DIET AND PREDIABETES – A SURVEY BASED STUDY .......

(1)

International Ayurvedic Medical Journal, (

DIET AND PREDIABETES –

Sanjib Kumar Das1, Anuradha Das

1_{Senoir Consultant, Central Ayurved Research Institute for Hepatobiliary Disorders,}

Bhubaneswar under CCAS.

2_{MD Scholar,Gopabandhu Ayurveda Mahavidyalaya,}

3_{Research officer, Scientist – 2, Central Ayurved Research Institu}

4_{Research officer, Scientist – 2, Central Ayurved Research Institute for Hepatobiliary Disorders,}

Email: [email protected]

ABSTRACT

A stage in which individuals are at greater risk of progressing to type 2 DM & have an increased risk of cardiovascular diseases is called as Prediabetes,

ern medicine T2DM is a burden upon health care

DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 382 million in 2013. Based on current trends

individuals will have diabetes by the year 2035

interaction of genetics & environmental factors. Depending on the etiology of the DM, factors contri uting to hyperglycemia include reduced ins

glucose production. In the countries DM is the leading cause of end

traumatic lower extremity amputations, & adult blindness. It also predisposes to cardiovascular

With an increasing incidence worldwide, DM will be a leading cause of morbidity & mortality in the future. As depicted in our classics addiction to the pleasure of some diets viz.,

of domestic, aquatic and marshy land a ly prepared alcoholic drinks, preparations of

Madhumeha (Prediabetes) on which a survey based study has been conducted.

Keywords: Diet, Prediabetes, Glycosylated Hemoglobin, T2DM

INTRODUCTION

Unlike many other chronic diseases, T2DM is not heralded by a discrete physiologic event

INTERNATIONAL

AYURVEDIC

MEDICAL JOURNAL

International Ayurvedic Medical Journal, (ISSN: 2320 5091) Volume 6, Issue 1, January, 2018

– A SURVEY BASED STUDY

Anuradha Das2, Banamali Das3, Purnendu Panda4

ved Research Institute for Hepatobiliary Disorders,

Gopabandhu Ayurveda Mahavidyalaya, Puri, Odisha, India

2, Central Ayurved Research Institute for Hepatobiliary Disorders,

A stage in which individuals are at greater risk of progressing to type 2 DM & have an increased risk of Prediabetes, if neglected converted to T2DM in long term.

ern medicine T2DM is a burden upon health care facilities in all countries. The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 382

n 2013. Based on current trends, the International Diabetes Federation projects that 59

the year 2035. Several distinct types of DM are caused by a complex interaction of genetics & environmental factors. Depending on the etiology of the DM, factors contri uting to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. In the countries DM is the leading cause of end-stage renal disease

traumatic lower extremity amputations, & adult blindness. It also predisposes to cardiovascular

With an increasing incidence worldwide, DM will be a leading cause of morbidity & mortality in the depicted in our classics addiction to the pleasure of some diets viz., Curds, soup of the flesh

and marshy land animals, milk preparations, freshly harvested food particles, fres ly prepared alcoholic drinks, preparations of jaggery are responsible for the caution of

(Prediabetes) on which a survey based study has been conducted.

, Glycosylated Hemoglobin, T2DM

Unlike many other chronic diseases, T2DM is not heralded by a discrete physiologic event

which defines diagnoses; rather it sits at one end of a continuous glucose control spectrum with ved Research Institute for Hepatobiliary Disorders,

liary Disorders,

2, Central Ayurved Research Institute for Hepatobiliary Disorders,

A stage in which individuals are at greater risk of progressing to type 2 DM & have an increased risk of if neglected converted to T2DM in long term. In

mod-facilities in all countries. The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 382 projects that 592 million Several distinct types of DM are caused by a complex interaction of genetics & environmental factors. Depending on the etiology of the DM, factors

contrib-ulin secretion, decreased glucose utilization, and increased stage renal disease (ESRD), non traumatic lower extremity amputations, & adult blindness. It also predisposes to cardiovascular diseases. With an increasing incidence worldwide, DM will be a leading cause of morbidity & mortality in the Curds, soup of the flesh nimals, milk preparations, freshly harvested food particles,

fresh-responsible for the caution of Purwarupa of

(2)

IAMJ: VOLUME 6, ISSUE 1, JANUARY, 2018 19

normal glucose control at the other. In-between these two boundaries exists a region of abnor-mal glucose control which is already character-ized by concomitant insulin resistance & β – cell dysfunction but does not yet reach the crite-ria for T2DM[1] is called Prediabetes (a stage in which individuals are at greater risk of pro-gressing to T2DM & have an increased risk of cardiovascular diseases) [2].Those diagnosed with T2DM typically spend an extended period in this region of impaired glucose regulation, sometimes for more than a decade, before pro-gressing to T2DM[3] which is strikingly re-semble with the purwarupa of madhumeha (a stage in which polydipsia, Burning -sensation in the palm and sole, numbness in palm and sole, Lassitude, etc. are predominant)[4]. The Diabe-tes Prevention Program (DPP) demonstrated that intensive changes in lifestyle (diet and ex-ercise for 30 min/d five times/week) in individ-uals with IGT prevented or delayed the devel-opment of T2DM when implemented in the stage of prediabetes [5] were already inscribed by our classics with the pact [6] which implies looking after our body by means of

