Diabetes has become an enormous and fast developing health problem. The majority of people with diabetes live in urban areas. It is also the primary cause of death in most developed countries. Every six seconds one person dies from diabetes. It has long been regarded as a chronic progressive condition and a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Diabetes is an ailment which affects the entire body within a short period. A global statistical analysis has revealed that the complications of diabetes are highly prevalent in developing and developed countries. It can be ameliorated but not cured. The burden of this disorder is enormous, owing to its rapidly increasing global prevalence, the devastating damage it can do to many organs of the body, as well as direct and indirect costs.
“Every six seconds one person dies from diabetes.”
Usually, your blood sugar level is regulated by glucagon (a hormone released by the pancreas which acts to increase blood glucose) and insulin (another hormone released by the pancreas to decrease blood glucose). Both play a critical role in maintaining your blood sugar level, which is vital for the balanced use of energy sources, such as carbohydrates, amino acids, and fatty acids by the body. If people have a total lack of insulin, they suffer from diabetes 1, if they however have too little insulin or cannot use insulin effectively, they have diabetes 2. The three major tissues largely responsible for clearing glucose from the blood in healthy individuals are the liver, muscle, and adipose tissue. These however become insulin resistant when having diabetes. While it has a variety of functions, the liver plays a distinctive role in managing carbohydrate metabolism by retaining glucose concentrations in an optimum range. In modern societies, both increased consumption of unhealthy high-calorie diets and sedentary behavior have been recorded and form the basis for the occurrence of diabetes and also cancer. While a high saturated fat and fructose-containing Western diet contributes to an increased lifetime risk of these diseases, plant-based diets offer protective effects.
“Plant-based diets offer protective effects.”
Currently available synthetic anti-diabetic agents produce serious side effects, such as hypoglycemic coma (low sugar coma) and rapid deterioration of the kidney function. Management of diabetes with medication devoid of any side effects is still a challenge to the medical system. The management of diabetes includes diet, exercise as well as oral remedies to lower or increase blood glucose. These treatments do not effectively prevent the complications of diabetes and the treatment with the above said allopathic medication has several side effects.
Diabetes in the Indian and Tamil population
Asia is the major site of a rapidly emerging diabetes epidemic. Estimates based on population growth, ageing and rate of urbanisation in Asia show that India will remain one of the countries with the highest numbers of people with diabetes by 2030. Already in 2000, there were an estimated 21 million adults with diabetes among the Indian population. In recent decades, diabetes has also become a considerable health problem in countries like Sri Lanka and results in an increasing economic burden hindering the social and economic development of these countries.
“India will remain one of the countries with the highest numbers of people with diabetes by 2030.”
The risk to develop diabetes is four times higher in people with South Asian ancestry, as compared to people of Caucasian origin. Diabetes occurs most in the South Asian ethnic group than in any other. This is due to the fact that the prevalence of impaired glucose tolerance is high in many Asian people, suggesting the presence of a large number of people with the potential risk to develop diabetes. Apart from the glucose tolerance, Asian populations are also more insulin resistant than people of most other races. Insulin resistance and compensatory excess levels of insulin in the blood are reported even in children and adolescents of Asian Indian origin. These factors probably play a major part in the escalating prevalence of diabetes in young populations in Asia, because diabetes also develops at a younger age in Asian populations than in people of Caucasian ancestry, hence the morbidity and mortality associated with the disease and its complications are also common in young Asian people. Its prevalence in the UK is 14 times higher in Asian children than in children of European ancestry!
“The risk to develop diabetes is four times higher in people with South Asian ancestry, as compared to people of Caucasian origin.”
The prevalence of diabetes is increasing in urban and rural populations in India. The rapidly increasing rate of diabetes in Asia is driven by lifestyle changes caused by modernisation and urbanisation, which cause enormous changes in diet, physical activity and health. In this way, physical activity decreases and body-mass index/upper-body adiposity increase considerably. South Asian people also have more severe and negative reactions to outer influences than other ethnic groups. Even though urban populations eat more diverse diets, more macronutrients and animal-based food than do rural residents, they also have a higher intake of refined carbohydrates, processed foods, saturated and total fat, and lower fibre. Obesity is usually a major determinant of diabetes, however, in contrast to European people, the association in Asian populations is not entirely mediated through the body-mass index.
