition is the main cause and contributory factor towards the onset, progression and manifestation of this special type of Diabetes named ‘Diabetes Type 5’, it can be considered under the discussion of a subtype of patients of Prameha i.e. ‘Krisha Pramehi’ – lean diabetics.

–        Krsha = thin, lean, undernourished, malnourished, depleted

–        Pramehi – patient suffering from prameha

Prameha, a disease explained in Ayurveda, has been correlated with diabetes. The patients broadly classified under two categories –

–        Sthula Pramehi i.e. obese prameha patients and

–        Krsha Pramehi i.e. thin prameha patients

That also classifies Prameha into two kinds –

–        Prameha presenting with obesity / overweight condition and

–        Prameha presenting with leanness / emaciation and signs of malnutrition and undernourishment

The second category of either classification fits into the discussion of the current topic of Type-5 Diabetes.

Further classification of Prameha is made on the lines of dosha predominance. There are 10 kinds of Kaphaja Prameha, 6 types of Pittaja Prameha and 4 types of Vataja Prameha.

Krsha Pramehis seem to fit into the ‘Type 5 Diabetes’ category. Conversely, those diagnosed with ‘Type 5 Diabetes’ are Krsha Pramehis.

Vata Predominance – In Krsha Pramehi, the person has become malnourished, emaciated and lean, has lost sufficient tissues and is hence weak. Chronic Malnourishment or Undernourishment leads to tissue depletion and this further leads to increase of Vata. Vata increase further damages the tissues. This is a vicious process. So, we can consider Type 5 Diabetes as a ‘Vata predominant condition’.

From the perspective of symptoms – All symptoms of Type 5 Diabetes point out towards the involvement of Vata in their causation.

Persistent fatigue, unintentional weight loss, low body fat, nutritional deficiencies – are all due to high vata.

So, vata dominates the picture of Type 5 Diabetes.

Ayurveda Principles of Treating Type5 Diabetes

Brimhana Therapy

Krsha Pramehi – malnourished, lean or emaciated Prameha patient should be treated through Brimhana therapies. Brimhana therapies are those which build up the body and bulk and also strengthen the person.

The high protein diets, balanced intake of carbohydrates and healthy fats and micronutrient supplementation – all are included in Brimhana Therapy. Ayurveda also has specified Madhura Ahara – foods which are predominant in sweet taste (carbohydrates, fats etc?) and Sneha – healthy fats as the best remedies for calming aggravated vata.

Anti-Vata Remedies

Since vata dominates the picture of Type 5 Diabetes, it is important to address the aggravated vata. All vata balancing foods, lifestyle and behavioural changes, medicines and therapies should be brought into play in the treatment of Type 5 Diabetes.

Once Vata is controlled and balanced, the tissues will recover. The tissue destruction comes to a halt and the reverse engineering of restoring the tissues and their strength is initiated.

Once the tissue destruction stops, the Brimhana therapies will further boost up the tissue restoration.

The person will gain back weight and his energy levels will be restored. The other symptoms will automatically be addressed as the pathogenesis starts reverting back towards normalcy.

Vataja Prameha Chikitsa

Diabetes Type 5 can also be treated on the lines of treating Vata predominant Prameha.

We need to note something more in this context.

Vataja Prameha can be caused due to vata aggravated as a result of dhatu kshaya i.e. severe depletion of tissues. This condition is considered incurable. So, attempts should be made by administering Brimhana therapies by intimating the patient and his attendants about the nature and incurability of the disease.

So, Type 5 Diabetes in which there is malnourishment leading to mild to moderate undernourishment without significant tissue loss along with symptoms of vata increase shall be treated with Brimhana therapies.

Prameha vis-a-vis Type 5 Diabetes in which increased vata is associated with pitta or kapha and is causing its symptoms should be treated with sneha i.e. medicated ghee or oil as indicated by Acharya Charaka. Here vata aggravation is either in the form of anubandha i.e. association with increased pitta or kapha or in the form of avarana i.e. vata aggravation due to it being blocked by kapha or pitta.

Type 5 Diabetes having severe depletion of tissues should be treated with Brimhana therapies and attempts be made to check the progression of tissue loss after intimating the patient and concerned people about its difficult prognosis.

Finally,

Krisha Pramehi is a lean patient whose clinical picture has not been explained in detail in Ayurveda. It has been said that this patient is weak and emaciated and has to be treated with Brimhana. So, this condition is treatable, unlike the dhatukshayaja vataja prameha (vataja prameha caused by severe tissue depletion) which is incurable.

So, Krisha Pramehi is a diabetic who is lean and can be treated and the tissue depletion is not so severe so as to classify it under vataja prameha. These conditions need to be differentiated.

So, Type 5 Diabetes, being a curable condition, comprises patients considered as Krsha Pramehi and not those severely emaciated people brought about by severe tissue destruction leading to vata increase.

Mathematically, Type 5 Diabetes can be treated with Brimhana Therapies.