Pathyapalana (Maintenance of proper diet

without much more addiction to the pleasure of some diets viz., Curds, soup of the flesh of do-mestic, aquatic and marshy land animals, milk preparations, freshly harvested food particles, freshly prepared alcoholic drinks, preparations of jiggery)which is the only way of preventing our body from the encroachment of the most devastating metabolic disorder,T2DM. The Re-search in Ayurveda is just searching out the idea about the mechanism of action of the remedies & compelling us to bow down before Acharya Rising Faith & belief in our horizon.

Demography:

The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 382 mil-lion in 2013. Based on current trends, the inter-national diabetes federation projects that 592 million individuals will have diabetes by the year 2035 [7].

Aims and objectives:

To assess the diets consumed in excessive quan-tity held responsible for Prediabetes.

Materials and Methods:

A total 60 no. of patients attending OPD of the

Institute for Postgraduate Teaching,

Gopabandhu Ayurveda Mahavidyalaya & Hos-pital, Puri were selected irrespective of their sex, caste etc. taking into consideration the in-clusion and exin-clusion criteria.

Selection Criteria Inclusion Criteria:

a) Purwarupa of Madhumeha (Prediabetes)

1. Pipasa (Thirstiness)

2. Karapada Daha ( Burning sensation in the palm and sole)

3. Karapada Supata ( numbness in palm and sole)

4. Alasya (Lassitude)

b) Biochemical Estimation of Prediabetes 1. IFG -100 – 125 mg/dl

2. IGT- 140 – 199 mg/dl 3. HbA1c - 5.7 – 6.4 mg/dl

Exclusion criteria:  Pregnant ladies.  Retinopathy.  Renal failure.

(3)

Sanjib Kumar Das et al : Diet And Prediabetes

IAMJ: VOLUME 6, ISSUE 1, JANUARY, 2018

 Autonomic neuropathy.

 Infraction/ MI (Myocardial Infarction).  TIAs (Transient Ischaemic Attacks)

Laboratory investigation: [8]

Impaired fasting glucose (IFG), Impaired gl cose tolerance (IGT) & HbA1C (Glycosylated

OBSERVATION AND RESULTS

Table 1: Showing the incidence of curd intake of the patients

(N= Total no. of patients, f= frequency=No. of patients, %=percentage) Sl. No.

1 2

Total

In the study more patients with this disease had the history of taking curd i.e. 51 (85%) in co parison to those who didn’t have the history of

Table 2: Showing the incidence of Flesh of domestic a

Sl. No. Flesh of domestic animals

1 Yes

2 No

Total

From the above table it is resulted that patients taking Flesh of domestic animals were maxima ly affected by this disease i.e. 45 (75 %) in comparison to patients having no such type of

Sanjib Kumar Das et al : Diet And Prediabetes – A Survey Based Study

E 1, JANUARY, 2018

Infraction/ MI (Myocardial Infarction). Attacks)

Impaired glu-(Glycosylated

Hemoglobin) have been adopted by WHO as the standard diagnostic criteria for Prediabetes.

Ethical approval:

The research protocol was approved by the “I stitutional Ethical Committee,”

Ayurveda Mahavidyalaya & Hospital, Puri.

OBSERVATION AND RESULTS

Showing the incidence of curd intake of the patients N=60 (N= Total no. of patients, f= frequency=No. of patients, %=percentage)

curd f %

Yes 51 85

No 9 15

60 100

patients with this disease had the history of taking curd i.e. 51 (85%) in com-parison to those who didn’t have the history of

taking curd i.e. 9 (15%). So the curd intake type of ethology Prediabetes is becoming more ev dent.

Showing the incidence of Flesh of domestic animals intake of the patients.

Flesh of domestic animals f %

45 75

15 25

60 100

From the above table it is resulted that patients domestic animals were maximal-ly affected by this disease i.e. 45 (75 %) in comparison to patients having no such type of

food habit i.e 15 (25%). From this incidence the Flesh of domestic animals intake type of etiol gy of Pre diabetes is becoming more evi

20

Hemoglobin) have been adopted by WHO as the standard diagnostic criteria for Prediabetes.

The research protocol was approved by the “In-stitutional Ethical Committee,” Gopabandhu Ayurveda Mahavidyalaya & Hospital, Puri.