Siddha medicine – a summary
The Traditional Medicinal System (TMS) is one of the centuries-old practices to fight against disease and to lead a healthy life. Every indigenous people have been using their unique approaches of TMS practices, whereas those originating from India are renowned worldwide. India has a unique Indian System of Medicines (ISM) consisting of Ayurveda, Siddha, Unani, naturopathy and homoeopathy. About 60% to 70% of the rural population in Sri Lanka, for example, rely on this indigenous medicinal systems as their main source for primary health care. Siddha Medicine is one of the four Sri Lankan traditional medicinal systems and it is practiced mostly in the Eastern and Northern provinces of Sri Lanka where the majority of Tamils resides.
“About 60% to 70% of the rural population in Sri Lanka rely on indigenous medicinal systems as their main source for primary health care.”
The origin of Siddha medicine dates back to BC 10’000 to BC 4’000 and is the most ancient indigenous system of medicines of Indian origin and, in India, practiced exclusively in Tamil Nadu and in some parts of the neighboring states. The Siddhars are saints as well as eminent scholars, who have attained Ashtamahasiddhi or enlightenment and it is them who have postulated, practiced, contributed and established the concept of the Tamil medicinal system called Siddha System of Medicine (SSM). Since ancient times, SSM has flourished and has been widely practiced in the Southern part of India particularly in Tamil Nadu. The induction of the modern medicinal system has negatively influenced the existence of SSM and has made the SSM principles and practices undervalued/extinct, even though the World Health Organization (WHO) recommends the practice of traditional systems of medicine as it is affordable, safe and culturally acceptable.
“Siddha medicine dates back to BC 10’000 to BC 4’000 and is the most ancient indigenous system of medicines of Indian origin.”
Siddha remedies pursue the balance of physical humors and elements. In this worldview, man is the microcosm and the Universe, the macrocosm. Cosmogenesis symbolises that there are five principal elements in nature: earth, water, fire, wind and ether. They are the origin of all corporeal things, which then die out, resolving themselves again into these elements. Siddha science defines clearly that three cardinal humors – wind, bile, and phlegm – are responsible for a person’s mental and physical qualities and dispositions. Treatment is aimed at the restoration of equilibrium among these three humors with the help of six tastes: sweet, sour, pungent, bitter, salty, and astringent. “Food is medicine; medicine is food’’. This phrase infers that what we eat is medicine for our body and that the same food is responsible for illnesses as well. The tastes in return are formed with the selective unification of the five elements, so sweet (is earth and water), sour (is water and fire), pungent (is air and fire), bitter (is air and sky), salt (is earth and fire), and astringent (is earth and air).
“Food is medicine; medicine is food.”
Siddha treatment for Diabetes
In the Siddha medical system, diabetes (Neerizhivu) is portrayed as Aiyyam (symbolises earth and water), a humor derangement disease that can be neutralised by Vali humor (representants of air and space) predominant drugs. To undo the detrimental effects of diabetes, the proposed drug should possess either bitter or pungent or astringent taste, which will retract the deranged Aiyyam humor, because of its predominant Vali humor. Antidiabetic plants are a crucial healthcare resource in Sri Lankan Siddha Medicine. Plants, in particular, provide an abundant source of biologically active molecules that have played critical roles in pharmacology. The use of natural products–based drugs minimises hazards caused by synthetic drugs. In fact, phytotherapy has been widely used because of the low cost and the easy availability of medicinal plants. Ancient Indian medical scriptures mention various indigenous plants and mineral preparations for the treatment of diabetes. There are different combinations of these medicinal extracts which can be given orally and for prolonged periods of time. Confection or ‘Ilekiyam’ is one of the internal forms of medicine recommended in Siddha literature. These are prepared by heating certain decoctions, juices and milk with additional sugar until a thick consistency is reached. Then the syrup-like remedy is mixed up with ghee (clarified butter) and honey.
