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Diet and Lifestyle Guidelines for Diabetes: Evidence Based Ayurvedic Perspective

  • All india institute of Ayurveda sarita vihar New Delhi


Background and Aims: Ayurveda strongly emphasize on preventive and promotive aspects of health rather than curative. Centuries ago, Ayurveda laid the concepts of Dinacharya (daily regimen for healthy living), Ritucharya (seasonal regimen for healthy living), Sadvaritta (moral conducts) and Achara Rasayana (social conducts) as well established guidelines for healthy diet and lifestyle; but in current era, hardly anyone aptly follow it. As a result, there is tremendous rise in lifestyle disorders as pandemics, diabetes being the most menacing among them. The aim of this review is to bring into the limelight the Ayurvedic dietary and lifestyle guidelines for prevention of type 2 diabetes and available factual research evidence validating it. Materials and methods: Ayurvedic recommendations for prevention of diabetes were rationally reviewed in light of published information from several articles. Publications in Pubmed, Scopemed, Dhara online and other allied databases covering fields of therapeutics, pharmacology, biomedicine and health were also screened and taken into study for the report. Conclusion: Ayurvedic lifestyle guidelines of adopting a healthy dietary pattern together with physical activity are valuable tools in the prevention of type 2 diabetes.
Jamnagar 361008, Gujarat, India; Mobile: 09408325831
corresponding author e-mail:
Rohit Sharma , Prajapati PK
Department of Rasashastra and Bhaishajya Kalpana, I.P.G.T. & R.A.,
Gujarat Ayurved University, Jamnagar, India
September 13, 2014
October 24, 2014
available online:
December 15, 2014
Background and Aims: Ayurveda strongly emphasize on preventive and promotive
aspects of health rather than curative. Centuries ago, Ayurveda laid the concepts of
Dinacharya (daily regimen for healthy living), Ritucharya (seasonal regimen for healthy
living), Sadvaritta (moral conducts) and Achara Rasayana (social conducts) as well
established guidelines for healthy diet and lifestyle; but in current era, hardly anyone
aptly follow it. As a result, there is tremendous rise in lifestyle disorders as pandemics,
diabetes being the most menacing among them. The aim of this review is to bring into the
limelight the Ayurvedic dietary and lifestyle guidelines for prevention of type 2 diabetes
and available factual research evidence validating it. Materials and methods: Ayurvedic
recommendations for prevention of diabetes were rationally reviewed in light of
published information from several articles. Publications in Pubmed, Scopemed, Dhara
online and other allied databases covering fields of therapeutics, pharmacology,
biomedicine and health were also screened and taken into study for the report.
Conclusion: Ayurvedic lifestyle guidelines of adopting a healthy dietary pattern together
with physical activity are valuable tools in the prevention of type 2 diabetes.
key words: Ayurveda, Diabetes Mellitus, Diet, Lifestyle, Madhumeha.
All polyuric diseases in Ayurveda are
described under Prameha’, and Madhumeha is
one amongst them, equated to Type 2 Diabetes
Mellitus. The description of the acquired form of
Prameha; refered to as Apathyanimittaja
Prameha, is very similar to type 2 diabetes.
Apathya Ahara (dietetic incompatibilities/
unwholesome diet) and Apathya Vihara
(lifestyle incompatibilities) both are the major
risk factors for Madhumeha [1].
Diabetes Mellitus is the most threatening
endemic lifestyle disorder, having social,
medical and economic ramifications globally. As
per a recent report of the International Diabetes
Federation, each year 3.8 million deaths are
attributable to diabetes and related
complications; at least 50% of diabetics are
unaware of their condition (indicating lack of
awareness); and up to 80% of type 2 diabetes is
preventable by adopting a healthy diet and
increasing physical activity [2]. Studies have
proved that active participation of the patients in
the form of lifestyle changes can result in less
© 2014 ILEX PUBLISHING HOUSE, Bucharest, Roumania
Rom J Diabetes Nutr Metab Dis. 21(4):335-346
doi: 10.2478/rjdnmd-2014-0041
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336 Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014
expense for the management of diabetes and
ensure good glycemic control also [3].
Each person needs an individualized
treatment. Insulin or oral hypoglycemic agents
are only prescribed for Type 2 diabetics if diet
and exercise alone fail to lower the glycemic
level. Ironically, drug approach could not cure
disease condition or prevent further progress of
disease and in spite of good glycemic control,
patient lands into life threatening complications.
Besides that, conventional antidiabetic drugs are
either expensive or often associate adverse
effects. Therefore the key for management is to
consult a doctor and a dietician, which means
adjusting one’s diet, activity, and sometimes
taking medication [4].
Substantial evidence now exist to suggest
that diabetes is strongly associated with
increasing urbanization, population growth,
aging, patient’s unhealthy lifestyle choices,
reduced physical activity, obesity, behavioral
patterns, socioeconomic changes and perhaps
most importantly a ‘Western style’ diet [5,6].
Type 2 diabetes is a largely preventable disease
and intensive lifestyle interventions are not only
highly effective but cost-effective too. Here,
Ayurvedic Pathya Ahara (wholesome diet) and
Pathya Vihara (wholesome lifestyle) can play a
major role in disease prevention.
Taking these facts into consideration, the
present review was undertaken to bring into the
limelight the role of suitable Ayurvedic dietary
and lifestyle guidelines to prevent diabetes in
view of the available evidence based supporting
Matherials and methods
Search strategy and Inclusion criteria
Diet and lifestyle related etiologies
accountable for diabetes as mentioned in
Ayurvedic treatises were rationally reviewed
along with recommendations of Pathya Ahara
(wholesome diet) and Pathya Vihara
(wholesome lifestyle) as preventive strategies.
The search was conducted in light of
contemporary scientific supporting data
available in electronic and internet media for
possible justification and validation of these
Ayurvedic principles. Publications in Pubmed,
Scopemed, Dhara online and other allied
databases covering fields of therapeutics,
pharmacology, biomedicine and health were also
screened and taken into study for the report.
Information extracted from original articles,
review works, randomized control trials (RCTs)
and meta-analyses including reports of
experiments on humans and animal model
systems and cross references were collected.
