Efficacy of Vamana Karma (therapeutic emesis) followed by Darvyadi Kwatha (herbal decoction) in the management of prediabetes (Prameha) - A single-arm clinical trial.

Background: Prediabetes is an alarming condition to control and prevent from developing diabetes mellitus which occurs due to the change in lifestyle and food habits. Timely untreated prediabetes turn into type-2 diabetes mellitus within a year and systemic complications such as retinopathy, nephropathy, and neuropathy could occur and in later stage multi system damage could take place.

Aims: The ai of this study is to evaluate the efficacy of Vamana Karma (therapeutic emesis) with Ikshuvaku Yoga and followed by oral administration of Darvyadi Kwatha (herbal decoction) in the management of prediabetes.

Materials and methods: After approval of IEC and registration under clinical trial registry of India, 20 patients suffering from prediabetes were registered in the trial. Diagnosis criteria were hemoglobin A1c (HBA1c), fasting blood sugar (FBS) and postprandial blood sugar (PPBS), and assessment criteria includes HBA1c, FBS, PPBS, along with improvement in Agnibala (strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength), relief sign and symptom of prediabetes (Prameha), and improvement in quality of life (SF-36 Score). Classical Vamana Karma followed by oral administration of Darvyadi Kwatha was done. Total duration of treatment was 45 days and last follow-up was done on the 120^th day. Student's t- test was used for the analysis of parametric data.

Results: After the treatment were observed that there is improvement in subjective as well as in objective parameters. Statistically highly significant result was observed in HBA1c (BT [day 0] Mean score 6.25 and AT [day 120] 5.63 [P < 0.001]), FBS (BT [day 0] mean score 120.05 and AT [day 120] 93.31 [P < 0.001]) and PPBS (BT [day 0] mean score 165.26 and AT [day 120] 112.84 [P < 0.001]), sign and symptoms of Prameha, Dehabala, Agnibala, Satvabala, and quality of life (SF-36 Score).

Conclusion: The present clinical study concludes that therapeutic emesis (bio purification) followed by Darvyadi Kwatha as internal medicine shows significant result in treating prediabetes (Prameha) safely and effectively also control and prevent developing diabetes mellitus. None of the patient converted to diabetes mellitus on the day 120.