A Mind-Body Approach to Diabetes
Part of truly appreciating our human experience is enjoying the sweetness of life. A perfectly ripe peach. A fresh slice of homemade bread. A scoop of chocolate ice cream. In life’s paradoxical way, however, at the same time that we have greater access to the world’s rich variety of sweet delicacies than ever before, the number of people with difficulties metabolizing sugar in their bloodstream is soaring. This condition, commonly known as diabetes, is reaching epidemic proportions in many countries.
Although medical science has made great advancements in the treatment of acute diseases such as infectious illnesses, trauma, and other life-threatening conditions, we are seeing a dramatic rise in chronic diseases, including diabetes. According to the most recent report from the Centers for Disease Control and Prevention, the number of people in the U.S. diagnosed with diabetes rose from 1.5 million in 1958 to 18.8 million in 2010. Diabetes is the seventh leading cause of death in the U.S. and is a major cause of heart disease, stroke, kidney disease, lower limb amputation, and blindness. Data from international studies show that the number of people with diabetes worldwide in 2011 has reached 366 million.
Fortunately, while there is not yet a cure for diabetes, there are interventions and lifestyle changes we can make to affect the course of this disease and prevent complications. The healing system of Ayurveda offers valuable wisdom and guidance that can help us listen to the signals of our body, notice the first signs that we’re getting out of balance, and make the necessary changes to reverse the imbalances.
By taking a fresh look at the ancient and comprehensive knowledge base of Ayurveda, we can become better able to treat and manage this complex disease. We can also expand our potential to develop treatment strategies that combine ancient wisdom with modern medicine.
What Is Diabetes?
The current medical understanding of diabetes mellitus is that it is a group of related diseases in which the body is unable to regulate the amount of sugar, specifically glucose, in the blood. Glucose provides our body and mind with vital energy. It is the main source of energy for our cells and the main source of fuel for our brain.
In a healthy individual, several hormones, including insulin, regulate blood glucose levels, allowing glucose to be used for fuel. However, in people with diabetes, the body either does not make enough insulin (type 1 diabetes), or is not able to use it well (type 2 diabetes). In some types of diabetes, the body is both unable to produce enough insulin and unable to use it efficiently. When the body is unable to efficiently incorporate glucose from the blood into the cells where it is needed, glucose stays in the blood, where it can cause serious problems. In addition, the cells don’t receive the energy they need to function properly. In all types of diabetes, there is a risk of the blood sugar level becoming too high and causing serious health problems, both acute and chronic.
An Ayurvedic Perspective
One of the earliest references to the disease we would recognize today as diabetes appears in the Atharvaveda, one of the four sacred Vedas that originated in approximately 1,500–1,000 B.C. in India. The traditional comprehensive healing system of Ayurveda was developed from material that is found in these ancient texts.
In Ayurveda, diabetes is referred to as madhumeha, a Sanskrit term that directly translates as “sweet urine” disease. Indeed, when our blood sugar levels rise above a certain threshold, it spills over into the urine and can be detected. The ancient description of this disease includes an appreciation for the fact that derangements in body tissues take place due to imbalances in metabolism. The term for this in Sanskrit is dhatupaka janya vikruti.
The cause, symptoms, prognosis, and management of diabetes were also described in detail in the Vedic texts thousands of years ago. Ayurveda recognizes the multifactorial nature of diabetes, making reference to tendencies inherited at birth as well as accumulated imbalances of potentially all three doshas or mind-body constitutions (Vata, Pitta, and Kapha). Learn more about the three doshas here.
The Different Types of Diabetes
Ayurveda also identifies different types of diabetes, including a form known in Sanskrit as apathyanimittaja that tends to occur later in life and whose contributing factors include excessive sleep, overindulgence in food and sweets, and a lack of physical activity. This description correlates well with our modern medical understanding of type 2 diabetes. Scientific research has found that the risk factors for this form of diabetes include a high-fat diet, high alcohol intake, being overweight, and a sedentary lifestyle.
A Closer Look at Type 2 Diabetes, Often Linked to an Imbalance of the Kapha Dosha
Type 2 diabetes used to be a disease that mainly occurred in older patients, but it is now rising dramatically in children and adolescents, a population that is much more sedentary and overweight than previous generations. Obesity is a major risk factor for type 2 diabetes, as well as making it more difficult to control.
From an Ayurvedic perspective, type 2 diabetes is primarily an imbalance, or excess, of the Kapha dosha, which consists of the earth and water elements. Kapha governs the physical structure of our body and several metabolic processes, but when it builds to excess, can manifest in weight gain, lethargy, allergies, and resistance to change. Ayurveda identifies an excessive appetite, especially for sweet food, as a causative factor in the development of type 2 diabetes. However, overeating is sometimes provoked by an imbalance in the Vata dosha, which can easily become aggravated. When people with Vata imbalances overeat to soothe themselves, Kapha can in turn become imbalanced and, over time, contribute to the development of type 2 diabetes. (In this article, we will focus on this type of diabetes, but it’s important to note that Ayurveda considers type 1 diabetes to be primarily an imbalance of the Vata dosha.)