Searches were not limited by date or place of
publications but to publications in English
Diet related etiologies and contraindicated
Apathya Ahara in Ayurveda
Excessive use of curds, flesh of animals of
domestic, aquatic and marshy places, use of
dairy preparations, new water (water of rivers
and tanks during rains and floods), new grains,
puddings made of jaggery/sugar and using more
similar factors (heavy diets, fatty foods that
increase body weight, cholesterol and causes
obesity etc.) which increase Kapha Dosha [7]. In
addition, the foods / drinks which increase
Medas (adipose tissue), Mutra (urine), and diets
which are sweet, sour, salty, fatty, not easily
digestible, slimy, cold, drinks like beer and
molasses were also considered as the causative
factors [1,8]. In another context it is said that
excessive intake of dry substances (Ruksha
Ahara), light food (Laghu Ahara), excessive use
of pungent, bitter, cool items, excessive fasting
etc. increase Vata and also cause Madhumeha
[9]. According to Ayurveda, there are mainly
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two types of diabetic persons: Sthula (obese) and
Krisha (lean and thin), both having different
etiology and lifestyle intervention.
Contraindicated Apathya Ahara for diabetes
are: alcohols like Sauveera, Sukta, Maireya and
Sura, milk, milk products, oil, ghee, sugarcane
juice or sugar, jaggery, alkaline, curd, grain
cakes (Pishta), sour substances, sweet drinks
(Panakas), and meats of domestic, aquatic and
swamp animals [10].
Contemporary supporting data
Evidences have proved that high fat (total
and saturated) and meat intake were associated
with a higher risk of type 2 diabetes. High fat
or oil intake is reported to decrease the
favorable high-density lipoprotein (HDL)
cholesterol levels in the blood and may
adversely affect the lipid profile [11,12].
supports Ayurvedic claims on the role of fatty
items, marshy animals, aquatic animals (which
are heavy with fats) and milk items in diabetes.
It is reported that, bakery and dairy products,
sugar/sugar items, jaggery, molasses, alcohol
(wine, beer) and sugar added foods are
predisposing factors for diabetes [13-16]. These
foods immediately burden the beta cells of
Langerhans, can lead to insulin resistance, etc
[17]. Reports linking bovine serum albumin
(BSA) antibodies and diabetes suggest that milk
protein have a strong diabetogenic effect. In
some cases, bovine serum albumin may cross-
react with a protein (P.69) which can be induced
on pancreatic beta cells membrane by the
inflammatory mediator interferon gamma [18].
This study also supports the Ayurvedic concept
that the excessive use of milk and milk products
may cause diabetes.
In the current era, people are fond of flour
preparations, sweetened drinks, refrigerated,
preserved and reheated food items, due to the
busy schedules of society today, wherein they
hardly have time to eat at home. Such food is
low in fiber, high in glycemic loads and is
associated with increased risk of diabetes [19].
Adhyashana (over eating) is also proved as a risk
factor for DM [20]. T
hese dietary irregularities
further contribute to disturb the carbohydrate
and lipid metabolism and result in Madhumeha
in susceptible individuals.
These studies
confirm the Ayurvedic etiology for diabetes.
WHO identified one particular type of
Diabetes as ‘Malnutrition Related Diabetes
Mellitus’, which is common in India. Most of
these patients are lean and thin young adults
between 15 to 35 years age and more often
reported in Kerala and Orissa states [21,22]. This
type can be correlated to Krisha Pramehi. It is
presumed that diabetes is mainly caused by
heavy food which increases Kapha, Medas etc.
But Ayurveda also emphasized that excessive
starvation and intake of dry substances can also
cause another variety of Prameha (diabetes).
In Northern Europe and North America Ice
lands, the unusual rise of type 1 diabetes in
children born in the month of October was
hypothesized to be explained by the high
Nitrosamine content of smoked mutton
traditionally used at Christmas. In mice
experiments it was proved that, this effect was
mediated via the parental germ cell rather than
by direct effect on pancreatic beta cells of fetus
[23]. The Ayurvedic literature cautioned that,
mutton of marshy lands might cause Prameha
hence to be restricted. Nevertheless, more
confirmative studies are required.
Ayurvedic Diet and lifestyle protocols
for diabetes
(1) First and foremost guideline is to avoid
the diet and lifestyle related etiological factors
involved in type 2 diabetes (Nidanaparivarjana)
[7]. (2) Sthula Madhumehi person diet should be
Apatarpanaguna and heavy for digestion, while
Krisha Madhumehi persons diet should be
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338 Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014
Santarpanaguna and light for digestion. Krisha
patients diet should be such that it doesn’t
increase meda [7]. (3) Octafactor guidelines for
proper use of diet like Prakriti, Karan, Sanyoga,
Rashi, Desha, Kala, and the user, must be taken
into consideration [24]. (4) According to Ritu
(seasons), various diets and activities should be
prescribed depending upon the nature of prakriti
and doshas [25].
Pathya Ahara for diabetics in Ayurveda
Ayurveda has given utmost emphasis for the
maintenance of Pathya Ahara. Ayurveda stated
that if one take wholesome diet and activities
suitable to all Dhatus (tissues), he can never
suffer from Madhumeha [9]. It is said that, like
bird reaches its nest on the tree, in the same way
Prameha reaches the person who eats more,
unhygienic (even by not taking bath) and lazy
[9]. Quantity and quality of diet should be
decided on the basis of Agnibala (digestive
power). The recommended diet for Madhumehi
is detailed in Table 1 [7,26].
Table 1. Recommended Pathya Ahara for diabetics
(adapted after [7,26]).
Name of items
Yava (barley)- Hordeum vulgare, Godhuma
(Wheat)- Triticum sativum, Shashtika Shali
(rice)- Oryza sativa, Kodrava (grain
variety)- Paspolum Scrobiculatum,
Uddalaka, Shyamaka, Bajara
Chanaka (bengal gram)- Cicerarietinum,
Adhaki (toor dal)- Cajanus cajan, Mudga
(green gram)-Phaseolus aureus, Kulattha
(Horse gram)- Dolichos biflorus
(bitter and
Methika (fenugreek)- Trigonella foenum,
Patola (pointed gourd)- Trisanthus dioica,
Karvellaka (bitter gourd)- Momordica
charantia, Tanduleyaka (Choulayee)-
Amaranthus spinosus, Vastukam (Bathuva),
Shobhanjana (drum stick)- Moringa
oleifera, Karkotaka Momordica dioica,
Rasona (garlic)- Alium sativum, Kadali
(raw banana)- Musa paradisiaca.
Jambu (Jamun)-Eugenia jambolana,
Talaphala- Borassus flabellifer, Amalaki
(goose berry)-Emblica officinalis, Kapittha
(monkey fruit)- Limonea acidissima,
Dadima (pomegranate) Punica granatum,
Tinduka Disospyros embrayoptesis.
