CRITICAL REVIEW OF PRAMEHA

Prameha is a complex metabolic disorder described in Ayurveda, characterised by polyuria, turbidity of urine, and derangement of Medo dhatu (adipose tissue metabolism). It encompasses twenty distinct subtypes based on the Doshas—Kapha, Pitta, and Vata. The condition is primarily rooted in Kapha dosha vitiation, leading to im-paired carbohydrate and lipid metabolism and accumulation of Meda and Kleda within the body. From a modern biomedical perspective, Prameha closely correlates with diabetes mellitus and metabolic syndrome, conditions involving insulin resistance, obesity, and dyslipidemia. The Ayurvedic pathophysiological concept (Samprapti) of Prameha describes a cascade of metabolic impairments resulting from Agnimandya (digestive and metabolic dysfunction), ultimately leading to Ojas kshaya (loss of vital essence). According to recent public health data from the World Health Organisation (WHO), the situation of diabetes in India is as follows: In India, an estimated 77 million adults (age ≥ 18) are living with diabetes (type 2), and nearly 25 million are classified as pre diabetics — that is, at elevated risk of developing full-blown diabetes in the near future.31 More than 50% of people with diabetes in India remain unaware of their condition — a fact which significantly heightens the risk of complications due to delayed diagnosis and treatment. This significant and partly hidden burden underscores the seriousness of diabetes as a national health challenge in India, making early detection, prevention, and public health awareness essential. Management strategies in Ayurveda include Ahara (dietetic regulation), Vihara (lifestyle modification), and Aushadhi (therapeutic formulations) aimed at restoring Agnibala and metabolic balance. Herbs such as Haridra (Curcuma longa) and Amalaki (Emblica officinalis) exhibit hypoglycemic and antioxidant properties, aligning with modern pharmacological findings. An integrative approach combining Ayurvedic principles and contempo-rary biomedical understanding provides a holistic framework for the prevention and management of diabetes and related metabolic disorders.