AYURVEDIC PANCHAKARMA-BASED MULTIMODAL INTERVENTION FOR TYPE 2 DIABETES: GLYCEMIC CONTROL AND ANTIDIABETIC DRUG REDUCTION IN 67 PATIENTS — A RETROSPECTIVE ANALYSIS

Background: Type 2 diabetes mellitus (T2DM) is a growing metabolic burden in India, with conventional pharmacotherapy achieving suboptimal glycemic targets while requiring lifelong medication escalation. Ayurveda conceptualizes Prameha — the classical analogue of diabetes mellitus — as a disorder rooted in Kapha-Medovaha Srotas dysfunction, amenable to intervention through Panchakarma, dietary correction, and herbal formulations. Real-world evidence from structured Ayurvedic multimodal protocols remains limited. Objectives: To evaluate the effect of a structured integrative Ayurvedic protocol — comprising BMI-stratified Panchakarma therapy (CDC-SP and CDC-KP), an 800 kcal low-carbohydrate Prameha diet, and individualized herbal medication — on glycemic, anthropometric, cardiometabolic, and insulin resistance parameters, and to quantify reduction in antidiabetic medications. Methods: Retrospective observational study of 67 T2DM patients treated at Madhavbaug Clinics, Mira Road. Panchakarma comprised Snehan (Neem Siddha Taila), Swedan (Dashmula Kwath), and Basti (Gudmar, Daru Haridra, Yashti Madhu) — Kwath-based in CDC-SP (BMI ≥23) or oil-based in CDC-KP (BMI <23). Outcomes included HbA1c, RBS, BMI, abdominal girth, blood pressure, lipid profile, TG/HDL ratio, and antidiabetic medication status. Paired t-tests were used for within-group comparisons. Results: Significant improvements (all p<0.001) were seen across all primary parameters. HbA1c declined from 9.37 ± 2.39% to 6.72 ± 1.05% (Δ −2.65%). RBS reduced by 50.7% (254 → 125 mg/dL). TG/HDL ratio — a key surrogate of insulin resistance — improved from 5.11 to 3.15 (Δ −26.4%, p<0.001); 52.4% of patients shifted to a lower cardiovascular risk category, and 71.4% achieved TG/HDL <3.5 post-treatment. Regarding antidiabetic medications: 50.0% achieved complete cessation and 33.3% partial reduction (total 83.3% with drug reduction). Conclusion: A structured Ayurvedic multimodal protocol produced clinically meaningful improvements in glycemic, cardiometabolic, and insulin resistance parameters, with 83.3% of patients achieving partial to complete antidiabetic drug reduction. The TG/HDL ratio analysis reveals simultaneous reversal of insulin resistance — a finding with important cardiovascular implications. Prospective controlled trials are warranted.