ISSN: 2320-5407 Int. J. Adv. Res.

12(03), 1081-1087

Journal Homepage: - www.journalijar.com

Article DOI: 10.21474/IJAR01/18496

DOI URL: http://dx.doi.org/10.21474/IJAR01/18496

RESEARCH ARTICLE
AN AYURVEDIC METHODOLOGY FOR MANAGING DIABETIC DYSLIPIDEMIA - A CASE REPORT

Dr. Avinash Kumar Srivastava1, Dr. Paridhi Painuly2, Dr. Vandana2 and Dr. Mudita Negi2
1. Assistant Professor, Department of Kayachikitsa, Patanjali Bhartiya Ayurvigyan Evum Anusandhan Sansthan,
Haridwar.
2. Post Graduate Scholar, Department of Kayachikitsa, Patanjali Bhartiya Ayurvigyan Evum Anusandhan
Sansthan, Haridwar.
……………………………………………………………………………………………………....
Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Diabetic dyslipidemia is characterized by elevated plasma triglyceride
Received: 28 January 2024 levels, decreased HDL cholesterol levels, and an increase in small
Final Accepted: 29 February 2024 dense LDL-cholesterol particles. These lipid alterations in diabetes are
Published: March 2024 linked to heightened free fatty acid flux due to insulin resistance. With
the availability of various lipid-lowering medications and supplements,
Key words:-
Diabetic Dyslipidemia, patients now have more options to reach target lipid levels. Lipid-
Medovahasrotas/Medovaha Srotodushti, lowering therapies in modern medicine, such as statins and fibrates, are
Insulin Resistance generally well-tolerated with minimal side effects. However, these
treatments often necessitate lifelong usage, which can impose
significant financial strain, particularly in developing countries like
India.In Ayurveda, dyslipidemia is understood as the manifestation of
an imbalance in the Medovahasrotas.Dyslipidemia manifests as the
consequent output of Medovahasrotodushti. A 31-year-old male patient
presented with complaints of pain in calf muscles and weight gain.
Upon investigation, his total cholesterol level was found to be elevated
at 211 mg/dl, and triglycerides were elevated to 683.80 mg/dl.
Giloykwath along with arjunkwath, Madhunashinivati extra power,
Tablet lipidom, and Tablet Madhugrit were administered for the
shaman therapy. Upon completion of the treatment, significant
improvements were observed in the patient's complaints. Additionally,
a significant improvement was noted in the Lipid Profile.

Copy Right, IJAR, 2024,. All rights reserved.

……………………………………………………………………………………………………....
Introduction:-
The progression of technology, busy lifestyles, sedentary habits, and dietary changes have heightened individuals'
susceptibility to various lifestyle disorders, with Diabetic Dyslipidemia emerging as a prominent example.
Approximately 30-60% of individuals diagnosed with type 2 diabetes mellitus (T2DM) are estimated to experience
dyslipidemia[1]. This prevalent metabolic abnormality, often associated with diabetes, is characterized by
quantitative and qualitative changes in lipids and lipoproteins. One typical manifestation, termed diabetic
dyslipidemia, involves elevated triglyceride levels, decreased concentrations of high-density lipoprotein (HDL)-
cholesterol, and a shift towards small, dense low-density lipoprotein (LDL)[2].

In Ayurveda, diabetic dyslipidemia can be correlated with medovahasrotodushti. Medas, one of the saptadhatu, is
the fourth dhatu formed from the essence of āhāra rasa and has a maternal origin. Its principle function is the

Corresponding Author:- Dr. Paridhi Painuly 1081

Address:- Post Graduate Scholar, Department of Kayachikitsa, Patanjali Bhartiya
Ayurvigyan Evum Anusandhan Sansthan, Haridwar.
ISSN: 2320-5407 Int. J. Adv. Res. 12(03), 1081-1087

impartation of snehabhāva (unctuousness). Rasa, when solidified, converts to mamsa, which, when acted upon by
mamsadhatvagni—dominated by agni, ap, and snigdha—transforms into medas. Consequently, medas is inferred as
'lipids,' and MedaDhatu as adipose tissue [3].

Medas' function is also stated as bringing about corpulence and strength due to its guru - snigdha nature.
Medodushtilakshana, as outlined in Ayurvedic classics, include symptoms such as Snigdhāngata, udara-
pārsvavridhi, kāsa, shwas, and dourgandyam. Specific causes contributing to the vitiation of medovahasrotas include
lack of exercise, daytime sleeping, consumption of fatty foods, and excessive alcohol intake. These factors have a
direct effect on Kapha Pitta vitiation, which, in turn, contributes to the manifestation of Santarpanottavyadhi[4].

Bahu and abadhameda are explained as dushyavisesha in pramehanidāna, where aggravated Kaphadosha first mixes
with meda, which is in surplus, non-compact form, and similar in properties to kapha. In the context of the nidāna of
Madhumeha, aggravated meda is said to obstruct the path of vata, leading ojas to vastipradesha[5].