%

85 15

100

(15%). So the curd intake type of ethology Prediabetes is becoming more

evi-nimals intake of the patients. N=60

(4)

Table 3: Showing the incidence of Flesh of aquatic animals intake of the patients

Sl. No. Flesh of aquatic animals

1 Yes

2 No

Total

From the above table more patients were taking Flesh of aquatic animals i.e. 43 (72 %) in co parison to those who were not taking i.e. 17

Table 4: Showing the incidence of Flesh of marshy land animals intake of the patients

Sl. No. Flesh of marshy land animals

1 Yes

2 No

Total

The above table shows that more patients (60 %) had the history of taking

marshy land animals in comparison to others who didn’t have history of taking

E 1, JANUARY, 2018

Showing the incidence of Flesh of aquatic animals intake of the patients N=60

Flesh of aquatic animals f

43

60

From the above table more patients were taking . 43 (72 %) in com-parison to those who were not taking i.e. 17

(28%). So the Flesh of aquatic animal intake type of etiology of Prediabetes is becoming more evident.

Showing the incidence of Flesh of marshy land animals intake of the patients Flesh of marshy land animals

The above table shows that more patients i.e 36 (60 %) had the history of taking Flesh of marshy land animals in comparison to others history of taking Flesh of

marshy land animals ie 24 (40 %). So the Flesh of marshy land animals intake type of etiology of Pre Diabetes Is becoming more evident

21

N=60

f %

43 72

7 28

60 100

(28%). So the Flesh of aquatic animal intake Prediabetes is becoming

Showing the incidence of Flesh of marshy land animals intake of the patients N=60

F %

36 60

24 40

60 100

marshy land animals ie 24 (40 %). So the Flesh of marshy land animals intake type of etiology

(5)

Sanjib Kumar Das et al : Diet And Prediabetes

Table 5: Showing the incidence of milk intake of the patients

Sl. No. Milk

1 Yes

2 No

Total

From the above table it is evident that maximum no. of patients i.e. 56 (93%) were taking Milk comparison to those who were not taking

Table 7: Showing the incidence of Fresh grains and water Sl. No. Fresh grains and water

1 Yes

2 No

Total

Above table shows that maximum patients i.e 31 (52%) with this disease were not taking Fresh

E 1, JANUARY, 2018

Showing the incidence of milk intake of the patients N=60

Milk f %

Yes 56 93

No 4 7

60 100

From the above table it is evident that maximum taking Milk in comparison to those who were not taking i.e.

4(7%) in connection to this disease which just fies the Milk Intake type of etiology of Prediabetes.

Showing the incidence of Fresh grains and water intake of the patients N=60

Fresh grains and water f

29 31 60 Above table shows that maximum patients i.e 31

(52%) with this disease were not taking Fresh

grains and water as compared to the 29 (48 %).

22

%

93 7

100

4(7%) in connection to this disease which justi-fies the Milk Intake type of etiology of

N=60

% 48

31 52

100

(6)

Table 8: Showing the incidence of Jaggery/

Sl. No. Jaggery / Sugar/ its products like sweets

1 Yes

2 No

Total

From the incidence of Jaggery/ Sugar/ its pro ucts like sweets, out of 60 patients, 51 (85 %) patients had the history of Jaggery/ Sugar/ its

DISCUSSION

CURD:

In the study more patients had the history of ta ing curd i.e. 51 (85%) in comparison to those who didn’t have the history of taking curd i.e. 19(15%). So the curd) intake type of etiology of Prediabetes is established.

FLESH OF DOMESTIC ANIMALS ( Sheep):

75 % of the patients were taking the above diet followed by 25 % of patients not taking it. So it

E 1, JANUARY, 2018

wing the incidence of Jaggery/Sugar/ its products like sweets intake of the patients Jaggery / Sugar/ its products like sweets

From the incidence of Jaggery/ Sugar/ its prod-ucts like sweets, out of 60 patients, 51 (85 %) patients had the history of Jaggery/ Sugar/ its

products like sweets. But 9 (15 %) patients didn’t have such type of history.

In the study more patients had the history of tak-i.e. 51 (85%) in comparison to those who didn’t have the history of taking curd i.e. type of etiology of

FLESH OF DOMESTIC ANIMALS (Goat,

75 % of the patients were taking the above diet followed by 25 % of patients not taking it. So it

is revealed that persons taking flesh of domestic animals are affected by this disease.

FLESH OF AQUATIC ANIMALS:

More patients were taking Flesh of aquatic an mals i.e. 72 % in comparison to those who are not taking i.e. 28 %. So the Flesh of aquatic a imals intake type of etiology of Prediabetes is established.

