A study on the efficacy of homoeopathic medicines in the management of diabetes mellitus satisfying the criteria of psychological condition affecting medical condition of DSM -IVTR
Dr Rajiv Abraham
Diabetes was known even in ancient times. The name of this disease, which is characterized by excessive flow of urine and insatiable thirst, was coined by the Graeco-Roman physician Aretaeus of Cappadocia (approx.80–130 A.D.) and is derived from the Greek word diabainein (‘to flow through’). The adjective mellitus, which comes from Latin and means ‘honey-sweet’, was added by the German physician Johann Peter Frank (1745–1821) in order to distinguish diabetes mellitus, or ‘sugar diabetes’, from diabetes insipid us. Johann Peter Frank was also who in 1790, by introducing a yeast fermentation test for the quantitative determination of urinary glucose, relieved the physicians of his time of the need to taste their patients’ urine. According to ayurveda , it is called as madhumeha, is a metabolic kapha type of disorder in which diminished functioning of agni leads to a tendency toward high blood sugar.
Diabetes mellitus
Diabetes mellitus (DM) comprises a group of common metabolic disorders that share the phenotype of hyperglycemia2.a.The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. It occurs when pancreas does not produce enough insulin or alternatively, when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.
Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
Epidemiology
The World Health Organization (WHO) estimates that more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030. In 2005, an estimated 1.1 million people died from diabetes. Almost 80% of diabetes deaths occur in low and middle-income countries. Almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths are in women Indeed, by 2010 it has been estimated that the diabetic population will increase to 221 million from 110 million in 1994.3, The majority of the new cases will be those with type 2 diabetes and most of these will be in China, the Indian subcontinent and Africa. It is estimated that from 65 million cases of type 2 diabetes in Asia and Oceania in 1995, the number will double to 135 million by 2010.
In India it is estimated that presently 19.4 million individuals are affected by this deadly disease, which is likely to go up to 57.2 million by the year 2025 . By the year 2025, India is predicted to have the most number of people with diabetes mellitus in the world1. In Kerala about 8% of adult population is diabetic; this ranges from 3% in rural areas and 20% in cities. Only exception is costal fisher folk among whom prevalence is as low as 3%.By most conservative estimate there are about 1.5 million diabetics’ subjects in Kerala9b .
Psychological symptoms affecting medical condition
This class belongs under Psychological Factors Affecting General Medical Condition. These symptoms do not meet full criteria for an Axis I disorder significantly affect the course or treatment of a general medical condition (the accompanying general medical condition is coded on Axis III )
The Essential feature of Psychological factor affecting Medical condition is the presence of one or more specific psychological or behavioral factors that adversely affect a general medical condition. It is classified under Other Conditions that may be a Focus of Clinical Attention of DSM-IV-R. Psychological Factors play a potential role in the presentation or treatment of almost every medical condition. As per classification is only reserved for situations in which psychological factors have a clinical significant effect on the course or out come of the general medical condition or place the individual at a significantly higher risk for adverse outcome, although it may often not be possible to demonstrate direct causality or the mechanisms underlying the relationship.
Medicines were selected on basis on constitutional similarity also taking into consideration of stress factors.Among 30 cases medicine indicated most of times is Nat.mur- 23%(9 cases). Then Calc.carb 10%,in 4 cases followed by Phos.acid, Ars.alb, and, Lyco, 10%,in 3 cases each Aur.met, Caust, Mag.mur 7%ie,2 cases each.Phos &Sep 3%i.e,1 This shows the effectiveness of Constitutional drugs having in the treatment of Diabetes Mellitus.The most effective was Nat.mur,Calc.carb and Phos.acid. followed by other drugs.
Discussion
To arrive at a valid conclusion, I am indebted to discuss some of the findings that have evolved out of this study.
The result is exclusively based on the observation and result presented in former section.
1. Age incidence: The incidence was maximum in the age group 40-50 i.e 46.6%,The next greater prevalence was in age group 30-40.i.e26.6%.
2. Sex Predominance :In study Female out numbered males.
2. Domicile: Rural population amount to56.6% % and urban population 43.3 %
3. Distribution of patients according to socio economic class:-In this study conducted, Diabetes mellitus is found more among poor class (66.7%) followed by middle class.It showing life situation and environment plays a significant role.
4. Duration of Illness of Majority was 1-5 years followed 5-10 years.
5. The Family History of Diabetes was noted in 21 cases i.e 70% cases compared with %30 having no family history of Diabetes. Showing strong Genetic Trait.
6. Distribution of clinical features: Among the symptoms given Weakness was dominating feature, Weight loss, Burning Sensation followed by Increased thirst,and Increased hunger.
7. The Miasmatic Dominance noted was Psora(53%),followed by Sycosis 28% and Syphilis 19%.Diabetes Mellitus has involvement of all 3 miasms.,in varied proportions.
8. Evaluation of change in disease criteria: The comparison of the FBS measurement before and after treatment showed statistically significant result.
9. Stressful life events associated in a major number cases were Death of closed loved ones, resulting in significant period of grief, which was followed by Stressful periods due to financial difficulties.
10. Medicines used: Medicines were selected on basis on constitutional similarity also taking into consideration of stress factors. Among 30 cases medicine indicated most of times is Nat.mur- 23%. Then Calc.carb 10%, followed by Phos.acid, Ars.alb, and, Lyco, 10%, Aur.met, Caust, Mag.mur 7%,Phos &Sep 3% This shows the effectiveness of Constitutional drugs in the treatment of Diabetes Mellitus.
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