A Randomized open label Comparative Clinical Study To Evaluate Effectiveness of Tambula Sevana An Ayurvedic Daily Regimen in Pre Diabetes with special reference To Impaired Glucose Tolerance IGT

Abstract

The prevalence of metabolic disorders particularly pre-diabetes has reached alarming levels worldwide, posing grave public health challenges. Pre-diabetes is broadly characterized by elevated blood glucose levels that remain below the threshold for type 2 diabetes mellitus (T2DM) diagnosis, but still within a high-risk range. For instance, individuals with fasting plasma glucose between 100 mg/dL and 125 mg/dL, or an HbA1c measure between 5.7% and 6.4%, are typically diagnosed with pre-diabetes. The alarming increase in pre-diabetes worldwide underscores the urgency of identifying and implementing preventive measures that are both efficacious and culturally viable. Ayurveda, with its emphasis on daily routines and holistic well-being, aligns with the conceptual framework for lifestyle disease prevention. Tambula-Sevana, a traditional practice involving the chewing of betel leaves and select herbal ingredients, emerges as a candidate for scientific scrutiny given preliminary reports suggesting metabolic benefits and widespread cultural acceptance in many regions. newlineThe pathophysiological mechanisms underlying prediabetes primarily involve insulin resistance, relative insulin deficiency, and disturbances in glucose metabolism. Insulin resistance affects various tissues, including muscle and adipose tissue, leading to impaired glucose uptake [7]. Additionally, the prevalence of ectopic fat deposition is noted in individuals with prediabetes, contributing to inflammation and further insulin resistance newlineClassical Ayurvedic scholars emphasize that Prameha, if unchecked, may progress into Madhumeha, analogous to advanced stages of diabetes mellitus. This progression from a borderline state (akin to prediabetes) into a more severe hyperglycemic condition underscores a continuum of metabolic dysregulation recognized millennia ago. Textual references in Charaka Samhita outline that the management of Prameha involves not only herbal formulations but also dietary regulations and lifestyle modifications aimed