FLESH OF MARSHY LAND ANIMALS: 60 % of the patients had the history of taking Flesh of marshy land animals in comparison to others who didn’t have history of taking Flesh

23

sweets intake of the patients N=60

F %

51 85

9 15

60 100

products like sweets. But 9 (15 %) patients didn’t have such type of history.

is revealed that persons taking flesh of domestic animals are affected by this disease.

ATIC ANIMALS:

More patients were taking Flesh of aquatic ani-mals i.e. 72 % in comparison to those who are

So the Flesh of aquatic an-imals intake type of etiology of Prediabetes is

(7)

Of marshy land animals ie 24 (40 %). So the Flesh of marshy land animals intake type of eti-ology of Pre diabetes is proved.

MILK:

Maximum no. of patients i.e. 56 % of patients were taking milk followed by 7 % of patient not taking paya. It is evident from the above data milk intake type of etiology of Prediabetes is justified.

FRESH GRAINS AND WATER:

Maximum patients i.e. 52% are not taking Fresh grains and water as compared to the others i.e. 29 (48%). It is revealed from the study that both the varieties are affected by this disease.

JAGGERY / SUGAR/ ITS PRODUCTS LIKE SWEETS:

From the incidence of Jaggery/ Sugar/ its prod-ucts like sweets, out of 60 patients, 85 % pa-tients had the history of taking Jaggery / sugar/ its products like sweets But 15 % patients didn’t have such type of history. So it is evident that Jaggery/ Sugar/ its products like sweets intake type of etiology of Pre Diabetes Is justified. SUMMARY

Basing on the selection of patients, above de-picted diagnostic criteria viz., IFG, IGT HbA1c were availed in which 60 no of patients of prediabetes were registered for the sur-vey.T2DM is not heralded by a discrete physio-logic event which defines diagnoses; rather it sits at one end of a continuous glucose control spectrum with normal glucose control at the other. In-between these two boundaries exists a region of abnormal glucose control which is al-ready characterized by concomitant insulin re-sistance & β – cell dysfunction but does not yet reach the criteria for T2DM. It was evident from the survey that individuals addicted to the pleasure of Curds, soup of the flesh of domestic, aquatic or marshy land animals, milk, Fresh

grains and water, preparations of Jaggery / Sug-ar/ its products like sweets were encroached by the devastating prediabetes. If successful man-agement schedule is implemented in the process of consequence of insulin resistance syndrome, individual will get rid of its influence which has been inscribed from modern & classical point of view.

CONCLUSION

Unhealthy lifestyle and Prediabetes are inextri-cable linked, with the former being the primary causal agent of the latter. Unhealthy lifestyle practices attributable to modern industrialized environments have been shown to account for most of the cases of Prediabetes. Observational survey has suggested that overall dietary pat-terns are one of the important considerations. for example, addiction to the pleasure of some diets viz., Curds, soup of the flesh of domestic, aquat-ic and marshy land animals, milk preparations, freshly harvested food particles, freshly pre-pared alcoholic drinks, preparations of jiggery [8] are responsible for the caution of Prediabetes (Purwarupa of Madhumeha). On the other hand those consuming a prudent diet (intake of whole grain cereal, vegetables, legumes, low-fat dairy products, nuts, seeds, fish, and poultry), have a lower risk of Prediabetes.

References

1. International Textbook of Diabetes Mellitus, 4th edition, Edited by Ralph A. DeFronzo, E Ferrannini vol – 1, Page – 550.Zimmet, & K. George Alberti, 2015 John Wiley & Sons, Ltd.

2. Harrison’s principles of internal medicine (vol 2, p – 2401) 19th edition.

(8)

development. Lancet 2012; 379:2279 – 2290.

4. Agnivesha, Charakasamhita, Nidana Sthana 4/47. edited by Vaidya Yadavji Trikamji Acharya. Varanasi: Chaukhambha Surbharati Prakashan; 2008.

5. Harrison’s principles of internal medicine (vol 2, p-2406) 19th edition.

6. Agnivesha, Charakasamhita, Nidanas thana

6/7. edited by Vaidya Yadavji Trikamji Acharya. Varanasi: Chaukhambha Surbharati Prakashan; 2008.

7. Harrison’s principles of internal medicine

(vol 2, p-2400) 19th edition,

(http://www.idf.org/ )

8. WHO Diabetes guideline Development committee: Definition & Diagnosis of Dia-betes Mellitus and Intermediate hypergly-cemia. Geneva: WHO, 2006. WHO: Use of glycated hemoglobin (HbA1C) in the diag-nosis of DM. Abbreviated report of a WHO consultation. Geneva: WHO 2011.

Source of Support: Nil

Conflict Of Interest: None Declared

How to cite this URL: Sanjib Kumar Das et al : Diet And Prediabetes – A Survey Based Study. International Ayurvedic Medical Journal {online} 2017 {cited December, 2017} Available from: