To study the efficacy of Karavellaka Swarasa Bhavita Haritaki Churna as Nitya Virechana in Sthula Pramehi (Obese Type II Diabetics) - A single arm open labelled pilot study.

Ayurveda describes a set of complex clinical conditions with frequent, abnormal micturition, collectively called Prameha which has similar symptoms in Diabetes Mellitus1. For the persons who indulge constantly in Avyayama, Divaswapna, Kaphavardhaka Ahara Vihara etc2, the Tridosha get vitiated, mix with Medas, get localised in Vasti and manifests has Prameha which can be considered as Kapha Pradhana Tridosha Vyadhi.3

 Diabetes Mellitus is marked by hyperglycemia due to absolute insulin deficiency or diminished biological effectiveness. Epidemiological data from a 2019-2021 National Family Health Survey study reveals alarming prevalence rates: 8.65% for males and 7.39% for females, with abdominal obesity affecting 51.77% of males and 57.91% of females.4 Furthermore, the study indicates an 8.4% pre-diabetes prevalence and 6.8% diabetes prevalence, with obesity increasing diabetes risk by 8.3-fold compared to normal weight individuals.5

 The selected poly-drug combination aims to manage Sthaulya and Prameha Roga, which share common causes and complications. Both being Santarpanjanya Vyadhis,6 requiring similar treatment. For Sthoola Pramehi, Apatarpana Chikitsa i.e. Shodhana, Udvarthana7 is the treatment protocol mentioned in classics. However, time constraints may make Shodhana (Vamana, Virechana) challenging, in such cases Nitya Virechana offers an alternative.

Haritaki (Terminalia chebula Retz) Churna, a well-established Nitya Virechana drug, has demonstrated anti-hyperglycemic properties due to its rich content of tannins and flavonoids, which reduce glucose absorption.8,9,10 Similarly, Karavellaka (Momordica Charantia L.) contains Charantin, a cucurbitane-type triterpenoid with proven antidiabetic effects, particularly in protecting pancreatic beta cells from toxicity.11,12,13 Notably, both drugs possess Teekshna, Ushna, and Rooksha Guna, enabling them to target Medas and align with the principles of Apatarpana Chikitsa.

 According to Charaka Kalpa Sthana (12/47), Dravya Guna Vruddhi enhances drug efficacy by giving Bhavana with the Swarasa or Kashaya of same Dravya or the Dravya which has similar properties. This reduces the required dosage, shortens treatment duration, and minimizes complications.