Methika, Kamala- Nelumbo nucifera,
Utpala Nymphoea stellate,
Flesh (fat
free meat;
Harina (deer flesh), Shashaka (rabbit),
Birds likes Kapota (pigeon), Titira,
or alcoholic
Madhveeka Sura, Madhvasava (in Kapha
Pittaja Prameha), Purana Sura- old wine
Madhu (honey), Madhudaka (honey mixed
with water)
Nikumba (Danti- Baliospernum montanum),
Ingudi (Balanitis egyptica), Atasi (Linum
usitatisimum), Sarshapa (Mustard)
Others food
articles and
Dhani (pop corn of jowar), Laja/Murmura
(puffed rice), Maricha (Piper nigrum),
Saindhava (rock salt), Hingu- (asafoetida),
Haridra- (Turmeric), Ardraka- (Ginger)
The indigenous diet may not be useful in
lowering the blood sugar to the same extent as
insulin and other hypoglycemic agents.
However, by acting as Ayurvedic nutraceuticals,
it supplements and improves the quality of life;
therefore, may be useful as adjunct to manage
the disease and its complications. Ayurvedic
dietary plans comprise a wide range of
multivalent actions as health promoting dietary
additives as well as putative therapeutic agents,
which is of considerable importance to diabetic
Contemporary supporting data
Researchers have proved that simple
carbohydrates are broken down easily and
increases blood glucose levels fast. Hence
simple sugars like table sugar, honey, candy,
jam, cakes and pastries etc. are contraindicated,
while complex carbohydrates like cereals, whole
grains, and vegetables are recommended at least
to 50% of diabetic diet. Another study suggest to
avoid high fat, salt, alcohol, caffeine and refined
(white) foods such as white sugar, white flour,
white bread, pastries, and so on. These have high
glycemic index (GI) and will cause the blood
sugar levels to spike [27].
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Ayurveda suggests increased intake of fiber
rich green vegetables and cereals (Patola,
Tanduleyakam, Vastukam, Yava, etc.). Yava
(barley) is high in fiber content (4 g in 100 g)
and is highly recommended in diabetic diet in
different forms. In a primary clinical trial in
normal subjects, blood sugar pattern was
recorded after giving different types of food such
as wheat chappati, barley chappati, bajra
chappati, maize chappati, gram chappati and
rice with Patola curry separately. Three blood
samples were taken at hourly intervals. The
maximum rise was recorded in rice, followed by
wheat while the minimum rise in the case of
Yava which surpasses all cereals and pulses.
Thus barley proved to be the best diet for
patients with Prameha [28].
Comparatively, whole green gram, bengal
gram have more fiber content (4 g) than green
gram dal and bengal gram dal (1 g). Whole horse
gram and Toor dal also have rich fiber content (5
g) [29]. Hordeum vulgare, Oryza sativa,
Triticum sativum, Green gram, Toor dal,
fenugreek, onion, garlic, gooseberry, Jamun etc.
are recommended to diabetics by modern
researchers too [30]. Of interest, many reports
proved the advantages of vegan diet for
reduction in diabetes incidence [31,32], its
ability to improve insulin resistance being well
established [33].
Honey is a sweet but highly nutritive natural
product. Is it beneficial or detrimental in
diabetes? Honey supplementation alone or in
combination with antidiabetic drugs has been
found to reduce hyperglycemia in rodents and
humans with diabetes mellitus. However, the
mechanisms of the hypoglycemic effect of honey
remain unclear. The possible roles of fructose,
mineral ions (such as zinc, copper and
vanadium), phenolic acids and flavonoids have
been suggested. The protection of the pancreatic
beta cells against oxidative stress and damage
(via honey antioxidant molecules such as organic
acids and phenolic compounds) is one such
potential mechanism [34,35]. This supports the
Ayurvedic recommendation to use it alone or
mixed with water in diabetes.
Role of fruits, vegetables, spices
and seeds in diabetes
Fruits, vegetables, and spices are
micronutrient rich; influence various systems in
the body with diverse metabolic and
physiological functions, and enable elderly
diabetics to be fit and active. They provide
nutritional substances like dietary fiber,
vitamins, minerals, phytonutrients such as
flavonoids (antioxidants), saponins, polyphenols
(antioxidants), carotenoids (vitamin A-like
componds), isothiocyanates (sulphur-containing
compounds) and so on, which are essential to
ensure a balanced diet. Type 2 diabetics can
enjoy fruits except those containing high
carbohydrate and sugar levels (i.e. avoid high GI
items). Avoid fruits with high GI like Banana,
Cheekoo, Grapes, and Mango etc. but Orange,
Watermelon, and Apple Guava etc. can be
advised. Although watermelon has a high GI, the
Glycemic Load (GL) per food serving is low and
it will not have a big effect on glucose levels.
Try to avoid fruit juices; instead opt for whole
fruits, as they contain more fiber and are more
filling. Consume cooked or uncooked vegetables
with little or no dressing. Opt for fat-free or low
fat dressings on salads, as well as uncooked
Spices are food adjuncts that have been used
as flavoring and coloring agents and as
preservatives. They are recognized to possess
medicinal properties too, and their therapeutic
role is highly appreciated in Ayurveda. They
exert several beneficial physiological effects
including some antidiabetic effects like short
term blood glucose decrease and long term
improved glucose tolerance. A number of
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340 Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014
condiments and spices advocated in Ayurveda
including pepper, asafetida, fenugreek seeds,
cumin seeds, curry leaves, ocimum, rock salt,
turmeric, cinnamon, mustard, garlic, onion,
ginger and coriander are reported to possess
potential antidiabetic substances and have been
ascribed hypoglycemic activities, both
experimentally and clinically.
Vegetable and fruit fibers reduce the risk of
diabetes, delay sugar digestion and absorption,
improve the insulin sensitivity and glucose
utilization and relieve constipation. Along with
rich fiber content, fruits contain considerable
amount of phytates, which modulate glycemia
and produce a different GI of foods. Phytates
affects the digestability of starch by combining
with protein or digestive enzymes. Chromium is
a critical cofactor in insulin action and its
deficiency can lead to hyperglycemia. Some
studies have reported benefits of chromium
supplementation for glycemic control in
diabetes. Trivalent chromium is found in whole
grains, seeds/nuts (almond, walnut), green beans,
cereals etc [36-39].
