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Dr. Vikas Chothe                    Dr. Arti Firke
                                    Guide, Dept of Swasthavritta
PG Scholar, Dept of Swasthavritta
                                    CARC, Pune (India)
CARC, Pune (India)
Burden of Diabetes     Global                       India
2010                   285 million                  51 million
2030                   438 million                  87 million

                     -( Snehalatha and Ramachnadaran. Diabetes Care 2009)



   •loss of national income
   •high treatment costs
   •low priority to prevention


                                © Dr. Chothe. V.R
IN ALLOPATHY                                IN AYURVEDA
                                               oily and heavy diet
   Family History                             cold ,sweet, sour food
   Genetic factors                            excessive intake of
   Obesity (via BMI and WHR)                   yogurt
   Hypertension                               sugar and jaggery
   Low/High Birth Weight                      sleeping during the
    (Intra-uterine Environment                  daytime
    exposure)
                                               excessive sex
                                               jaatah(C. Chi)/sahaja(Su.
                                                Chi) and kulaja
                                                      -Charak sutrasthana 17/78-81
                                 © Dr. Chothe. V.R
   stress          (Discovery Medicine 2010 by Frans Pouwer
    et al.).



   tobacco and alcohol (Lancet
    1991 by Rimm EB).


   anxiety (           Golden et al.
    Psychoneuroendocrinology 2006).


   depression (vishada) (                           Knol et
    al. Diabetologia 2006)



   anger and hostility                          (J Intern
    Med 2009 Rod et al.).
   habitual sleep disturbances (Cappuccio FP.
    Diabetes Care 2010)




   unhealthy diets (C.Su.17)

   abdominal obesity ( S.Ni.6/25 and C.Su.17   and Arch Gen
    Psychiatry 2008 ).




   high cholesterol
 Over 25 percent of people
newly diagnosed with diabetes
are smokers.
(Malarcher AM et al. Diabetes Care 18:694–697, 1995)




 Alcohol abuse increases the
risk for diabetes.
(C.Su.17.78-89 and Diabetes Jan 2011;60(1):74-9 Joosten MM
et al. )



                                        © Dr. Chothe. V.R
Work Stress (Kumari M et al. Arch Intern Med 2004)
• excessive overtime
• over commitment to work

Unsatisfactory interpersonal
  relationships (Diabetes Care 1998 by Trief PM et al )
• poor marital relationship
• family conflicts
• nuclear families
• social withdrawal

                © Dr. Chothe. V.R
© Dr. Chothe. V.R
 no smoking                                healthy diet according
 weight reduction ≥                         to the Smart Diet
  5%                                         Score (SDS)
 leisure-time physical                     eat ≥400 g of
  activity (LTPA),                           vegetables and fruits
  walking for ≥30                            per day.
  minutes per day                           limit salt consumption
 BMI<23 kg/m2(Mohan et al.                  to <6 g/d.
    Diabetic Medicine, 2007)



by The Finnish Diabetes Prevention Study(DPS) and The Diabetes Prevention Program
Research Group published in New England Journal of Medicine (2002)
Labhopayo Hi Sastanam Rasadinam Rasayanam
 (C.Chi1/8)



   Rasayana is any herb, food, or activity which
    confers youthfulness and cures diseases.
   rasayana includes purification of all tissues
    from rasa to shukra.
   special health promoting conduct and
    behavior

                       © Dr. Chothe. V.R
SADVRITTA                                    KALA CHIKITSA
            (ETHICAL REGIMEN)
                                                           ( ART THERAPY)

                 Good
                mental
                conduct                                     aalekh
  Good                           Good
                                                            geet
religious
conduct
                                 social
                                conduct                     nrutya
                                                            natya
                                                            vadya
       Good                Good
       moral              personal
      conduct             conduct

                                     © Dr. Chothe. V.R
   LobhaShokaBhayaKrodhaManaVegan Vidharayet (C. Su
    7/27)


   Anger and hostility are associated with diabetes and influence
    HbA1c in diabetic patients struggling with glycemic control.
    (Diabetes Research and Clinical Practice.2006 by Attari A et al.)


   akrodham – calm and cheerful personality (C. Chi. 1/4)
   Dhiram- perseverant (C. Chi. 1/4)

   anrushasyaparam nityamnityam karunavedinam –
    devoted to love and compassion (C. Chi. 1/4)

   Hence one should strive to bring happiness and positive
    manasbhavas to all. This attitude is termed as Hitaya in our
    Indian culture.                © Dr. Chothe. V.R
   Jitatmanam-optimist and positivist (C. Chi. 1/4)

   Prashantam- calm (A.H.Su.2:46-48)

   Shastaacharamsankeernam- well behaved and simple

   Vrudhanamastikanam-keeping company of elders (C. Chi. 1/4)

