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''Mamejjaka'' (Enicostema littorale Blume) is used as a single herb and also as a part of an anti-diabetic mixture [15]. In a clinical study on patients with type 2 diabetes, E. littorale reduced blood glucose and prevented the progression of diabetic complications. There was a significant improvement in the lipid profile, blood pressure, and kidney function [25]. It significantly reduced blood glucose and lipid peroxides in rats with alloxan- induced diabetes, and increased superoxide dismutase, catalase, and glutathione peroxidase [26]. In studies on rats with streptozotocin- induced type 1 diabetes, E. littorale significantly reduced glucose, cholesterol, and triglyceride levels [27], and ameliorated diabetic nephropathy. Serum creatinine and urea were significantly decreased and glomerular function improved [28]. In rats fed a hypercholesterolemic diet, E. littorale decreased serum cholesterol, triglycerides, LDL, VLDL, liver, and kidney cholesterol levels, and lipid peroxidation levels. There was an increase in HDL and an increase in reduced glutathione levels [29].

''Mamejjaka'' (Enicostema littorale Blume) is used as a single herb and also as a part of an anti-diabetic mixture [15]. In a clinical study on patients with type 2 diabetes, E. littorale reduced blood glucose and prevented the progression of diabetic complications. There was a significant improvement in the lipid profile, blood pressure, and kidney function [25]. It significantly reduced blood glucose and lipid peroxides in rats with alloxan- induced diabetes, and increased superoxide dismutase, catalase, and glutathione peroxidase [26]. In studies on rats with streptozotocin- induced type 1 diabetes, E. littorale significantly reduced glucose, cholesterol, and triglyceride levels [27], and ameliorated diabetic nephropathy. Serum creatinine and urea were significantly decreased and glomerular function improved [28]. In rats fed a hypercholesterolemic diet, E. littorale decreased serum cholesterol, triglycerides, LDL, VLDL, liver, and kidney cholesterol levels, and lipid peroxidation levels. There was an increase in HDL and an increase in reduced glutathione levels [29].

A pilot study on an herbal mixture containing  ''tejapatra'' (Cinnamomum Tamala)<ref>Chandola HM, Tripathi S N. Hypoglycemic response of C.tamala in diabetes. In: Bajaj JS,ed. Diabetes Mellitus in developing Countries. New Delhi: Interprint, 1984: 383-386.</ref><ref>Chandola HM, Tripathi S N, Udupa KN. Effect of C.tamala on plasma insulin vis-à-vis  blood sugar in patients of diabetes mellitus. J Res Ayurveda Siddha 1980;1:3455-357. </ref>, ''pushkarmula'' (Inula racemosa), ''mamejjaka'' (E.littorale), ''meshashringi'' (Gymnema Sylvestre), and ''jambu'' (Syzygium cumini) seeds with ''karvellaka'' (bitter gourd; bitter melon; Momordica charantia) juice, administered at a dose of 5g twice a day before meals, decreased fasting and post- prandial blood glucose levels in patients with diabetes [32]. ''Avartaki'' (Cassia auriculata Linn.) and ''methika'' (Trigonella foenum- graecum) as single herbs and decoction of ''nimba'' or ''neem'' (Azadirachta indica A.juss;) have also demonstrated blood glucose- lowering  action33. In a clinical study on patients with type 2 diabetes, neem showed significant hypoglycemic effect. The effect of ''neem'' was comparable to that of glibenclamide [34,35].  

