Achar Rasayana in Diabetes prevention

Dr. Vikas Chothe

PG Scholar, Dept of Swasthavritta

CARC, Pune (India)

Dr. Arti Firke

Guide, Dept of Swasthavritta

CARC, Pune (India)

India-Diabetes capital of the world

•loss of national income•high treatment costs•low priority to prevention

© Dr. Chothe. V.R

Burden of Diabetes

Global India

2010 285 million 51 million

2030 438 million 87 million

-( Snehalatha and Ramachnadaran. Diabetes Care 2009)

Causes of Diabetes

IN ALLOPATHY IN AYURVEDA

oily and heavy diet cold ,sweet, sour food excessive intake of

yogurt sugar and jaggery sleeping during the

daytime excessive sex jaatah(C. Chi)/sahaja(Su.

Chi) and kulaja-Charak sutrasthana 17/78-81

© Dr. Chothe. V.R

Family History Genetic factors Obesity (via BMI and WHR) Hypertension Low/High Birth Weight

(Intra-uterine Environment exposure)

Modifiable Diabetes risk factors

stress (Discovery Medicine 2010 by Frans Pouwer

et al.).

tobacco and alcohol (Lancet

1991 by Rimm EB).

anxiety (Golden et al.

Psychoneuroendocrinology 2006).

depression (vishada) (Knol et

al. Diabetologia 2006)

anger and hostility (J Intern

Med 2009 Rod et al.).

habitual sleep disturbances (Cappuccio FP.

Diabetes Care 2010)

unhealthy diets (C.Su.17)

abdominal obesity ( S.Ni.6/25 and C.Su.17 and Arch Gen

Psychiatry 2008 ).

high cholesterol

Addiction

Over 25 percent of people newly diagnosed with diabetes are smokers.(Malarcher AM et al. Diabetes Care 18:694–697, 1995)

Alcohol abuse increases the risk for diabetes.(C.Su.17.78-89 and Diabetes Jan 2011;60(1):74-9 Joosten MM et al. )

© Dr. Chothe. V.R

© Dr. Chothe. V.R

Work Stress (Kumari M et al. Arch Intern Med 2004)

• excessive overtime• over commitment to work

Unsatisfactory interpersonal relationships (Diabetes Care 1998 by Trief PM et al )

• poor marital relationship• family conflicts• nuclear families• social withdrawal

© Dr. Chothe. V.R

Lifestyle modification in conventional medicine

no smoking weight reduction ≥

5% leisure-time physical

activity (LTPA), walking for ≥30 minutes per day

BMI<23 kg/m2(Mohan et al.

Diabetic Medicine, 2007)

healthy diet according to the Smart Diet Score (SDS)

eat ≥400 g of vegetables and fruits per day.

limit salt consumption to <6 g/d.

by The Finnish Diabetes Prevention Study(DPS) and The Diabetes Prevention Program Research Group published in New England Journal of Medicine (2002)

Rasayana for Diabetes (rejuvenation therapy)

Labhopayo Hi Sastanam Rasadinam Rasayanam (C.Chi1/8)

Rasayana is any herb, food, or activity which confers youthfulness and cures diseases.

rasayana includes purification of all tissues from rasa to shukra.

special health promoting conduct and behavior

© Dr. Chothe. V.R

Achara Rasayana (Ayurvedic lifestyle modification)

SADVRITTA(ETHICAL REGIMEN)

KALA CHIKITSA( ART THERAPY)

aalekhgeetnrutyanatyavadya

Good mental conduc

t

Good social

conduct

Good person

al conduc

t

Good moral

conduct

Good religio

us conduc

t

© Dr. Chothe. V.R

Manasika Sadvritta (Good mental conduct)

LobhaShokaBhayaKrodhaManaVegan Vidharayet (C. Su 7/27)

Anger and hostility are associated with diabetes and influence HbA1c in diabetic patients struggling with glycemic control. (Diabetes Research and Clinical Practice.2006 by Attari A et al.)

akrodham – calm and cheerful personality (C. Chi. 1/4)

Dhiram- perseverant (C. Chi. 1/4)

anrushasyaparam nityamnityam karunavedinam – devoted to love and compassion (C. Chi. 1/4)

Hence one should strive to bring happiness and positive manasbhavas to all. This attitude is termed as Hitaya in our Indian culture. © Dr. Chothe. V.R

Samajika Sadvritta(Good social conduct)

Jitatmanam-optimist and positivist (C. Chi. 1/4)

Prashantam- calm (A.H.Su.2:46-48)