   Dev go Brahman acharya vrudharchane ratam- worshipping
    God, cow, brahmanas, teacher, preceptor and elders (C. Chi. 1/4)

   Nivruttam madyamaithunat- abstaining from liquor and
    excessive sexual intercourse (C. Chi. 6) (James E Muller et al. The American
    Journal of Cardiology 1999)
© Dr. Chothe. V.R
   Adhyatma pravanendriyam -Having senses concentrated
    to spiritualism (C. Chi. 1/4)

   Japa- repeating incantations (C. Chi. 1/4)

   Dharma shastraparam- devoted to holy scriptures (C. Chi. 1/4)

   religious involvement or spiritual well-being helps in coping
    with social isolation (Brown, & Manger, 1983. Journal of Religion and
    Health) and depression in T2DM patients (Bickel et al.1998 American
    Journal of Epidemiology)

                                    © Dr. Chothe. V.R
Spirituality for Healthy Living
DINACHARYA                                     RITUCHARYA

   dina – day & acharya –                           Following the seasonal
    behavior                                          taste
                                                      adjustments, dietetics
   In order to keep the                              and regime is beneficial
    tridoshas and agni                                in keeping seasonal and
    (metabolism) in a state                           lifestyle disorders at
    of healthy                                        bay.
    equilibrium, Ayurveda
    prescribes for each
    individual a specific
    daily routine
                              © Dr. Chothe. V.R
snan (daily clean bath) (C.Chi.6/50)
nivrutam madya (alcohol)

shaucha (Cleanliness) (C. Chi. 1/4)
vyayama(Exercise) (A.H.Su.2, C.Ni.4/5 C.Chi
6/50) (Orozco LJ.et al. Cochrane Database Syst Rev. 2008 July)


chankraman (Daily walking)
(C.Ni 4/50)


yoga (Badr Aljasir et al. Evid Based Complement
Alternat Med. 2010 )


samajagarana swapnam (Good
sleep) (C. Chi. 1/4) (Chisa G. Int J Endocrinol.
2011,Cappuccio FP. Diabetes Care 2010)
   dananityam and tyaga- observing
    charity and simplicity (A.H.Su.2:46-48)
   yuktidnyamahankrutam- intelligent
    and unconceited (C. Chi. 1/4)
   upasitaram-self controlled (C. Chi. 1/4)
   satyavadinam- speaking the truth (C. Chi. 1/4)
   priyavadinam- sweet spoken (C. Chi. 1/4)

   marital adjustment, high family cohesion and
    social support are important in improving
    glycemic control and self-management
    behavior (Garay-Sevilla ME. J Diabetes Complications
    9:81–86, 1995)
   Art is the expression of feeling of the artist,
    who derives the joy of aesthetic experience
    (ananda) influencing beneficially the mind of
    the viewers– Abhinavagupta

   Ranging from ancient rock cave paintings at
    Bimbetaka and mandalas to new aged clinical
    therapy, art has been used for stress
    reduction in Ayurveda.



                 © Dr. Chothe. V.R
Art therapy is a ‘mental health’
profession that uses the creation of
art as a way to increase mental and
emotional well-being.
 -(American Art therapy Association)




                © Dr. Chothe. V.R
   A good painting cleanses and curbs anxiety and
    banishes bad dreams -Vishnudharmottara
    Puranana


   Ragas (Music) exhibit positive effect on
    sleep, emotions and prolongs life. – (A.H.Su-7)


   Imagery, touch, music and dance as adjuncts to
    diabetic and cardiac care. - Lancet 366:211-
    217.


   Dancing (nrutya) is a good form of exercise and
    helps in management of stress and obesity
   If every individual observes rules and
    regulations as described in Swasthavritta
    i.e. daily and seasonal regimen, ethical
    regimen, takes proper food, sleep and
    enjoys controlled sexual activity, he can
    enjoy long and healthy life.

                      © Dr. Chothe. V.R
© Dr. Chothe. V.R
   cost-effective strategy to reduce global burden of
    diabetes

   Achara Rasayana (Ayurvedic lifestyle
    modification) has been highly significant clinically.
    Hence there is need for conducting prospective
    cohort studies without publication bias.

   awareness about Achara Rasayana in physicians
    and health care policy makers needed.
                         © Dr. Chothe. V.R
There is more to life than
increasing its speed.

-Mohandas K. Gandhi




 Thank You
Acknowledgements

• Thank you Dr. Atul Rakshe Sir, Dr.
  Bobade Sir and Dr. Arti Firke who
  have always been my guide and
  inspiration.

