Randomized Controlled Open label Clinical trial to Study add on effect of Triphaladi Kashay alongwith Metformin in management of Madhumeha w.s.r to type 2 Diabetes Mellitus

Ayurveda is a natural health care system that originated in India since the beginning of civilization. It is described by Acharya Charak that to achieve purushartha chatushtaya, Arogya is necessary. Ayurveda strongly emphasize on preventive and promotive aspects of health rather than curative. The concepts of Dincharya, Ritucharya, Sadvritta and Achara Rasayana along with guidelines for healthy diet and lifestyle is well established in Ayurveda, but in current scenario, hardly any one follows it as a result ,there is tremendous rise in lifestyle disorders as pandemics, Diabetes being most menacing among them. Diabetes is fourth leading cause of global death by disease. Type 2 DM is responsible for approximately 90% of cases. Therefore today’s India is called nation of DM.

Madhumeha "Richman’s disease", since Vedic period, is familiar to mankind. Madhumeha is a disease in which mutra (Urine) of the patient attains similar property like those of madhu (Honey). It is documented as one among the twenty obstinate urinary disorders i.e. Prameha. It is also explained that, when the other Prameha are left untreated, this lead to the condition called Madhumeha. So Madhumeha can also be considered as an advanced condition or stage of Prameha.

Diabetes Mellitus is a chronic disorder of carbohydrate metabolism, marked by hyperglycemia and glycosuria and resulting from inadequate production or use of insulin. Traditionally, Madhumeha can be equated with diabetes mellitus, as many similarities in view of their causative factors, pathogenesis, signs and symptoms, classification, complications and treatment has been found.

Diabetes mellitus is a clinical syndrome characterised by hyperglycemia caused by an absolute or relative deficiency of insulin & insulin resistance lack of insulin, whether absolute or relative, affects the metabolism of carbohydrates. Type II diabetes mellitus has become a global epidemic. Modern medicines, despite offering a variety of effective treatment options can have several adverse effects.

Diabetes Mellitus is classified into 2 types. 1. Type I (IDDM/juvenile diabetes) 2. Type II (NIDDM/adult onset diabetes) With regard to diabetes mellitus, Sahaj prameha and kulaj prameha correlate with type I diabetes and apathyanimittaja prameha correlates with type II diabetes. According to Ayurveda Prameha is Included in one of the Mahagadas. In prameha maximum no. of strotas, all 7 Dhatus & ojas get involved & prameha shows group of many symptoms due to this condition of patient goes on deteriorating day by day. The Ayurvedic management of Diabetes aims not only to achieve a strict glycemic control but also to treat the main & root cause of disease. Many drugs & formulae have prescribed for internal & external use in Ayurved samhitas, one of which is “Triphaladi Kashay” .This thesis is an attempt to study the add on effect of “Triphaladi Kashay alongwith Metformin” in Madhumeha & improve the personal & social life of a patient, it is an effort of scholar to observe the add on effect of Triphaladi kashay alongwith Metformin in Madhumeha (NIDDM)