Introduction
Diabetes is a chronic non-communicable disease caused by defects in insulin secretion, ineffective insulin utilization, or both, resulting in elevated blood glucose levels. Persistent hyperglycemia can lead to complications affecting the heart, eyes, kidneys, and nerves. Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of diabetes cases worldwide. More than 422 million people are affected globally, with over 1.5 million deaths directly attributed to diabetes each year. The age-adjusted prevalence of diabetes in Southeast Asia is estimated at 10.0%.1
Current approaches to diabetes management
Conventional diabetes management focuses on preventing complications and improving glycemic control through:
- Lifestyle modifications
- Diabetes screening programs
- Insulin therapy
- Oral antidiabetic medications, including:
- Biguanides
- Sulfonylureas
- Meglitinides
- Thiazolidinediones
- α-glucosidase inhibitors
- Dipeptidyl peptidase-IV inhibitors
These interventions form the primary and secondary healthcare strategies for diabetes management.
Ayurvedic understanding of diabetes
Ayurveda describes diabetes under the disease categories of Prameha Roga and Madhumeha.
Key Ayurvedic concepts include:
- The term Prameha is derived from “pra” meaning excess and “meha” meaning passing urine.
- Prameha Roga encompasses disorders characterized by increased frequency of urination.
- Madhumeha is described as a subtype of Prameha characterized by excessive passage of urine that is sweet in nature.
- Traditional Ayurvedic management utilizes herbal medicines and polyherbal formulations that have been used for centuries in clinical practice.2
Traditional herbal formulations used in T2DM
A commonly used Ayurvedic decoction for T2DM contains:
- Musa paradisiaca L.
- Tribulus terrestris L.
- Phyllanthus emblica L.
- Salacia reticulata Wight
- Santalum album L.
- Sida rhombifolia subsp. alnifolia (L.) Ugbor.
Some practitioners additionally incorporate Coccinia grandis (L.) Voigt into the formulation.
Therapeutic relevance of individual herbs
Several ingredients used in these formulations have a long history of traditional use in diabetes management:
- Leaves of Coccinia grandis have been used as a complementary approach for diabetes management.
- Salacia reticulata is a widely utilized Ayurvedic herb for diabetes, and randomized controlled trials have shown reductions in fasting blood glucose, glycated hemoglobin (HbA1c), and body mass index in patients with T2DM.
- Stem juice of Musa paradisiaca has traditionally been used for diabetes mellitus in several tropical countries.
- Tribulus terrestris is used in multiple traditional medicine systems for diabetes management.
- The fruit of Phyllanthus emblica plays an important role in the management of T2DM and its metabolic complications.
- Sida rhombifolia subsp. alnifolia has been utilized in folk medicine for diabetes.
Future perspectives and clinical evidence
Herbal therapies have been used by complementary and alternative medicine practitioners for centuries. However, there remains a need for scientific evaluation of their efficacy and safety through rigorous clinical methodologies, particularly randomized controlled trials.
Available evidence suggests that the polyherbal product LG significantly improves glycemic indices and quality of life in individuals with diabetes. Additional benefits on metabolic parameters have also been observed through lipid-lowering effects.3
Conclusion
Ayurveda offers a longstanding therapeutic framework for diabetes through the concepts of Prameha Roga and Madhumeha. Traditional polyherbal formulations containing Salacia reticulata, Phyllanthus emblica, Musa paradisiaca, Tribulus terrestris, Coccinia grandis, and Sida rhombifolia continue to be used in clinical practice. Emerging clinical findings support their potential role in improving glycemic and metabolic outcomes, highlighting the importance of further scientific evaluation of these traditional interventions.4,5
Refrences:
1. Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. doi:10.1016/j.diabres.2021.109119. https://www.sciencedirect.com/science/article/abs/pii/S0168822721004782
2. Rannan-Eliya RP, Wijemunige N, Perera P, et al. Prevalence of diabetes and pre-diabetes in Sri Lanka: a new global hotspot-estimates from the Sri Lanka Health and Ageing Survey 2018/2019. BMJ Open Diabetes Res Care. 2023;11(1):e003160. doi:10.1136/bmjdrc-2022-003160. https://pmc.ncbi.nlm.nih.gov/articles/PMC9936281/
3. Sathasivampillai SV, Rajamanoharan PRS, Heinrich M. Siddha Medicine in Eastern Sri Lanka Today-Continuity and Change in the Treatment of Diabetes. Front Pharmacol. 2018;9:1022. Published 2018 Oct 10. doi:10.3389/fphar.2018.01022. https://pmc.ncbi.nlm.nih.gov/articles/PMC6192459/
4. Jayasinghe DM, Buddhadasa HK, Rajapaksa DH, Jayethilaka KGP. Ayurveda Pharmacopeia. Department of Ayurveda; 1979:30-32. https://pcimh.gov.in/show_content.php?lang=1&level=1&ls_id=56&lid=54
5. Perera B, Goonaratna C, Ariyawansa H, Senaratna N, Perera J. Efficacy and Safety of an Ayurveda Herbal Formulation in Uncomplicated Type 2 Diabetes mellitus. J Evid Based Integr Med. 2025;30:2515690X251347167. doi:10.1177/2515690X251347167. https://pmc.ncbi.nlm.nih.gov/articles/PMC12125513/#section5-2515690X251347167