Efficacy of integrated ayurveda Management protocol in prediabetes A randomized controlled clinical trial

Abstract

ABSTRACT Introduction Prediabetes is a metabolic disorder characterized by blood sugar levels that are elevated but not high enough to meet the diagnostic criteria for Type 2 Diabetes Mellitus (T2DM). It represents a critical phase where timely intervention can help prevent the onset of diabetes. The condition is identified through diagnostic markers such as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and increased HbA1c levels. Affecting 8–14% of the global population, its prevalence is increasing due to sedentary lifestyles, poor dietary habits, and obesity. Prediabetes results from insulin resistance, where cells fail to respond to insulin, and beta-cell dysfunction, impairing insulin production. Contributing factors include chronic low-grade inflammation, oxidative stress, and genetic predisposition. Key risk factors include obesity, sedentary behavior, an unhealthy diet, and advancing age, with central fat accumulation playing a pivotal role in the development of insulin resistance. Beyond its transitional nature, prediabetes is linked to severe health risks, such as cardiovascular disease, kidney dysfunction, and neuropathy. Management typically involves lifestyle changes, including diet, exercise, and weight control, supplemented by pharmacological options like metformin. However, adherence to these interventions is challenging, and pharmacotherapy may have side effects. Ayurveda, a holistic Indian medical system, offers promising management strategies for prediabetes, termed Prameha, emphasizing dosha balance, Panchakarma, and herbal remedies like Guduchi, Haridra, and Amla. These xxvi

interventions target root causes like Kapha dosha imbalance and provide comprehensive care through dietary modifications and lifestyle adjustments. Yoga complements Ayurveda by improving insulin sensitivity, reducing stress, and enhancing metabolic health. Studies highlight the benefits of asanas, pranayama, and meditation for fasting glucose and HbA1c control. Despite encouraging findings, integrated Ayurveda and Yoga therapies remain underexplored, necessitating robust randomized controlled trials to validate their efficacy. These traditional interventions offer a holistic and sustainable alternative for addressing the growing public health challenge of prediabetes.