The liver plays a pivotal role in lipid metabolism, aiding in the synthesis of VLDL, HDL, TG, cholesterol, and in the
synthesis and oxidation of fatty acids. Hormones of the anterior pituitary, such as GH and ACTH, promote the
mobilization of fat depots, increasing lipolysis and fatty acid metabolism. Insulin facilitates the formation of fat
from glucose, its deposition in adipose tissue, and prevents its breakdown. Thyroid hormones influence all major
metabolic pathways by increasing basal energy expenditure through lipid, protein, and carbohydrate metabolism,
affecting the synthesis, mobilization, and degradation of lipids. The suprarenals also aid in lipid metabolism via
hormones of the cortex and medulla[6].

Alterations in lipid metabolism clinically present as dyslipidemia, a significant risk factor for developing
atherosclerosis and heart disease. Symptoms of altered lipid metabolism manifest in conditions such as obesity,
Type 1 and 2 diabetes, hypothyroidism, Cushing's syndrome, certain types of renal failure, and certain cancers.
Dietary factors such as intake of fats, especially saturated fats, which account for almost 40% of total calories, and
cholesterol-rich foods, as well as habitual alcohol consumption, are implicated in altered lipid metabolism.
Epinephrine, with its potent lipolytic action, plays a crucial role, and its impairment is implicated in the pathogenesis
of obesity. The renin-angiotensin mechanism can lead to hypertension and insulin resistance if activated in adipose
tissue. Intramyocellular lipids (IMCL) are valuable energy stores, but in the absence of exercise, along with
overconsumption of fat, they are positively correlated with obesity and have detrimental effects on muscular insulin
sensitivity. Metabolic syndrome, defined as a conglomerate of conditions like hypertension, hyperglycemia,
dyslipidemia, and increased fat around the waist occurring together, increases the risk of heart disease, stroke, and
diabetes. Recent studies on metabolic syndrome, hyperlipidemia, atherosclerosis of blood vessels, fatty liver, and
fatty kidneys demonstrate obesity's contributory role. Centuries ago, Ayurvedic classics precisely explained this
morbidity of Medovahasrotas, expressed as Pramehapoorvaroopa and sthoulyalakshana, with its complications in
chronic long-standing cases[7].

Material and Method

A 31-year-old male patient residing in Dehradun sought treatment at PatanjaliAyurvedic Hospital, Haridwar, in the
outpatient department of Kayachikitsa in October 2023. He had previously been diagnosed with diabetes and
dyslipidemia and presented with complaints of calf muscle pain persisting for three months, accompanied by weight
gain and fatigue over the past year. Additionally, he reported experiencing acidity and indigestion for the past
month. Laboratory tests revealed elevated total cholesterol and triglyceride levels, along with high random blood
glucose levels. The patient also had a history of alcohol consumption spanning ten years.

He was prescribed the following oral medications for a duration of one month: Arjun Kwath and GiloyKwath,
MadhunashiniVati Extra Power, Lipidom tablets, and Madhugrit tablets.
s.no. Drug prescribed Dose anupana
1. Arjun kwath + giloykwath 100 ml x bd before meal -
2. Tab. Madhunashinivati extra power 2 tab x bd before meal Lukewarm water
Tab. lipidom
3. Tab. Madhugrit 2 tab x bd after meal Lukewarm water

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Arjun kwath-
Terminalia arjuna (Roxb.) Wight and Arn., commonly referred to as ‘Arjuna’, is a medicinal plant indigenous to
India with a rich history of therapeutic applications. Recognized as a cardiotonic, Arjuna has been traditionally
utilized in the management of heart failure, ischemic conditions, cardiomyopathy, atherosclerosis, and myocardial
necrosis. Additionally, it has been employed for addressing various human ailments such as blood disorders, anemia,
venereal and viral diseases. Beyond cardiovascular health, Arjuna finds utility in treating fractures, ulcers, hepatic
conditions, and exhibits a wide array of pharmacological properties including hypocholesterolemic, antibacterial,
antimicrobial, antitumoral, antioxidant, antiallergic, antifeedant, antifertility, and anti-HIV activities.[8]

Giloykwath–
Sharma et al. reported significant hepatoprotective effects of Tinosporacordifolia water extract (TCE) against
hepatic and gastrointestinal toxicity. In alcoholic samples, there was a notable increase in gamma-
glutamyltransferase, aspartate transaminase, alanine transaminase, triglyceride, cholesterol, HDL, and LDL levels (P
< 0.05), which were subsequently downregulated following TCE intervention, leading to normalized liver function.
Additionally, in one study, T. cordifolia demonstrated hepatoprotective properties by markedly improving clinical
and hemato-biochemical markers of CCl4-induced hepatopathy in goats. T. cordifolia extract also shielded the livers
of CCl4-toxic mice, with a significant decrease observed in serum levels of SGOT, SGPT, ALP, and bilirubin post-
intoxication. The herb is attributed with numerous pharmacological properties, including immunomodulation, anti-
diabetic, antifungal, and hepatoprotective effects." [9]

