A study of Ayurvedic Pharmacoepidemiology and therapeutics of Madhumeha (Type 2 Diabetes mellitus): An Untapped potential for new drug discovery’

Abstract

Ayurveda do have information regarding frequent urination i.e. Prameha which has been described in many classical Ayurvedic texts such as Brihattrayi and laghuttrayi. Various herbal and herbominaral formulations have been recommended as a therapy for various conditions of Prameha and madhumeha. Rational thinking behind the therapeutic guidelines as a whole and the formulations specifically reveals the reversal of pathophysiology (shatkriyakalas). Thousands of Ayurvedic drug manufacturing units are producing and marketing these formulations, and are available for diabetic patients without need of prescriptions as well as with scarcity of patient information leaflets. If sufficient Pharmacoepidemiological evidence is collected safety and efficacy can be generated. Study of labels of these marketed formulations shown that the labels follow mandatory instructions; however the specific information of bheshaj kala (time of administration) , anupan (vehicle), and indication - contraindication as per Ayurvedic therapy were not displayed. Our study is of first of its kind as no studies are reported in literature regarding Ayurvedic Antidiabetic drug usage by Diabetic patients.The drug utilization study in diabetic patients noted varied percentage of using Ayurvedic medicines for diabetes. As these were pilot studies, conducted 8 for the first time adopting the conventional method; the results can’t be applied to the community. KAP survey of diabetic patients presented better knowledge score than the attitude and practice.In KAP survey of Ayurvedic physicians among all physicians reveals good knowledge compare to practice. The potential drawback of our study is a report from a single study hence cannot be generalized to the diabetic population of Mumbai Alpha Glucosidase inhibition study by MAAF and phytoactives showed dose dependent inhibition of the enzyme suggesting a new target for antidiabetic drug discovery. AyPE needs triple competence in clinical pharmacology, medicine, and epidemiology or a team with such diverse expertise. This is because as per WHO estimates, almost 80% of population of many Asian and African countries relies on traditional medicine for primary health care. Ayurvedic pharmacoepidemiology approach can provide early evidence of the safety, efficacy and acceptability of Ayurvedic drugs. Such an endeavor may precede Observational Therapeutics and Reverse Pharmacology.