Ayurvedic medicine for diabetes: how it fits with your sugars

Ayurvedic medicine has a real role in type 2 diabetes, and it is a supporting one. Used as an addition, with the sugars being measured, it helps. Used as a replacement, it has put people in an emergency ward.

What we are trying to achieve

• A lower average sugar, measured by HbA1c three months later, not by how the person feels on a good day.
• Fewer spikes after meals, which is where several of these preparations genuinely work.
• Weight coming down and staying down, because in type 2 diabetes that is the single most effective intervention available.
• Feeling well enough to keep taking the tablets that actually control the disease, rather than quietly abandoning them.
• Protection of what is already at risk: eyes, kidneys, feet, nerves.

Type 1 and insulin: the line that does not move

• Type 1 diabetes is an absolute insulin shortage. No herbal preparation supplies insulin, and reducing or stopping it can cause diabetic ketoacidosis within a day or two.
• Anyone with type 1, with ketones, or who is losing weight while their sugars run high, belongs with an endocrinologist and on insulin. We work alongside that, never instead of it.
• Long-standing type 2 that has burned out and now needs insulin is in the same category. The medicine can be added; the insulin stays.
• A person who has been told to stop insulin by anyone selling a herbal product has been put in real danger. That instruction is not medicine, and it is not what we do.

What we actually prescribe

• Guduchi, tinospora, one of the better-studied of the group, used for the fasting sugar and the general metabolic picture.
• Madhunashini, gymnema, the plant whose name means sugar destroyer. It blunts the sweet taste and reduces post-meal rise. There is human work behind it, and there are also case reports of liver injury, so it is dosed carefully and not taken indefinitely without checking.
• Karela, bitter gourd, as juice or extract, mainly for the post-meal number.
• Methi, fenugreek seed, the most ordinary and most underrated of them. Fibre, and a real effect on post-meal sugar. A spoonful of soaked seed is a genuine intervention, not a folk remedy.
• Nisha-amalaki, turmeric and amla together, an old preparation we still use, mild and tolerable.
• Vijaysar juice, from the devil's tree, used in some traditions for the urinary sugar. Its evidence is thin and we say so.
• Ashwagandha where stress and poor sleep are driving the sugars up, which is common in people whose diabetes appeared after a bad year.
• Punarnava and similar preparations where swelling is the presenting complaint, always after the kidneys have been checked.
• The combination is per person, and the dose is set against the medicines already being taken.

What the effect actually is

• In the small Indian trials of these preparations the fall in HbA1c is modest, a few tenths of a percent. That is worth having and it is not the point at which a tablet can be dropped.
• A serious change in diet, weight and activity does more than every formulation on this page combined. Anyone who says otherwise is selling something.
• These are slow. Judging one at two weeks is meaningless.
• They do not repair a pancreas, cure diabetes, or remove the need for monitoring.

The interaction that actually bites

• Add a sugar-lowering herb to a sulfonylurea or to insulin and the combined effect can push sugars too low. Sweating, shaking, confusion, and in an older person a fall.
• This is why the allopathic dose may need reducing, and why that reduction is made by the doctor who prescribed it, with readings in hand. Not by the patient, and not by whoever handed over the herbal packet.
• Metformin, and the newer classes, stay. They are doing the work. The herbal addition is doing a smaller job alongside.
• Before surgery, an infection, or a period of not eating, the whole question of low sugar has to be revisited.
• Liver and kidney function are checked on long courses, the same as for any medicine taken for years.

What we will not do

• We do not stop your prescribed diabetes medication.
• We do not promise reversal, cure, or a normal HbA1c.
• We do not sell an unlabelled powder. Products seized in regulatory testing have occasionally been found to contain glibenclamide or other drugs added to herbal diabetes powders, sometimes at high dose. That is a real hazard: an undisclosed drug in something bought as natural.
• We do not treat thyroid, pituitary or adrenal disease. Those are endocrine problems too, and they belong with an endocrinologist.
• We do not touch gestational diabetes with herbal medicine. Pregnancy is a place where sugars must be controlled precisely and where these preparations have no safety data.

How it is judged

• Home readings kept through the change, so the pattern is visible rather than guessed.
• HbA1c at three months, the same test that would be done anyway.
• Weight, blood pressure, and if relevant kidney and eye review on the usual schedule.
• If the number has not moved, the medicine is not continued out of politeness. It is stopped or changed.

Where medicine is not enough

• Sugars that stay very high despite everything, with weight loss, thirst, or blurred vision. That needs the conventional treatment escalated, quickly, and herbal support is not a reason to delay it.
• Ketones, vomiting, drowsiness, or heavy breathing. Emergency care, now.
• A foot that has gone numb, an ulcer that will not heal, a vision change, recurrent urine or skin infection, or protein appearing in the urine. These are complications, not a sugar problem, and each has its own specialist pathway.
• The tablet is the last ten percent. Food, walking, weight and sleep do the rest, and none of them require a prescription.