Shastaacharamsankeernam- well behaved and simple

Vrudhanamastikanam-keeping company of elders (C. Chi. 1/4)

Dev go Brahman acharya vrudharchane ratam- worshipping God, cow, brahmanas, teacher, preceptor and elders (C. Chi. 1/4)

Nivruttam madyamaithunat- abstaining from liquor and excessive sexual intercourse (C. Chi. 6) (James E Muller et al. The American Journal of Cardiology 1999)

love thy neighbor

© Dr. Chothe. V.R

Dharmic SadvrittaGood religious conduct

Adhyatma pravanendriyam -Having senses concentrated to spiritualism (C. Chi. 1/4)

Japa- repeating incantations (C. Chi. 1/4)

Dharma shastraparam- devoted to holy scriptures (C. Chi. 1/4)

religious involvement or spiritual well-being helps in coping with social isolation (Brown, & Manger, 1983. Journal of Religion and

Health) and depression in T2DM patients (Bickel et al.1998 American Journal of Epidemiology)

© Dr. Chothe. V.R

Spirituality for Healthy Living

Sharirika SadvrittaGood personal conduct

DINACHARYA

dina – day & acharya – behavior

In order to keep the tridoshas and agni (metabolism) in a state of healthy equilibrium, Ayurveda prescribes for each individual a specific daily routine

RITUCHARYA

Following the seasonal taste adjustments, dietetics and regime is beneficial in keeping seasonal and lifestyle disorders at bay.

© Dr. Chothe. V.R

snan (daily clean bath) (C.Chi.6/50)

nivrutam madya (alcohol)

shaucha (Cleanliness) (C. Chi. 1/4)

vyayama(Exercise) (A.H.Su.2, C.Ni.4/5 C.Chi 6/50) (Orozco LJ.et al. Cochrane Database Syst Rev. 2008 July)

chankraman (Daily walking) (C.Ni 4/50)

yoga (Badr Aljasir et al. Evid Based Complement Alternat Med. 2010 )

samajagarana swapnam (Good

sleep) (C. Chi. 1/4) (Chisa G. Int J Endocrinol. 2011,Cappuccio FP. Diabetes Care 2010)

Vyavaharika SadvrittaGood moral conduct

dananityam and tyaga- observing charity and simplicity (A.H.Su.2:46-48)

yuktidnyamahankrutam- intelligent and unconceited (C. Chi. 1/4)

upasitaram-self controlled (C. Chi. 1/4)

satyavadinam- speaking the truth (C. Chi. 1/4)

priyavadinam- sweet spoken (C. Chi. 1/4)

marital adjustment, high family cohesion and social support are important in improving glycemic control and self-management behavior (Garay-Sevilla ME. J Diabetes Complications 9:81–86, 1995)

What is Art (Kala)?

Art is the expression of feeling of the artist, who derives the joy of aesthetic experience (ananda) influencing beneficially the mind of the viewers– Abhinavagupta

Ranging from ancient rock cave paintings at Bimbetaka and mandalas to new aged clinical therapy, art has been used for stress reduction in Ayurveda.

© Dr. Chothe. V.R

What is art therapy?

Art therapy is a ‘mental health’profession that uses the creation ofart as a way to increase mental andemotional well-being. -(American Art therapy Association)

© Dr. Chothe. V.R

A good painting cleanses and curbs anxiety and banishes bad dreams -Vishnudharmottara Puranana

Ragas (Music) exhibit positive effect on sleep, emotions and prolongs life. – (A.H.Su-7)

Imagery, touch, music and dance as adjuncts to diabetic and cardiac care. - Lancet 366:211-217.

Dancing (nrutya) is a good form of exercise and helps in management of stress and obesity

If every individual observes rules and regulations as described in Swasthavritta i.e. daily and seasonal regimen, ethical regimen, takes proper food, sleep and enjoys controlled sexual activity, he can enjoy long and healthy life.

© Dr. Chothe. V.R

© Dr. Chothe. V.R

Conclusion

cost-effective strategy to reduce global burden of diabetes

Achara Rasayana (Ayurvedic lifestyle modification) has been highly significant clinically. Hence there is need for conducting prospective cohort studies without publication bias.

awareness about Achara Rasayana in physicians and health care policy makers needed.

© Dr. Chothe. V.R

 

Thank You

There is more to life than increasing its speed.

-Mohandas K. Gandhi

Acknowledgements

• Thank you Dr. Atul Rakshe Sir, Dr. Bobade Sir and Dr. Arti Firke who have always been my guide and inspiration.

• Thanks to Department of Swasthavritta, CARC, Akurdi (India)

© Dr. Chothe. V.R