Conventional approach to diet therapy
Given the heterogeneous nature of type 2
diabetes, diversified diet with a judicious choice
from a variety of food groups is essential to
provide the necessary nutrients. However,
overeating should be avoided. Meal plans and
diet modifications are generally individualized
by a registered dietitian to meet patient needs
and lifestyle. A typical conventional approach
would recommend a diet composed of 60-65
percent carbohydrate, 25-35 percent fat, and
10-20 percent protein, with limited or no alcohol
consumption [40]. The dietary choices ought to
be practical, dynamic and flexible, based on the
prevailing situation. Food related approaches,
both in qualitative and quantitative terms, should
be well planned.
Diabetic meal plan
A diabetic meal plan matches calories from
foods to individual physical activity and insulin
levels. In a balanced diet, a wide variety of
selected vegetables, fruits, cereals, spices and
minimally processed foods would be expected to
help maintain the glycemic level and BMI within
limits and reduce the risk of a range of chronic
degenerative illnesses. WHO recommends intake
of whole grain foods, with a minimum
consumption of 5-10 portions of fruits and
vegetables per day [41,42]. A 1500 calories
Diabetic Diet chart suggested by the National
Institute of Nutrition, India, is detailed in Table 2
Table 2. 1500 calories diabetic diet chart
(Adapted after [43]).
Food stuff
Amount (g)
Green leafy
Other vegetables
Flesh foods
This diet provides
% calories
Lifestyle related etiologies
of diabetes in Ayurveda
Asayasukha (habituation to sitting on soft
cushions for long periods) and
Swapanasukha/Atinidra (prolonged sleeping) are
suggested as key predisposing factors for
diabetes [1]. Divasvapna (day sleeping) is also
one of the causes of Prameha [44,45]. Charaka
has also emphasized that anxiety, anger, worry,
grief, and similar other stress producing factors
lead to the development of Prameha in
susceptible individuals. Madyapana (alcohol
consumption) has a significant role in the
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Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014 341
etiology of Madhumeha [46]. Vyavayi, Vikasi
etc. ten Guna (properties) of Madya (alcohol) are
opposite to Ojas, causes Tridoshadushti
(vitiation) and Kshubdhata (altered state) in Ojas
[46] which in turn can hamper
Vyadhikshamatava (immunity); it may be one of
the predisposing factors of Madhumeha.
Contemporary supporting data
Machines have made us sluggish. In parallel
with lifestyle changes, walking habits have
changed, supported by the increased use of
automobiles and two wheelers. The prevalence
of type 2 diabetes is raising much more rapidly
because of sedentary lifestyle or reduced activity
levels [20,47]. A pathway through which obesity
causes insulin resistance has recently been
discovered in mice, in the form of an adipose
tissue derived hormone named resistin an
important link between the adipocyte and
diabetes [47-49]. Hyperinsulinemia and insulin
resistance factors are insidious features of
obesity, having direct correlation with BMI [50].
Although BMI and physical activity are
independent predictors of incident diabetes and
mortality, the magnitude of the association with
BMI is much greater than with physical activity
Day napping and short night sleep are
reported as a potential risk factor for diabetes
[52]. Though much evidences are not available
on the role of Ratrijagarana (vigil) in diabetes
development, a report of the University of
Chicago Medical Center showed that sleep
deprivation severely affects the body ability to
metabolize glucose, which can lead to early
stage type 2 diabetes. It was observed that both
short-term (<6 h) and long term (>8 h) sleep, as
well as sleep loss, are related to glucose
intolerance and to increased risk of type 2
diabetes [53-55].
Stress related anxiety has been shown as a
major contribution factor for type 2 diabetes
[56]. Middle to old age is the common age group
of type 2 diabetics and this is the period in life in
which persons get exposed to a variety of stress.
Further stress causes imbalance in hormonal and
nervous regulation of the body and makes the
person susceptible to different disorders
including diabetes. A high risk of complications
of diabetes is associated with influence of
psycho-stressors and depressive disorders [57].
This is supported by a study wherein diabetes
was induced by stress in albino rats and their
blood examination showed increase rate of
catalase activity, suggesting the acceleration rate
of cell injury and free radical generation, which
in turn is a precursor to diabetes [58]. Addiction
may also adversely affect the diabetic health.
Tobacco chewing, smoking and alcoholism are
considered as risk factors for diabetes [59].
Pathya Vihara for diabetics in Ayurveda
For preventing Prameha, Sushruta has
recommended walking of 100 yojan in 100 days
i.e. 1 yojan per day (1 yojan is ~ 7.5 km) [10]. A
quotation Nihsukhatva Sukhaya cha’ in
Kaphasya upakrama mentioned by Vagbhata is
very appropriate for preventing type 2 diabetes
[8], which means withdrawing of luxury to
create happiness. Sthula Pramehi are advised to
do exercises like wrestling, horse riding,
vigorous walking etc but Krisha Pramehi are
advised to protect their strength and not to do
exercises [7].
Contemporary scientific supporting data
A study reported that a daily brisk walk of
7.5 km (brisk is walking with speed of at least 5
km/hr) for 100 days can reverse Glucose
Tolerance Test to normal [60,61]. Lack of
exercise may be one of the main factors for the
bad glycemic control in chronic cases. Risk of
getting diabetes can be reduced by regular
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342 Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014
exercises and maintaining ideal body weight.
Physical activity has been shown to reduce
hyperinsulinemia and improve peripheral insulin
activity in 65 year old subjects [62], which
shows that even at this age, chronic diseases can
be fought through a better lifestyle. Exercise
improves insulin sensitivity and glucose
absorption, transport and uptake are increased in
perfused skeletal muscle, which reduces the
insulin requirement. Exercising also increases
blood flow through distal muscle groups
increasing oxygenation to tissues in the feet and
hands. Distal extremity blood flow is decreased
primarily in a stocking and glove pattern. This
increase in oxygenation lessens the chances of
tissue ischemia and neuropathy and increases
capillary blood flow. Aerobic exercise also
increases stroke volume and heart muscle
contractibility, thus increasing vascular
efficiency [63]. Though Ayurveda cautions
sedentary life styles as a factor for diabetes it
also cautions excessive starvation and excessive
exercises which may also lead to another variety
of Diabetes. This may be either Type-I or
Malnutrition Diabetes.
Earlier, exercise was considered as a major
tool to control diabetes to a certain extent and it
was recommended to each and every diabetic
patient. But as mentioned in Ayurveda, Krisha
Pramehi are suggested not to do high intensity
exercises and advised to protect their strength.
Similarly in type 1 diabetes, there are risks of
hypoglycemia during or after high exercises or
of worsening metabolic control if insulin
deficiency is present; therefore, well planned
exercises regimens are suggested for them [64].
Evidences from lifestyle intervention
RCTs and Meta-analyses
Recently conducted randomized control
trials and systematic reviews showed that
progression to type 2 diabetes in high risk
individuals can be prevented/delayed by
adopting a lifestyle intervention program
(increasing physical activity, dietary
modification, and weight loss). It reduced the
rate of conversion from Impaired Glucose
Tolerance (IGT) or pre-diabetes to type 2
diabetes [65-68]. Lifestyle intervention reduced
or delayed the risk of diabetes by ~ 60% over a
3-year period in people at high risk (IGT). These
interventions included intensive lifestyle
modifications, with goals of > 7% loss of body
weight and 150 minutes of physical activity per
week. Both emphasized restriction of energy,
lower fat intake, and higher fiber intake.
No exercise or less exercise may cause
insulin resistance and reduce glucose utilization
or insulin sensitivity. A recent meta-analysis
showed that exercise reduces HbA1c levels by
an amount that is expected to reduce diabetic
complications, without a mean effect on body
weight [69].
In the Nurses’ Health Study, the
combination of a high GL and a low cereal fiber
intake further increased the risk of diabetes
(relative risk = 2.5) when compared with a low
GL and high cereal fiber intake [70]. Refined
starch could be more important in this context
than refined sugars because, weight for weight,
starch yields twice as much glucose than
sucrose, and can be rapidly digested and
absorbed. Glycemic excursions appear to be
similar between starches and sucrose (table
sugar). White bread intake may be one of the
best single food predictors of type 2 diabetes
[71]. A stronger association has been observed
between total fat and saturated fat intake and
type 2 diabetes [72,73]. Intakes of both whole
grains [74,75] and dietary fiber (in particular,
cereal fiber) are associated with lower risk of
type 2 diabetes [76].
Need of society awareness and
self care strategies for diabetics
The rapid rise in the incidence of diabetes is
attributable to the social change. Initiation of
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Romanian Journal of Diabetes Nutrition & Metabolic Diseases / Vol. 21 / no. 4 / 2014 343
prevention strategies to develop preventive
measures is strongly needed. Community
awareness is required to improve knowledge and
attitudes about the role of physical activity,
nutrition, and healthy eating behavior in disease
prevention. Increased community skills to
change behaviors and adopt a healthy lifestyle
through community-based interventions in a
variety of settings such as schools, worksites,
churches, community centers is needed.
Self-care coping strategies in patients with
diabetes are needed and these would be more
achievable if they are well aware and advised to
follow suitable dietary and lifestyle
recommendations mentioned in Ayurveda.
According to the literature, neither the curative
model nor the compliance/adherence model is
rigorously effective in diabetes care. An
alternative paradigm is needed that recognizes
the patient is in control of, and responsible for,
the daily self management of their diabetes.
Yoga provides an appropriate lifestyle
intervention that would be greatly helpful in
preventing or postponing the diabetes
prevalence. Significant physical, physiological,
psychological and endocrine changes have been
reported by following various Yoga regimens
(Asana, Pranayama etc) over a period of time. It
is also postulated that rejuvenation or
regeneration of beta cells of pancreas may be
taking place, which may increase utilization and
metabolism of glucose in peripheral tissues, liver
and adipose tissues through enzymatic processes.
It is effectively proven to improve quality of life
in diabetics and should be adopted in daily
routine [77-79].
Disorderly lifestyle plays an important role
in the development of type 2 diabetes. Along
with drug interventions, emphasis must be given
to socioeconomic, behavioral and nutritional
issues and to promote a healthier lifestyle (in
order to increase compliance to the lifestyle
modifications) especially for high risk
individuals. Dietary and lifestyle plans should be
made in accordance with the day-to-day
requirement of an individual. Due importance
must be given to adopt Yoga in daily routine.
Maintaining physical wellbeing, mental
tranquility and sanctity is equally crucial.
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... Ayurveda (an ancient Indian system of medicine) had mentioned the importance of the food, its benefits in maintenance of the health, and also its usage as medicine or for therapeutic use. Ayurveda had described many dietary supplements in various contexts e.g., Dinacharya (daily regimen) and Ritu Charya (seasonal regimen) [7,8] . Although, the modern nutraceutical industry dates to 1980s in Japan, its roots can be traced to the Ayurveda. ...
Full-text available
Dietary risks factors have raised attention worldwide for non-communicable diseases (NCDs). The recent report form data in the 2019, showed that around 7.9 million deaths and 187.7 million disability-adjusted life-years (DALYs) are linked to dietary risk factors and NCDs [1] . this is an awakening alarm to the health community in food sciences, pharmaceuticals and preventive medicine towards adapting a natural food based lifestyle. These NCDs are mainly due eating junk food, and low intake of dietary fruits or fibers leading to nutritive deficient states and, later diseases [2] . The term nutraceutical (coined by 1989 Dr. Stephen de-Felice) is derived form a combination of two words namely ‘nutrition’ and ‘pharmaceutical’. It is defined as any substance that is a food or a part of food that provides medicinal or health benefits including the prevention and/or treatment of a disease. The food products that provide health benefits and aid in reducing the risk of chronic diseases apart from nutrition may be inclusive under this term [3-5] . There is a paradigm shift in choice of daily food, and related practices towards nutraceuticals, owing to factors such as low risk, potential value and, the therapeutic effects they seem to offer. The nutraceutical market is growing tremendously worldwide and is valued at 74.7 billion in 2020, from its previous value of 36.6 billion dollars in 2016 [6] . Given the importance of nutraceuticals, the changing trends in perception of people and, the growing industrial/ markets, it’s imperative to discuss the basic type of dietary supplements with medicinal values (general nutraceuticals) with implications of Ayurveda. The current review is aimed to discuss the basic herbal nutraceuticals, their value in health and disease states.
... More than 90% of people with diabetes are type 2 diabetes mellitus (T2DM), whose pathological characteristics are mainly progressive beta-cell failure or insulin resistance (IR) [1,2]. According to the International Diabetes Federation (IDF) Global Diabetes Map, the number of T2DM patients worldwide reached 463 million in 2021 [3]. ...
Full-text available
Purpose: Gegen Qinlian Decoction (GGQL) has been employed to treat type 2 diabetes mellitus (T2DM) in the clinical practice of traditional Chinese medicine. However, the underlying mechanism of GGQL in the treatment of T2DM remains unknown. This study was aimed at exploring the pharmacological mechanisms of GGQL against T2DM via network pharmacology analysis combined with experimental validation. Methods: The effective components of GGQL were screened, and the target was predicted by using traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP). The candidate targets of GGQL were predicted by network pharmacological analysis, and crucial targets were chosen by the protein-protein interaction (PPI) network. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analyses were performed to predict the core targets and pathways of GGQL against T2DM. Then, T2DM mice were induced by a high-fat diet combined with streptozotocin. The model and GGQL groups were given normal saline and GGQL aqueous solution (10 and 20 g/kg/d) intragastric administration, respectively, for 8 weeks. The mice in the GGQLT groups were administered with GGQLT at 10 and 20 g/kg/d, respectively. The pathological changes in liver tissues were observed by hematoxylin-eosin staining. The protein expression of TNF-α and NF-κB was verified by western blotting. Results: A total of 204 common targets of GGQL for the treatment of T2DM were obtained from 140 active ingredients and 212 potential targets of T2DM. GO and KEGG enrichment analysis involved 119 signaling pathways, mainly in inflammatory TNF signaling pathways. Animal experiments showed that GGQL significantly reduced the serum levels of body mass, fasting blood glucose, fasting insulin, HOMA-IR, TNF-α, and IL-17. The liver pathological section showed that GGQL could improve the vacuolar degeneration and lipid deposition in the liver of T2DM mice. Mechanistically, GGQL downregulated the mRNA expression of TNF-α and NF-κB. Conclusions: This study demonstrated that GGQL may exert antidiabetic effects against T2DM by suppressing TNF-α signaling pathway activation, thus providing a basis for its potential use in clinical practice and further study in treating T2DM.
... In addition to following diet and lifestyle guidelines, due to the significant hypoglycemic effect of metformin, it is often recommended to intervene with metformin in patients with T2DM (Sharma et al., 2015;Sanchez-Rangel and Inzucchi, 2017). However, due to the certain limitations of metformin in long term use, options from natural products are being searched to meet the need (Sharma and Prajapati, 2017). In recent decades, traditional Chinese medicine (TCM) and its active ingredients have become increasingly popular in Asian countries, and combined with metformin, is widely used as a reinforcing agent in glycemic control (Pang et al., 2018;Tian et al., 2019;Wu et al., 2019). ...
Full-text available
Background: In China, Coptis chinensis Franch. (Chinese name: Huanglian) prescriptions (HLPs) are prominent hypoglycemic agents used in glycemic control. However, the curative effect of HLPs as adjunctive therapies for type 2 diabetes mellitus (T2DM) has not been evaluated. Based on a systematic review and a meta-analysis, this study was conducted to assess the effects of HLPs combined with metformin as a reinforcing agent for T2DM. Materials and methods: A total of 33 randomized controlled trials (RCTs) reporting on 2,846 cases concerning the use of HLPs in the treatment of T2DM were identified from the China National Knowledge Infrastructure (CNKI), Weipu (VIP), Wanfang, PubMed, Cochrane Library, and EMBASE databases. Primary outcomes included fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, type A1c (HbA1c), fasting serum insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and gastrointestinal dysfunction (GD). Continuous data were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The methodological quality of the included RCTs was assessed by Cochrane evidence-based medicine systematic evaluation. Statistical analysis was performed using the Review Manager and Stata software. The required information size and treatment benefits were evaluated by trial sequential analysis (TSA). The quality of evidence was rated using the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach. Results: The results revealed that HLPs are beneficial to improve the following: FBG (MD = −1.16%, 95% CI: −1.24 to −1.07), 2hPG (MD = −1.64%, 95% CI: −1.84 to −1.43), HbA1c (MD = −0.78%, 95% CI:−0.96 to −0.60), FINS (MD = −1.94%, 95% CI: −2.68 to −1.20), HOMA-IR (MD = −0.77%, 95% CI: −1.28 to −0.27), TC (MD = −0.70%, 95% CI: −1.00 to −0.39), TG (MD = −0.57%, 95% CI: −0.74 to −0.40), LDL-c (MD = −0.70%, 95% CI: −0.97 to −0.43), and HDL-c (MD = −0.21%, 95% CI: −0.32 to −0.10) for patients with T2DM. The funnel plot, Egger’s test, and trim-and-fill method indicated a moderate publication bias in the results. The TSA showed that the required sample size of HLPs in improving FBG, 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c could sufficiently draw reliable conclusions. GRADE assessment revealed that the quality of the evidence for the effectiveness of HLPs in improving FBG was moderate, but the quality of evidence for 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c was low, and for GD was very low. Conclusion: The systematic review and meta-analysis suggested that HLPs were beneficial for achieving glycemic control. However, HLPs recommended for T2DM patients have yet to be confirmed because of the poor methodological quality of some trials. Therefore, more RCTs with multicenter and double-blind designs are needed to assess the efficacy of HLPs for patients with T2DM.
... Diabetes mellitus is nowadays considered one of the "lifestyle" disorders, and over centuries, various species of plants are considered a fundamental resource of potent hypoglycaemic agents [1]. In developing nations, specifically, medicinal agents are utilized to treat DM to overcome the cost burden of conventional medications on the population [2]. Since decades, plants and their byproducts have been used as a major source of medicines due to their therapeutic potential. ...
Full-text available
Background: Diabetes is considered one of the most encyclopedic metabolic disorders owing to an alarming rise in the number of patients, which is increasing at an exponential rate. With the current therapeutics, which only aims to provide symptomatic and momentary relief, the scientists are shifting gears to explore alternative therapies which not only can target diabetes but can also help in limiting the progression of diabetic complications including diabetic neuropathy (DN). Methods: Tecoma stans leaf methanolic extract was prepared using the Soxhlet method. A streptozotocin (STZ; 45 mg/kg)-induced diabetic animal model was used and treatment with oral dosing of T. stans leaf extract at the different doses of 200 mg/kg, 300 mg/kg, and highest dose, i.e., 400 mg/kg, was initiated on day 3 after STZ administration. The pharmacological response for general and biochemical (angiogenic, inflammatory, and oxidative) parameters and behavioral parameters were compared using Gabapentin as a standard drug with the results from the test drug. Results: Parameters associated with the pathogenesis of diabetic neuropathy were evaluated. For general parameters, different doses of T. stans extract (TSE) on blood sugar showed significant effects as compared to the diabetic group. Also, the results from biochemical analysis and behavioral parameters showed significant positive effects in line with general parameters. The combination therapy of TSE at 400 mg/kg with a standard drug produced nonsignificant effects in comparison with the normal group. Conclusion: The leaves of T. stans possess antidiabetic effects along with promising effects in the management of DN by producing significant effects by exhibiting antioxidative, antiangiogenic, and anti-inflammatory properties, which are prognostic markers for DN, and thus, T. stans can be considered as an emerging therapeutic option for DN.
