title: Prameha in Ayurveda: correlation with obesity, metabolic syndrome, and diabetes mellitus. Part 1-etiology, classification, and pathogenesis.
abstract: BACKGROUND
  Obesity, metabolic syndrome, and diabetes mellitus are increasing in epidemic proportions globally. Prameha is a syndrome described in the ancient Ayurvedic texts that includes clinical conditions involved in obesity, prediabetes, diabetes mellitus, and metabolic syndrome.
  
  
  METHODS
  Integrating the theory and modalities of Ayurveda in the management of these disorders may prove to be beneficial. Even though Prameha is a Tridoshaja Vyadhi (a disease involving all three of the psychophysiologic principles known as Doshas [i.e., Vata, Pitta, and Kapha]), it is basically a disease with Kapha predominance.
  
  
  RESULTS
  There are 20 subtypes of Prameha due to the interaction of the three Doshas and 10 Dushyas (disturbed functioning of the principles that support the various bodily tissues); several of these subtypes have sweet urine, whereas some of them have different coloration of the urine, highlighting the inflammatory conditions involved in the metabolic syndrome. This disease has close ties to Sthaulya (i.e., obesity). With regard to diabetes mellitus, Sahaja Prameha and Jatah Pramehi correlate with type 1 diabetes; Apathyanimittaja Prameha correlates with type 2 diabetes. Madhumeha is a subtype of Vataja Prameha (Prameha with Vata predominance) that can occur as the terminal stage of type 2 diabetes (in which insulin is required), or as type 1 diabetes beginning in early childhood. The latter is defined as Jatah Pramehi Madhumehino in Charaka Samhita, one of the classical Ayurvedic texts.
  
  
  CONCLUSIONS
  Various dietary, lifestyle, and psychologic factors are involved in the etiology of Prameha, particularly in relation to disturbances in fat and carbohydrate metabolism. The ancient Ayurvedic knowledge regarding Prameha can be utilized to expand the current understanding of obesity, metabolic syndrome, and diabetes.
authors.affiliation: Center for Integrative Medicine and Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH, USA. sharma.2@osu.edu
authors.forename: Hari
authors.initials: H
authors.lastname: Sharma
authors.forename: H M
authors.initials: HM
authors.lastname: Chandola
mesh_terms: D001824:Body Constitution; D048909:Diabetes Complications; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D006801:Humans; D007249:Inflammation; D008515:Medicine, Ayurvedic; D008659:Metabolic Diseases / Q000145:classification / Q000652:urine; D024821:Metabolic Syndrome; D009765:Obesity; D010551:Personality