An Open Labelled Randomised Active Controlled Evaluation of Sarivadi Lauha in the Management of Diabetic Neuropathy

Diabetes Mellitus (DM) is a systemic metabolic disease that causes abnormally high levels of blood sugar. It occurs when the body doesn’t produce enough insulin or the patient has developed insulin resistance. The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045. The prevalence of diabetes in India has risen from 7.1% in 2009 to 8.9% in 2019. Currently, 25.2 million adults are estimated to have impaired glucose tolerance, which is estimated to increase to 35.7 million in the year 2045. The complications of diabetes mellitus can be distinguished into acute and chronic complications.

The Acute Complication of DM include –

Diabetic ketoacidosis and Diabetic coma, Hypoglycemia due to incorrect dose of medication and sudden lifestyle and diet changes, Hyperglycemia

The Chronic Complications of DM include –

Macroangiopathy: Coronary artery disease, cerebrovascular complication, peripheral vascular disease, Diabetic renovascular disease.

Microangiopathy: Diabetic retinopathy, Diabetic nephropathy, Diabetic neuropathy, Diabetic foot.

Diabetic neuropathy is a serious diabetes complication that may affect as many as 50% of people with diabetes. However, it can be often prevented or progress can be slowed with consistent blood sugar management and a healthy lifestyle. There was no direct reference available for diabetic neuropathy. As per Ayurvedic principals there is involvement of  Vata and Pitta Dosa in DN. Symptoms like Suptata(numbness), Daha(burning sensation) in Hastapad (hands-feet) are described in Purvarupa of Prameha. Daha is also mentioned in Upadravas(complication) of Prameha. Which shows close resemblance with signs and symptoms of DN. Prameha Updrava are – Trushna(Thirst), Atisara(Diarrhea) ,Jwara(Fever) , Daha(Burning Sensation), Durbalata(Weakness), Aruchi(Anorexia), Avipaka(Indigestion). In diabetic neuropathy, micro and macrovascular changes and neuronal ischemia are the important steps in the pathology that can be compared with Raktadusti and Vatadusti which lead to Paddah, Hastpad Suptata. This pathology and symptoms are similar to Vatarakta. In Phalashruti of Sarivadi Lauha  it is indicated in  Pramehapidika, Vatarakta ,Arsha, Twaggda. Recent researches in Ayurveda have proved efficacy of various herbal and herbomineral drugs in DN. Drugs like Ashwangha, Amlaki, Guduchi, Shilajatu etc were evaluated through preclinical and clinical studies but still effective management is not available for DN.