• Thanks to Department of
  Swasthavritta, CARC, Akurdi (India)

            © Dr. Chothe. V.R

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Ayurvedic Diabetes Prevention Program

  • 1. Dr. Vikas Chothe Dr. Arti Firke Guide, Dept of Swasthavritta PG Scholar, Dept of Swasthavritta CARC, Pune (India) CARC, Pune (India)
  • 2. Burden of Diabetes Global India 2010 285 million 51 million 2030 438 million 87 million -( Snehalatha and Ramachnadaran. Diabetes Care 2009) •loss of national income •high treatment costs •low priority to prevention © Dr. Chothe. V.R
  • 3. IN ALLOPATHY IN AYURVEDA  oily and heavy diet  Family History  cold ,sweet, sour food  Genetic factors  excessive intake of  Obesity (via BMI and WHR) yogurt  Hypertension  sugar and jaggery  Low/High Birth Weight  sleeping during the (Intra-uterine Environment daytime exposure)  excessive sex  jaatah(C. Chi)/sahaja(Su. Chi) and kulaja -Charak sutrasthana 17/78-81 © Dr. Chothe. V.R
  • 4. stress (Discovery Medicine 2010 by Frans Pouwer et al.).  tobacco and alcohol (Lancet 1991 by Rimm EB).  anxiety ( Golden et al. Psychoneuroendocrinology 2006).  depression (vishada) ( Knol et al. Diabetologia 2006)  anger and hostility (J Intern Med 2009 Rod et al.).
  • 5. habitual sleep disturbances (Cappuccio FP. Diabetes Care 2010)  unhealthy diets (C.Su.17)  abdominal obesity ( S.Ni.6/25 and C.Su.17 and Arch Gen Psychiatry 2008 ).  high cholesterol
  • 6.  Over 25 percent of people newly diagnosed with diabetes are smokers. (Malarcher AM et al. Diabetes Care 18:694–697, 1995)  Alcohol abuse increases the risk for diabetes. (C.Su.17.78-89 and Diabetes Jan 2011;60(1):74-9 Joosten MM et al. ) © Dr. Chothe. V.R
  • 7. Work Stress (Kumari M et al. Arch Intern Med 2004) • excessive overtime • over commitment to work Unsatisfactory interpersonal relationships (Diabetes Care 1998 by Trief PM et al ) • poor marital relationship • family conflicts • nuclear families • social withdrawal © Dr. Chothe. V.R
  • 9.  no smoking  healthy diet according  weight reduction ≥ to the Smart Diet 5% Score (SDS)  leisure-time physical  eat ≥400 g of activity (LTPA), vegetables and fruits walking for ≥30 per day. minutes per day  limit salt consumption  BMI<23 kg/m2(Mohan et al. to <6 g/d. Diabetic Medicine, 2007) by The Finnish Diabetes Prevention Study(DPS) and The Diabetes Prevention Program Research Group published in New England Journal of Medicine (2002)
  • 10. Labhopayo Hi Sastanam Rasadinam Rasayanam (C.Chi1/8)  Rasayana is any herb, food, or activity which confers youthfulness and cures diseases.  rasayana includes purification of all tissues from rasa to shukra.  special health promoting conduct and behavior © Dr. Chothe. V.R
  • 11. SADVRITTA KALA CHIKITSA (ETHICAL REGIMEN) ( ART THERAPY) Good mental conduct  aalekh Good Good  geet religious conduct social conduct  nrutya  natya  vadya Good Good moral personal conduct conduct © Dr. Chothe. V.R
  • 12. LobhaShokaBhayaKrodhaManaVegan Vidharayet (C. Su 7/27)  Anger and hostility are associated with diabetes and influence HbA1c in diabetic patients struggling with glycemic control. (Diabetes Research and Clinical Practice.2006 by Attari A et al.)  akrodham – calm and cheerful personality (C. Chi. 1/4)  Dhiram- perseverant (C. Chi. 1/4)  anrushasyaparam nityamnityam karunavedinam – devoted to love and compassion (C. Chi. 1/4)  Hence one should strive to bring happiness and positive manasbhavas to all. This attitude is termed as Hitaya in our Indian culture. © Dr. Chothe. V.R
  • 13. Jitatmanam-optimist and positivist (C. Chi. 1/4)  Prashantam- calm (A.H.Su.2:46-48)  Shastaacharamsankeernam- well behaved and simple  Vrudhanamastikanam-keeping company of elders (C. Chi. 1/4)  Dev go Brahman acharya vrudharchane ratam- worshipping God, cow, brahmanas, teacher, preceptor and elders (C. Chi. 1/4)  Nivruttam madyamaithunat- abstaining from liquor and excessive sexual intercourse (C. Chi. 6) (James E Muller et al. The American Journal of Cardiology 1999)