A pilot study on an herbal mixture containing  ''tejapatra'' (Cinnamomum Tamala)<ref>Chandola HM, Tripathi S N. Hypoglycemic response of C.tamala in diabetes. In: Bajaj JS,ed. Diabetes Mellitus in developing Countries. New Delhi: Interprint, 1984: 383-386.</ref><ref>Chandola HM, Tripathi S N, Udupa KN. Effect of C.tamala on plasma insulin vis-à-vis  blood sugar in patients of diabetes mellitus. J Res Ayurveda Siddha 1980;1:3455-357. </ref>, ''pushkarmula'' (Inula racemosa), ''mamejjaka'' (E.littorale), ''meshashringi'' (Gymnema Sylvestre), and ''jambu'' (Syzygium cumini) seeds with ''karvellaka'' (bitter gourd; bitter melon; Momordica charantia) juice, administered at a dose of 5g twice a day before meals, decreased fasting and post- prandial blood glucose levels in patients with diabetes<ref>Singh B, Singh G, Vyas SN, Chandola HM. The role of  Virechana and herbal drugs in the management of MadhuMeha (diabetes mellitus). MD (Ayu) thesis. Institute of  Post Graduate Teaching and Resaerch in Ayurveda, Gujarat Ayurveda University, Jamnagar, India, 1992</ref>. ''Avartaki'' (Cassia auriculata Linn.) and ''methika'' (Trigonella foenum- graecum) as single herbs and decoction of ''nimba'' or ''neem'' (Azadirachta indica A.juss;) have also demonstrated blood glucose- lowering  action33. In a clinical study on patients with type 2 diabetes, neem showed significant hypoglycemic effect. The effect of ''neem'' was comparable to that of glibenclamide<ref>Waheeda A, Miana GA, Ahmead SI. Clinical investigation of hypoglycemic effect of seeds of Azadirachata indica in type-2 (NIDDM) diabetes mellitus. Pak J Pharm Sci 2006; 19: 322-325</ref><ref>Khosla P, Bhanwra S,Singh J, et al. A study of hypoglycaemic effect of Azadirachata indica (Neem) in normal and alloxan diabetic rabbits. Indian J Physiol Pharmacol 2000:44:69-74</ref>.  

The herb ''gokshura'' (Tribulus Terrestris Linn.)36, ''asana'' (Pterocarpus marsupium Roxb.)37, ''kulatha'' (Vigna unguiculata (Linn.) Walp.), and saptaparna38 (Alstonia scholaris (Linn.) R.Br.) is also beneficial in treating ''prameha''. These herbs can be used in different combinations, depending on the doshic involvement and severity of illness. An herbal mixture comprised of one part each of ''karvellaka'' (bitter gourd; bitter melon; Momordica charantia), ''jambu'' (Syzygium cumini), ''gurmar'' (Meshashringi G.sylvestre), and ''amra'' (Moringa indica Linn.), taken along with ''shilajit'', was investigated in a clinical study on 805 patients with diabetes. The results showed a statistically significant reduction in fasting and postprandial blood glucose along with clinical improvement (website of India’s Central Council for Research in Ayurveda and Siddha).

The herb ''gokshura'' (Tribulus Terrestris Linn.)<ref>Amin A, Lotfy M, Shafiullah M, Adeghate E. The protective effect of Tribulus terreestris in diabetes. Ann NY Acad Sci 2006; 1084: 391-401</ref>, ''asana'' (Pterocarpus marsupium Roxb.)<ref>Anonymous. Sahasrayogam. 23rd ed. Alappuzha, Kerala, India: Vidyarambam Publisheres, 2000:93</ref>, ''kulatha'' (Vigna unguiculata (Linn.) Walp.), and saptaparna<ref>Dasa G. Bhaishajyaratnavali. Varanasi, India: Choukhamba Sanskrit Sansthan, 2000</ref> (Alstonia scholaris (Linn.) R.Br.) is also beneficial in treating ''prameha''. These herbs can be used in different combinations, depending on the doshic involvement and severity of illness. An herbal mixture comprised of one part each of ''karvellaka'' (bitter gourd; bitter melon; Momordica charantia), ''jambu'' (Syzygium cumini), ''gurmar'' (Meshashringi G.sylvestre), and ''amra'' (Moringa indica Linn.), taken along with ''shilajit'', was investigated in a clinical study on 805 patients with diabetes. The results showed a statistically significant reduction in fasting and postprandial blood glucose along with clinical improvement (website of India’s Central Council for Research in Ayurveda and Siddha).