“Diabetes is an ‘earth and water’ humor derangement disease that can be neutralised by ‘air and space’ humor predominant drugs.”
The efficiency of Siddha medical remedies has been tested by Western medicine over the last decades. One preparation being tested consisted of five plant parts in equal ratio: asparagus racemosus, Indian gooseberry, Salacia oblonga, clove, and heart-
leaved moonseed. As previously stated, diabetes is a disease that can be treated with ‘Vali remedies’, which means representatives of air and space, which in return are the tastes pungent, bitter and astringent. This polyherbal preparation containing Indian gooseberry, Salacia oblonga-stem and root (both having astringent taste), clove buds (pungent), heart-leaved moonseed-stem and root (bitter), asparagus spears/tubers (aphrodisiac property) was therefore formulated to treat experimental diabetes in various studies. All these ingredients are not toxic because they are all added to regular dishes and are consumed globally. The polyherbal preparation treatment was even found to improve deranged lipid profile, antioxidant status, glycogen content, and diminish lipid peroxidation, which provides stability to membrane integrity and thus facilitates insulin receptor to achieve better glucose tolerance through a holistic approach. This polyherbal preparation was initially tested on animals by Balaji V. et al. (2012 and 2013), whereas singular ingredients have proved to be effective against diabetes all along. Clinical trials applying such novel herbal preparations are of great interest and beneficial to disease management and human welfare at large.
“All these ingredients do not have any toxicity because these are all added to regular cuisines being consumed globally.”
‘Ilavankaathy ilekiyam’ is another authentic Siddha herbal remedy recommended for the treatment of Diabetes. It contains clove, honey, ghee, milk and jaggery as ingredients. Past researches proved that honey can be used as a hypoglycemic agent, meaning it decreases blood sugar and that eugenol (an active component of clove) is responsible for hypoglycemic activity. According to Siddha concept, the taste of Ilavankaathy ilekiyam is pungent which helps to pacify the deranged humors. The effect of the treatment was evaluated on the basis of the changes in the signs and symptoms, fasting blood sugar and urine sugar in another study done by Thembamala (2017). Out of the 827 patients, about 59% were being treated in government health centres and 41% were treated in private healthcare settings. Statistically, the herbal remedy highly improved the overall clinical manifestations of diabetes and reduced levels of fasting blood sugar. Therapeutic effectiveness of Ilavankaathy ilekiyam is statistically significant to notably reduce the overall clinical manifestation of Diabetes. This study concluded by stating that the daily supplementation of Ilavankaathy ilekiyam at a dose of 2.5 mg by oral route twice a day could be used as an effective treatment for Diabetes.
Siddha remedies are a commonly available, inexpensive, efficient and purely herbal source of medicine with no adverse effects for the patient. However, further studies would be essentially required to demonstrate the exact mechanism of decreasing blood sugar activity of the Ilavankaathy ilekiyam and to establish its efficacy and safety for further clinical use in diabetes treatment.
Indigenous medicine has a long history and has proven to be very efficient in dealing with many different kinds of illnesses. Urbanisation and along with it new dietary and lifestyle habits cause many civilisation diseases, such as diabetes and cancer. Instead of relying on expensive modern treatments which often cause severe side-effects, we are lucky to re-discover the importance and value of indigenous knowledge and traditional medical systems. With NILAM, we are actively involved in preserving this ancient knowledge and making it available for the modern society. Increasing urbanisation and western influence are a serious threat to local cultural heritage. As a consequence, indigenous knowledge, which is passed on from one generation to the next, easily gets lost in oblivion. As a ‘lived’ knowledge, it is not just a click away like many other forms of knowledge in the present age of modern technology. Youth living in or originating from societies led by tradition can gain a lot by being in touch with their cultural roots and their elders – because, the treasure of wisdom lies within them.