  • 15. Adhyatma pravanendriyam -Having senses concentrated to spiritualism (C. Chi. 1/4)  Japa- repeating incantations (C. Chi. 1/4)  Dharma shastraparam- devoted to holy scriptures (C. Chi. 1/4)  religious involvement or spiritual well-being helps in coping with social isolation (Brown, & Manger, 1983. Journal of Religion and Health) and depression in T2DM patients (Bickel et al.1998 American Journal of Epidemiology) © Dr. Chothe. V.R
  • 17. DINACHARYA RITUCHARYA  dina – day & acharya –  Following the seasonal behavior taste adjustments, dietetics  In order to keep the and regime is beneficial tridoshas and agni in keeping seasonal and (metabolism) in a state lifestyle disorders at of healthy bay. equilibrium, Ayurveda prescribes for each individual a specific daily routine © Dr. Chothe. V.R
  • 18. snan (daily clean bath) (C.Chi.6/50) nivrutam madya (alcohol) shaucha (Cleanliness) (C. Chi. 1/4) vyayama(Exercise) (A.H.Su.2, C.Ni.4/5 C.Chi 6/50) (Orozco LJ.et al. Cochrane Database Syst Rev. 2008 July) chankraman (Daily walking) (C.Ni 4/50) yoga (Badr Aljasir et al. Evid Based Complement Alternat Med. 2010 ) samajagarana swapnam (Good sleep) (C. Chi. 1/4) (Chisa G. Int J Endocrinol. 2011,Cappuccio FP. Diabetes Care 2010)
  • 19. dananityam and tyaga- observing charity and simplicity (A.H.Su.2:46-48)  yuktidnyamahankrutam- intelligent and unconceited (C. Chi. 1/4)  upasitaram-self controlled (C. Chi. 1/4)  satyavadinam- speaking the truth (C. Chi. 1/4)  priyavadinam- sweet spoken (C. Chi. 1/4)  marital adjustment, high family cohesion and social support are important in improving glycemic control and self-management behavior (Garay-Sevilla ME. J Diabetes Complications 9:81–86, 1995)
  • 20. Art is the expression of feeling of the artist, who derives the joy of aesthetic experience (ananda) influencing beneficially the mind of the viewers– Abhinavagupta  Ranging from ancient rock cave paintings at Bimbetaka and mandalas to new aged clinical therapy, art has been used for stress reduction in Ayurveda. © Dr. Chothe. V.R
  • 21. Art therapy is a ‘mental health’ profession that uses the creation of art as a way to increase mental and emotional well-being. -(American Art therapy Association) © Dr. Chothe. V.R
  • 22. A good painting cleanses and curbs anxiety and banishes bad dreams -Vishnudharmottara Puranana  Ragas (Music) exhibit positive effect on sleep, emotions and prolongs life. – (A.H.Su-7)  Imagery, touch, music and dance as adjuncts to diabetic and cardiac care. - Lancet 366:211- 217.  Dancing (nrutya) is a good form of exercise and helps in management of stress and obesity
  • 23. If every individual observes rules and regulations as described in Swasthavritta i.e. daily and seasonal regimen, ethical regimen, takes proper food, sleep and enjoys controlled sexual activity, he can enjoy long and healthy life. © Dr. Chothe. V.R
  • 25. cost-effective strategy to reduce global burden of diabetes  Achara Rasayana (Ayurvedic lifestyle modification) has been highly significant clinically. Hence there is need for conducting prospective cohort studies without publication bias.  awareness about Achara Rasayana in physicians and health care policy makers needed. © Dr. Chothe. V.R
  • 26. There is more to life than increasing its speed. -Mohandas K. Gandhi Thank You
  • 27. Acknowledgements • Thank you Dr. Atul Rakshe Sir, Dr. Bobade Sir and Dr. Arti Firke who have always been my guide and inspiration. • Thanks to Department of Swasthavritta, CARC, Akurdi (India) © Dr. Chothe. V.R

Editor's Notes

  1. Good morning to everybody. I am Dr.VikasChothe from CARC Pune and I would like to speak on the topic- AcharRasayana in Diabetes. This paper explores whether achararasayanaand Art therapy could be beneficial in lifestyle related disorders like type 2 diabetes.
  2. In short this picture would give a brief summary of these type A personalities. This man thinks about leisurely golf activities during office. When he is playing golf with friends he is wondering about his house hold job and when he is busy doing it he thinks about office work. Such people are found to be more prone to cardiac diseases and type 2 diabetes.
  3. Life is like an ice-cream, enjoy it before it melts..
  4. Finally what Gandhiji felt about life is that..My utmost gratitude to Dr. AtulRakshe, Director of Shree NiramayaAyurveda Kendra, Pune who has always been my guide and inspiration.