Our Diet, Our Health
Since Ayurveda considers diabetes mainly an excess of Kapha dosha, it recommends a Kapha-pacifying diet to keep diabetes under control. The guidelines include eating more foods that are bitter, astringent, or pungent in taste – and decreasing consumption of foods that are categorized as sweet, sour, or salty.
Here are some more recommendations for balancing Kapha. Keep in mind that an Ayurvedic dietary prescription takes many factors into account, such as age, body constitution, season, and other environmental and social factors, so a consultation with a trained practitioner is necessary to make specific individual recommendations.
- Eat foods that have a balancing effect upon the dominant dosha or that will pacify (balance) a dosha that has become excessive or aggravated. Because Kapha is heavy, oily and cold, favor foods that are light, dry, or warm.
- Reduce your intake of dairy, which tends to increase Kapha. You can use small amounts of ghee, low-fat milk, and low-fat yogurt.
- Drinking hot ginger tea with meals helps stimulate slow digestion. Drink 2–3 cups of ginger tea daily. Find the Chopra Center recipe for ginger tea here.
- All beans are good for Kapha types except for soybeans and tofu, which should be eaten in moderation.
- Favor lighter fruits such as apples, pears, pomegranates, cranberries, and apricots. Reduce heavier fruits like bananas, pineapples, and figs.
- Grains: Favor barley, corn, millet, buckwheat, and rye. Reduce intake of oats, rice, and wheat.
- All spices except salt are pacifying to Kapha. Use pungent spices like pepper, cayenne, mustard seed, and ginger freely in your diet.
The Ayurvedic perspective on balancing Kapha is consistent with Western medicine’s current understanding of the proper diet for diabetes, which recommends minimizing simple carbohydrates, fats, and other heavy foods while increasing “lighter” foods such as beans (as the main protein source), whole grains, and lighter fruits and vegetables.
Recent Research on Various Foods and Diabetes
Current Western medical studies have shown that the intake of whole grain, as opposed to refined grains, is inversely associated with risk of developing type 2 diabetes. Researchers think that this effect is due to improved insulin sensitivity, or an improved ability of the body to use insulin after the intake of whole grains. People who consume approximately three servings per day of whole grain foods are 20–30 percent less likely to develop type 2 diabetes than those who eat fewer than three servings per week. The intake of healthy whole grains in moderation can be consistent with the “low carb” diet that is typically recommended in diabetes.
There is also evidence to support the beneficial effects of a diet high in legumes, fruits, and vegetables in the prevention and management of diabetes. Like whole grains, these foods tend to be high in fiber, and prevent the rapid release of glucose into the blood, thereby preventing rapid release of insulin as well. Some studies have suggested that frequent consumption of processed meats may increase the risk of type 2 diabetes. Meats, especially processed meats, contain many pro-inflammatory chemicals that can contribute to a chronic state of inflammation in the body.
Many people are able to manage their diabetes with dietary changes, especially when these changes are made early on in the development of the disease. In fact, when early intervention is made with diet, people with pre-diabetes can prevent development of the disease itself.
Both Ayurveda and modern medicine recognize a lack of physical exercise as one of the lifestyle factors that contributes to the development and progression of diabetes. Obesity increases the risk of developing diabetes and negatively effects blood sugar control in individuals who have diabetes. For these reasons, being active and maintaining a healthy body weight is important in the treatment and prevention of diabetes.
Any type of physical activity helps lower blood glucose, and aerobic exercise in particular improves the functioning of insulin, allowing glucose to enter the cells where it is needed and keeping the level in the blood normal.
Increasing physical activity helps reduce excess Kapha dosha. However, vigorous exercise is not always recommended, especially in diabetic individuals who are frail or thin (where obesity does not play as much of a role), or are suffering from other medical issues. In these cases, professional guidance on a proper exercise regimen is recommended.
Yoga for Body-Centered Awareness and Balance
From an Ayurvedic perspective, there are specific yoga postures that offer the greatest benefits with the least amount of stress. Some of these poses include:
- Sun Salutation series
- Seated forward bend (paschimottanasana)
- Tree pose (vrksasana)
- Warrior I and II (virabhadrasana I and II)
- Extended side angle, (utthita parsvakonasana)
- Bridge pose (setu bandha sarvangasana)
- Alligator twist (jathara parivartasana)
- Relaxation pose (savasana)
Yoga Journal has an excellent website with a special section devoted to yoga poses where you can find detailed descriptions of the above poses and their benefits. For most people, it’s best to aim for moderate exercise for a total of thirty minutes a day, at least five days a week. If you are trying to lose weight, you may want to exercise more than thirty minutes a day. Start out slowly and gradually increase the intensity of exercise.
Try These Activities
Here are some examples of exercise you can incorporate into a daily routine:
- Take a brisk walk
- Participate in a yoga, tai chi, or qigong class
- Go dancing
- Take an aerobics class
- Swim or do water aerobics
- Go for a bike ride or use a stationary bike indoors.