''Prameha'' is described as a set of complex clinical disorders characterized by frequent abnormal micturition, with the etiology involving genetic predisposition as well as diet and life style. The role of stress and obesity in the pathogenesis is also elaborately described in ''prameha'' have much in common with those described for obesity, metabolic syndrome and diabetes mellitus. The management of ''prameha'' emphasizes dietary and life style recommendation and herbal preparations. Due to the richness and complexity of the compound in plants, herbal therapy has always been thought to act on multiple targets. Even one single compound can have multiple target which acts as a double edge sword in managing diabetes mellitus. ''Medhya'' or mental health promoting drugs, if added along with anti-diabetic therapy, will further potentiate anti-diabetic effect of the principal drug by counteracting stress. Ayurveda and modern medicine both are complimentary to each other. Simultaneous administration of Ayurvedic drug will not only potentiate therapeutic efficacy of modern drug rather it will also counteract or reduce the adverse effects of the modern drug, if any; to lead the patient a healthy and happy life. Moreover, organ specific ''rasayana'' may be added for prevention and cure of complications. Ayurvedic drugs should be use in its natural form without disturbing its natural combination/holistic principle of the drug. Single drug may have composite fractions and each fraction has its own medicinal value. Polyherbal combination potentiate therapeutic efficacy of a particular ingredient of the formulation and also counteract adverse effect if present in the combination. Instead of isolating a particular alkaloid it is suggested that the Ayurvedic drug should be use as a whole. All patients of diabetes are not similar, so a stepped care treatment is recommended. In early stage of disease and patients having ''kaphaja'' constitution, it is better to use Ayurvedic drugs alone. In acute stage and having ''pittaja'' constitution of patients wherever found necessary, oral insulin promoter may be added. In chronic stage and having ''vataja'' constitution, insulin therapy may also be added as these cases are insulin dependent.

''Prameha'' is described as a set of complex clinical disorders characterized by frequent abnormal micturition, with the etiology involving genetic predisposition as well as diet and life style. The role of stress and obesity in the pathogenesis is also elaborately described in ''prameha'' have much in common with those described for obesity, metabolic syndrome and diabetes mellitus. The management of ''prameha'' emphasizes dietary and life style recommendation and herbal preparations. Due to the richness and complexity of the compound in plants, herbal therapy has always been thought to act on multiple targets. Even one single compound can have multiple target which acts as a double edge sword in managing diabetes mellitus. ''Medhya'' or mental health promoting drugs, if added along with anti-diabetic therapy, will further potentiate anti-diabetic effect of the principal drug by counteracting stress. Ayurveda and modern medicine both are complimentary to each other. Simultaneous administration of Ayurvedic drug will not only potentiate therapeutic efficacy of modern drug rather it will also counteract or reduce the adverse effects of the modern drug, if any; to lead the patient a healthy and happy life. Moreover, organ specific ''rasayana'' may be added for prevention and cure of complications. Ayurvedic drugs should be use in its natural form without disturbing its natural combination/holistic principle of the drug. Single drug may have composite fractions and each fraction has its own medicinal value. Polyherbal combination potentiate therapeutic efficacy of a particular ingredient of the formulation and also counteract adverse effect if present in the combination. Instead of isolating a particular alkaloid it is suggested that the Ayurvedic drug should be use as a whole. All patients of diabetes are not similar, so a stepped care treatment is recommended. In early stage of disease and patients having ''kaphaja'' constitution, it is better to use Ayurvedic drugs alone. In acute stage and having ''pittaja'' constitution of patients wherever found necessary, oral insulin promoter may be added. In chronic stage and having ''vataja'' constitution, insulin therapy may also be added as these cases are insulin dependent.