... Nutritional deficiency Proper nutrition is imperative for the maintenance of an individual's health and disease prevention (Sharma & Prajapati, 2014). Pollen and honey/nectar serve as key components in the honey bee's diet. ...
Full-text available
Honey bees pollinate various crops and wild plants which ensures food security. However, in this modern world, bees are suffering. Decreasing global domesticated and wild bee populations while the demand for agricultural pollination services is increasing is a matter of concern. Colony losses are driven by such factors or interactions as changing environmental conditions, exposure to agrochemicals, parasite and pathogens attack and decreased flower abundance and diversity. All these stresses individually or together affect the immune system of bees and consequently bee fitness. Poor nutrition is the key stressor as it directly suppresses the immune system and reduces host resistance to other stressors. To cope with these stresses, honey bees have well-developed individual and social immune systems which initiate several defence reactions, but its activation, maintenance and use are detrimental for bee survival as it occurs at the cost of bee health. This review summarizes the causal factors and their possible interaction responsible for immune suppression in honey bees.
... (1) The holistic approach of Ayurveda to manage wide range of diseases includes dietary and lifestyle interventions as well as regimens of herbal/mineral based medicines. (2) Tinospora cordifolia (Family: Menispermaceae) a renowned medicinal vine of Ayurveda is reported to possess multidimensional biological properties. (3)(4)(5) Tinospora cordifolia (Family: Menispermaceae) is one of the most widely used plant from the Ayurvedic system of medicine. ...
Full-text available
Guduchi is a plant also known as Tinospora cordifolia, having heart shaped leave, an herb of the family Menispermaceae native of hot areas of the Indian subcontinent. In our classical Ayurvedic texts, it is indicated to be beneficial in treating various types of diseases like skin disorders, different types of fever, jaundice & gout. Guduchi also claimed to have various properties as an anti-oxidant, antihyperglycemic, antihyperlipidemic, hepatoprotective, cardiovascular protective, neuroprotective, osteoprotective, radioprotective, anti-anxiety, adaptogenic agent, analgesic, anti-inflammatory, antipyretic, athrombolytic agent, anti-diarrheal, anti-ulcer, antimicrobial and anti-cancer agent. Several experimental and clinical studies based on available reports, present paper is an attempt to assemble the information on immunomodulating property of Tinospora cordifolia.
... The holistic approach of Ayurveda aims to manage wide range of diseases through effective diagnostic methods, interventions (dietary and lifestyle) as well as medicinal treatments. (1,2) Several therapeutic regimens and therapeutic claims have been validated on the scientific grounds. (3,4,5,6) In Ayurvedic therapeutics, the role classical diagnostic and prognostic methods are undeniable and indisputable. ...
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In medicinal science each disorder is presented with certain signs and symptoms. Many disorders are having certain complications which affect the treatment. In modern medicine signs and symptoms of a disease depicting poor prognosis are described. They are very important during the treatment of patient because they have an impact on management of that particular disorder. Similarly in Ayurveda there is Arishta Lakshna i.e. those signs and symptoms when present, they are indicative of imminent death are known as Arishta or Arishta Lakshna. They are always present at the time of terminal illness. As Ayurveda is very patient specific for treatment of ailments therefore every disease the Arishta Lakshna are mentioned in Ayurveda. Knowledge and understanding of these Arishta is important so that physician may know the outcome of the disease and not indulge in the treatment of incurable diseases.
... Holistic approach of Ayurveda healthcare is aimed to balance the physical, mental and spiritual function of the human body [1][2] . Ayurvedic herbal, herbo-mineral or metal/mineral based medicines are the key tool in Ayurvedic armamentarium to treat wide range of diseases [3][4][5][6][7][8] . ...
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Considering the wide therapeutic properties of metals, Tin is used as therapeutic agent to treat the wide range of diseases like Prameha, Krimi, Pandu, Mutrakricha, Shaweta Pradara, Rakta Pradara, Kalaibya since ancient times. To get precise quality of drug and efficacious results it is important to prepare the Ayurvedic drugs as per classical reference. The numbers of procedures were described by our Rasa Vaidyas for the preparation of Bhasma and so many methods are adopted or adopting our research scholars to prepare the Vanga Bhasma in their study work. Based on reported studies, there is lack of uniformity in pharmaceutical process is an evident. The researchers have adopted different methods and have shown slight variations in pharmaceutical methods, analytical evaluations. The present report encompasses all the different pharmaceutical methods adopted and their analytical outcomes. This present report expected to provide, new needs to researchers working in the area of pharmaceutico therapeutic investigations on Vanga Bhasma.
In India, the presently ongoing infectious COVID-19 wave is caused by the delta variant of SARS-CoV-2 which has also led thousands of causalities across the globe. The government and healthcare agencies are hovering for effective strategies to counter the pandemic. The application of nanotechnology and repurposing of drugs are found an effective approach, not obsolete but partly in managing the COVID-19 disease. It has also immensely boomed the search of productive, reliable, cost-effective, and bio-assimilable alternative solutions. Since ancient times, the traditionally employed Ayurvedic bhasmas opted for diverse infectious diseases, which are now justified as a nanomedicine that could be applied for managing COVID-19 related health anomalies. Like currently existing engineered metal nanoparticles (NPs), the bhasma nanoparticles (BNPs) are also packed with unique physicochemical properties including multi-elemental nanocrystalline composition, size, shape, dissolution, surface charge, hydrophobicity, multi-pathway regulatory, and modulatory effects. Here, it is hypothesized that due to these conformational- and configurational- based physicochemical advantages, bhasma NPs might have promising potential to manage the COVID-19 pandemic and can reduce the incidence of pneumonia-like common lung infections in children as well as old-age-related inflammatory diseases by immunomodulatory, anti-inflammatory, antiviral, and adjuvant-related characteristics.
