Changes

====''Poorvarupa'' (prodromal symptoms) of ''prameha'' ====

====''Poorvarupa'' (prodromal symptoms) of ''prameha'' ====

For ''prameha'', these symptoms include excessive sweat, body odor, laziness, inclination towards rest, presence of excessive ''malas'' (waste products) in the eyes, ears, teeth, throat, palate, and tongue (buccal cavity), excessive growth of hair and nails, matting of the hair, excessive thirst, a sweet taste in the mouth, a burning sensation in the hand and feet, attraction of insect and ants toward the body and urine, and so on. Diabetes has close relationship to conditions within the oral cavity. It leads to adverse changes in gums and periodontal tissues: effects that may be evident even before clinical diabetes is recognized and diagnosed. Periodontal diseases are associated with higher levels of insulin resistance and are often a precursor of type 2 diabetes as well as with the higher levels of glycated hemoglobin. These findings may relate to the prodromal symptoms of excessive excretion of ''malas'' in the buccal cavity. A sweet taste in the mouth is a prodromal symptom that may be explained by the presence of glucose of saliva. If blood glucose levels are high, glucose is also present in the saliva, which can increase cavities and increase the risk of oral candidiasis.

For ''prameha'', these symptoms include excessive sweat, body odor, laziness, inclination towards rest, presence of excessive ''malas'' (waste products) in the eyes, ears, teeth, throat, palate, and tongue (buccal cavity), excessive growth of hair and nails, matting of the hair, excessive thirst, a sweet taste in the mouth, a burning sensation in the hand and feet, attraction of insect and ants toward the body and urine, and so on. Diabetes has close relationship to conditions within the oral cavity. It leads to adverse changes in gums and periodontal tissues: effects that may be evident even before clinical diabetes is recognized and diagnosed.<ref> https://www.coursehero.com/file/pd3u7l/Ketones-include-acetone-beta-hydroxybutyrate-and-acetoacetate-Progressive-rise accessed on 12 June 2017 </ref> Periodontal diseases are associated with higher levels of insulin resistance and are often a precursor of type 2 diabetes as well as with the higher levels of glycated hemoglobin<ref> Hampton T. Studies probe oral health diabetes link. JAMA 2008; 300:2471-2473. </ref>. These findings may relate to the prodromal symptoms of excessive excretion of ''malas'' in the buccal cavity. A sweet taste in the mouth is a prodromal symptom that may be explained by the presence of glucose of saliva. If blood glucose levels are high, glucose is also present in the saliva, which can increase cavities and increase the risk of oral candidiasis.

A burning sensation in the hands and feet is an important feature of neuropathy that results from diabetes mellitus. Excessive sweat as a consequence of obesity may result in bacterial growth that leads to body odor. Excessive thirst may be directly related to disturbed glucose metabolism. Thus, the symptoms described in the ''poorvarupa'' of ''prameha'' include prediabetic symptoms and the early manifestation (vascular changes, obesity, etc.) of diabetes or subclinical diabetes.

A burning sensation in the hands and feet is an important feature of neuropathy that results from diabetes mellitus. Excessive sweat as a consequence of obesity may result in bacterial growth that leads to body odor. Excessive thirst may be directly related to disturbed glucose metabolism. Thus, the symptoms described in the ''poorvarupa'' of ''prameha'' include prediabetic symptoms and the early manifestation (vascular changes, obesity, etc.) of diabetes or subclinical diabetes.

The role of ''meda'' (fat/adipose tissues) is of great importance in the pathogenesis of ''prameha''. Its role is not as ''dushya'' (disturbed functioning of the ''dhatus''), but something more than that. According to [[Charaka Samhita]], ''bahudrava shleshma'' (kapha that contains too much liquid) joins and affects ''meda'', causing it to become ''abaddha'' (unobstructed or fluid) in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. This has been described as ''sharira-kleda'' (body of fluid) in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Thus, excess water in the blood causes increased diuresis. It is very important to elaborate the term ''bahudrava shlesma''. ''Shleshma/ kapha'' is one among the three basic humors regulating all physiological and psychological process in the living organism. At its normal state, it causes binding of body tissues i.e. maintain the tissues integrity, represent the normal cell mediated immunity etc. ''Bahudrava'' means that ''kapha'' loses its natural properties and get vitiated, it is important to mention here that this derangement may be acquired or congenital, Whatever may be the cause this vitiated ''kapha'', it is unable to perform its normal functions. Describing the physical properties of ''kapha'' it is mentioned that it is unctuous in touch and looks like ''ghrita'' (ghee). Thus, it can be said that ''kapha'' in body represents lipid components of the body and vitiated ''kapha'' can be correlated with dyslipidemia. Role of dyslipidemia and metabolic abnormalities in the pathogenesis of diabetes is very obvious and well elaborated in modern medicine. Among the metabolic abnormalities that commonly accompany diabetes are disturbances in the production and clearance of plasma lipoproteins. Moreover, development of dyslipidemia may be a harbinger of future diabetes. A characteristic pattern, termed diabetic dyslipidemia, consists of low high density lipoprotein (HDL), increased triglycerides, and postprandial lipemia. This pattern is most frequently seen in type 2 diabetes and may be a treatable risk factor for subsequent cardiovascular disease.

The role of ''meda'' (fat/adipose tissues) is of great importance in the pathogenesis of ''prameha''. Its role is not as ''dushya'' (disturbed functioning of the ''dhatus''), but something more than that. According to [[Charaka Samhita]], ''bahudrava shleshma'' (kapha that contains too much liquid) joins and affects ''meda'', causing it to become ''abaddha'' (unobstructed or fluid) in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. This has been described as ''sharira-kleda'' (body of fluid) in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Thus, excess water in the blood causes increased diuresis. It is very important to elaborate the term ''bahudrava shlesma''. ''Shleshma/ kapha'' is one among the three basic humors regulating all physiological and psychological process in the living organism. At its normal state, it causes binding of body tissues i.e. maintain the tissues integrity, represent the normal cell mediated immunity etc. ''Bahudrava'' means that ''kapha'' loses its natural properties and get vitiated, it is important to mention here that this derangement may be acquired or congenital, Whatever may be the cause this vitiated ''kapha'', it is unable to perform its normal functions. Describing the physical properties of ''kapha'' it is mentioned that it is unctuous in touch and looks like ''ghrita'' (ghee). Thus, it can be said that ''kapha'' in body represents lipid components of the body and vitiated ''kapha'' can be correlated with dyslipidemia. Role of dyslipidemia and metabolic abnormalities in the pathogenesis of diabetes is very obvious and well elaborated in modern medicine. Among the metabolic abnormalities that commonly accompany diabetes are disturbances in the production and clearance of plasma lipoproteins. Moreover, development of dyslipidemia may be a harbinger of future diabetes. A characteristic pattern, termed diabetic dyslipidemia, consists of low high density lipoprotein (HDL), increased triglycerides, and postprandial lipemia. This pattern is most frequently seen in type 2 diabetes and may be a treatable risk factor for subsequent cardiovascular disease.<ref> http://press.endocrine.org/doi/10.1210/jcem.86.3.7304 accessed on 12 June 2017 </ref>

 

==== Causes of lipoprotein abnormalities in diabetes ====  

==== Causes of lipoprotein abnormalities in diabetes ====