Madhunashinivati extra power –

Madhunashinivati is made up of several medicinal herbs

Turmeric (Curcuma longa) –

The active compound in turmeric, curcumin, has garnered attention as a promising treatment for diabetes and its
complications, mainly due to its safety profile and cost-effectiveness. Research indicates that curcumin acts as a
potent agent in reducing glycemia and dyslipidemia in rodent models of diabetes.[10]

Kutki (Picrorhizakurroa) - Referred to as 'Kutki' in classical Ayurvedic texts, Picrorhizakurroa has long been
utilized as a remedy for diabetes. Previous preliminary studies have corroborated its antidiabetic effects in rats,
showing a significant reduction in elevated fasting blood glucose levels and effective control over dyslipidemia.[11]

Chirayata (Swertiachirayita) –
Among various herbal plants, Swertiachirayita stands out for its widespread recognition, particularly for its anti-
hyperglycemic properties. It is acknowledged to possess a myriad of therapeutic benefits, encompassing anti-
diabetic, anti-inflammatory, hypoglycemic, hepatoprotective, antibacterial, wound-healing, antipyretic,
antihelminthic, antioxidant, and antitussive effects.[12]

Gudmar(Gymnemasylvestre) -The administration of leaf extracts to hyperlipidemic rats for two weeks has been
observed to lead to a reduction in elevated serum triglyceride (TG), total cholesterol (TC), very low-density
lipoprotein (VLDL), and low-density lipoprotein (LDL) cholesterol in a dose-dependent manner. The initial
scientific validation of G. sylvestre use in human diabetics’ dates back almost a century, demonstrating that the
leaves of G. sylvestre reduce urinary glucose levels in diabetic individuals.[13]

Hence, the additional herbs found in MadhunashiniVati, such as jamun, karela, gokhru, methi, harad, amla, and
giloy, possess both antidiabetic properties and hepatoprotective qualities.

Lipidom –
Lipidom contains a potent combination of Gallic acid, Protocatechuic acid, Corilagin, Ellagic acid, Cinnamic acid,
Guggulsterone E, and Guggulsterone Z. These phytometabolites are recognized for their remarkable antioxidant,
anti-inflammatory, and lipid-lowering attributes. [14]

Madhugrit –
The efficacy of Madhugrit in addressing hyperglycemia and its associated complications is attributed to its rich
repertoire of anti-diabetic, anti-inflammatory, antioxidant, wound-healing, and lipid-lowering phytoconstituents.

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This study advocates for the translational application of Madhugrit as a potent medicine for diabetes and its
comorbidities.[15]

Before treatment
Lipid profile and Blood glucose -
Date Total Triglycerides HDL Non- HDL Glucose Hba1c
cholesterol fasting
plasma
7/9/23 211.00 mg/dl 683.80 mg/dl 30.70 mg/dl 180 mg/dl 269.60 mg/dl 10.1%

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After treatment

Lipid profile and blood glucose -

Date Total Triglycerides HDL VLDL Glucose Hba1c
cholesterol fasting
plasma
24/11/23 182 mg/dl 208 mg/dl 44.5 mg/dl 41.60 mg/dl 103 mg/dl 5.81%

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Discussion
Dyslipidemia stands out as a significant risk factor for cardiovascular disease in individuals with diabetes mellitus.
Timely identification and management of dyslipidemia in type-2 diabetes can effectively mitigate the risk of
atherogenic cardiovascular disorders. Diabetic dyslipidemia encompasses a triad of elevated triglycerides,
diminished HDL cholesterol, and an abundance of small, dense LDL particles. These lipid irregularities are
widespread in diabetes mellitus due to the impact of insulin resistance or deficiency on crucial enzymes and
pathways in lipid metabolism.

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In Ayurveda, diabetic dyslipidemia finds correlation with 'medovahasrotodushti,' wherein the vitiation of
medovahasrotas influences the imbalance of Kapha and Pitta doshas, thereby contributing to the manifestation of
'Santarpanottavyadhi.' Consequently, Ayurvedic treatment aims to restore the equilibrium of Kapha and Pitta doshas,
enhance metabolism, and stimulate hepatic functions. In this case study, we administered medications that pacify
Kapha and Pitta doshas while also possessing anti-diabetic, anti-inflammatory, and hepatoprotective properties."

Result
The patient demonstrated positive progress within four months, with noticeable improvement in his complaints of
pain and fatigue. Moreover, his lipid profile and blood glucose levels exhibited significant and marked changes. The
patient expressed satisfaction, and no adverse drug reactions were observed throughout the treatment.

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