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Type 2 diabetes is a chronic illness that has major long-term implications. It could be managed well by a proper diet and lifestyle changes. Ayurveda is an ancient medical practice that originated in India which gives diet the utmost importance for the management of the disease. In this review, a relation of Ayurvedic dietary management for mitigation of diabetes is critically discussed.
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Objective: To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non-insulin-dependent diabetes mellitus. Design: Cohort study. Setting: In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load. Main outcome measure: Non-insulin-dependent diabetes mellitus. Results: During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, P trend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR= 1.47; 95% CI, 1.16-1.86, P trend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72, 95% CI, 0.58-0.90, P trend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake. Conclusions: Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.
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Diseases of the endocrine glands highlight the importance of hormonal and nutritional factors in the regulation of metabolism in human beings. The nutritional alterations affect each and every aspect of the functioning of the endocrine glands leading to serious disorders. The last century was marked by the classical deficiency disorders, such as goiter, cretinism, hypothyroidism, and rickets. Industrialization coupled with increased availability of junk food leads to the epidemic of different nutritional endocrine disorders, such as obesity, metabolic syndrome, and diabetes. Endocrine disruptors are the new kids on the block with a variety of implications ranging from obesity to pubertal disorders. We give a concise outlook on various nutritional endocrine disorders in this review.
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Diabetes mellitus is a metabolic disorder that is charac-terized by chronic hyperglycemia, due to defects in insu-lin secretion and/or action activity (1). In the past decades, there has been a renewed interest in the use of natural products, including herbs and honey, in the treatment of diabetes. This commentary is written to allay fears that the use of honey is detrimental in diabetes. Recent find-ings indicate that honey improves glycemic control and exerts hypoglycemic effect in non-diabetic, alloxan-and streptozotocin-induced diabetic rats (2-5). The combina-tion of antidiabetic drugs with honey further improves glycemic control in diabetic rats (6). In humans, honey supplementation reduces hyperglycemia (3, 7). Only one study suggests that the use of honey in diabetes is det-rimental, observing that honey-supplemented diabetic patients had significantly increased glycosylated hemo-globin (8). In contrast, no such effect was observed in dia-betic controls (8). The findings from this study seem to suggest that the use of honey worsens glycemic control in diabetes. However, a closer examination of the study design and the honey that was used in the study indicates that such a conclusion is invalid. First, the honey-treated diabetic group received graded doses of honey orally for 8 weeks, starting from 1 g/kg/day for the first and second weeks, 1.5 g/kg/day for the third and fourth weeks, 2 g/kg/ day for the fifth and sixth weeks, and 2.5 g/kg/day for the seventh and eight weeks (8). Increasing the dose of any pharmacological agent, including honey, without prop-er therapeutic monitoring is inappropriate. Second, the majority of honey samples contain more fructose than glucose (or the same proportion) or fructose: glucose ratio ≥ 1.0 (6, 9). The honey used in the study had more glucose than fructose (fructose:glucose ratio, 0.46) (9), meaning that the amount of glucose in this honey was twice the amount of fructose. The reason for the unusu-ally high glucose content in this honey remains unclear. Whether this honey was adulterated, in whatever form, without the authors' knowledge is another subject en-tirely (10). This issue is significant due to its clinical implications in diabetic patients. Compelling evidence implicates the role of fructose in the hypoglycemic effect of honey (3). Therefore, administering honey that contains fructose levels that are twice as low compared with other honeys might not produce a similar effect as other honey variet-ies with high fructose contents. Further, administering Copyright c 2012 Kowsar M. P. Co. All rights reserved.
Diabetes has exploded in a majority of areas in the world. Healthy eating, as a strategy for controlling diabetes, and promoting walking, exercise, and other physical activities is advised. The main aim of the treatment of both types of diabetes is to achieve near normal blood glucose and blood pressure levels. This, together with a healthy lifestyle, will help to improve the well-being of the patients, as also protect them against long-term damage to the eyes, kidneys, nerves, heart, and major arteries. An attempt has been made in this review to focus on traditional uses and their multivalent actions as being health promoting, as well as putative therapeutic agents, especially in diabetes mellitus. Fruits, vegetables, and dietary spices represent a hope that is potentially very high, to limit harmful effects of them. They also influence various systems in the body, with diverse metabolic and physiological actions. They are helpful in various chronic diseases and have played a crucial role in the management of diabetes mellitus and form an important part of one's staple diet. They provide nutritional substances like dietary fiber, vitamins, minerals, and so on, which are essential for a balanced diet. The dietary pattern has beneficial effects on both human health development and treatment of various diseases, and hence, promoting adherence to this pattern is of considerable importance to public health.
Context Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results.Objective To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA1c) and body mass in patients with type 2 diabetes.Data Sources Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches.Study Selection We selected studies that evaluated the effects of exercise interventions (duration ≥8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded.Data Extraction Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted.Data Synthesis Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA1c was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, −0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P = .76).Conclusion Exercise training reduces HbA1c by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.
Objective. —To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non—insulin-dependent diabetes mellitus.Desing. —Cohort study.Setting. —In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load.Main Outcome Measure. —Non—insulin-dependent diabetes mellitus.Results. —During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, Ptrend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR=1.47; 95% CI, 1.16-1.86, Ptrend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72,95% CI, 0.58-0.90, Ptrend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake.Conclusions. —Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.
More than 100 million Americans have prediabetes or diabetes. Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes. People with prediabetes have an increased risk of Type 2 diabetes. An estimated 34% of adults have prediabetes. Prediabetes is now recognized as a reversible condition that increases an individual's risk for development of diabetes. Lifestyle risk factors for prediabetes include overweight and physical inactivity.Increasing awareness and risk stratification of individuals with prediabetes may help physicians understand potential interventions that may help decrease the percentage of patients in their panels in whom diabetes develops. If untreated, 37% of the individuals with prediabetes may have diabetes in 4 years. Lifestyle intervention may decrease the percentage of prediabetic patients in whom diabetes develops to 20%.Long-term data also suggest that lifestyle intervention may decrease the risk of prediabetes progressing to diabetes for as long as 10 years. To prevent 1 case of diabetes during a 3-year period, 6.9 persons would have to participate in the lifestyle intervention program. In addition, recent data suggest that the difference in direct and indirect costs to care for a patient with prediabetes vs a patient with diabetes may be as much as $7000 per year. Investment in a diabetes prevention program now may have a substantial return on investment in the future and help prevent a preventable disease.