Medicinal Herbs and Spices
Ayurveda identifies many herbs and spices that can be used to treat diabetes. We are beginning to identify some of the beneficial actions of these natural medicinals from a scientific perspective. There are currently over 1,200 species of plants that have known glucose-lowering effects. Here are a few:
This plant has been used to treat diabetes for more than 2,000 years. It is a woody, climbing vine common in central and southern India. Ayurvedic practitioners referred to this plant as gurmar, or “sugar destroyer.” Gymnema sylvestre was traditionally used in many forms, either by chewing the leaves, taking it as a powder, or preparing it with water as a beverage.
There has been extensive research on gymnema sylvestre in studies using animals, and it has been found to stimulate insulin secretion, increase the effects of circulating insulin, and decrease blood glucose levels. It has also been shown to have a protective effect on the pancreas, which is the organ that produces and secretes insulin. Gymnema sylvestre seems to increase the sensitivity of the tissue to insulin, which helps the body use glucose for energy.
Trigonella Foenum-graecum (Fenugreek)
Commonly known as fenugreek, this herb is cultivated throughout the world as a spice. In Sanskrit it is also called methi. In Ayurveda, the seed is used to treat diabetes by preparing it as a drink or mixing the powder or seed into curry or bread. Fenugreek seeds have a high fiber content, and several components of the seed have been identified as having direct glucose-lowering effects. Studies have shown that daily use of fenugreek seeds can decrease insulin resistance and improve blood sugar control.
This fragrant spice has received much attention recently as a sugar-lowering substance. Cinnamon has been shown to improve the body’s ability to use insulin in multiple ways. It stimulates insulin receptors on the cells, as well as acting directly on our DNA to “turn off” genes that are responsible for deactivating insulin receptors on our cells. These actions make it much easier for cells to take up glucose, thus reducing blood sugar levels. Including cinnamon in a meal that is high in carbohydrates also reduces the rise of glucose in the blood after eating. For example, you could add just one teaspoon of cinnamon to a cup of rice pudding. From an Ayurvedic perspective, cinnamon contains the pungent taste, which is recommended in a Kapha-pacifying diet.
This popular Indian spice has a long history of use as an anti-inflammatory, and due to the connection between inflammation and diabetes, is being studied in the prevention and treatment of diabetes.
A 2011 study of animal subjects published in Food and Chemical Toxicology found that the effects of turmeric were similar to a commonly prescribed diabetes medication, increasing insulin sensitivity and reducing blood sugar levels. The ingestion of turmeric resulted in a significant decline in body weight and fat content. Further research is needed to confirm these effects in humans. Current research reveals no significant side effects of using turmeric and supports using this spice to complement other therapies for diabetes.
Several foods have been also used traditionally as a remedy for diabetes and have been shown to decrease blood glucose levels. For example, bitter goard, or karela, is widely used to treat diabetes in many traditional healing systems. It is thought to work by decreasing absorption of glucose from the intestine, stimulating insulin secretion and increasing uptake of glucose into muscle cells. Used as a food in the Indian diet, there have been no reported toxicities.
Another gourd that has been shown to have glucose-lowering effects is ivy goard, or kanduri. The juice of this food contains an enzyme that humans naturally produce that breaks down sugars. Extracts of the root and leaf have been shown to lower blood sugar levels in animals.
Several studies show that eating almonds with a carbohydrate significantly lowered the release of sugar into the blood, similar to the addition of cinnamon to a meal. Try adding a handful of almonds to a salad, oatmeal, or cereal. At the Chopra Center, we have seen patients experience significant reductions in blood sugar when they make these dietary changes.
Be Established in Union: Meditation and Yoga
Yogastah kuru karmani is a Vedic saying that can be translated as “established in union, perform action.” Engaging in mind-body practices, such as meditation and yoga, helps establish the union of body, mind, and spirit, out of which true healing occurs. Often, once people begin a regular meditation and yoga practice, they notice that they start to perform spontaneous right action and make choices that are more aligned with good health. They begin to exercise more and choose the proper foods with less struggle and effort.
In addition, both meditation and yoga have been shown to reduce stress, which plays a significant role in the development and control of diabetes. When we face situations that we perceive as stressful, our body increases the production of “stress” hormones such as cortisol and adrenalin. Chronic stress can lead to insulin resistance, which in turn elevates blood sugar levels. With regular meditation or yoga, the levels of stress hormones in our bodies decrease, resulting in better blood sugar control.
The Healing Power of Deep Sleep
Many studies have also demonstrated the beneficial effects of meditation on sleep, including alleviating insomnia. This is particularly important for people with diabetes because poor sleep can worsen control of blood sugar. With inadequate sleep, chronic hormonal imbalances occur that can subsequently lead to impaired blood sugar control.
We have seen the clinical health benefits of meditation in patients who come to the Chopra Center. Often a regular meditation practice allows people to sleep properly for the first time in decades, thus allowing their hormones – including those that regulate blood sugar – to return to their natural balance and function effectively.
The key to fully enjoying the “sweetness” of life is a balanced, holistic approach that encompasses our body, mind, heart, and spirit. By nurturing our wholeness and health, we can not only prevent or effectively manage diabetes, but we can also experience expanded happiness, fulfillment, and wellbeing.