Ayurvedic Management of Early Insulin Resistance with Special Reference to Agni

Abstract

Insulin resistance is the most relevant metabolic derangement preceding type 2 diabetes mellitus and metabolic syndrome. It is characterized by reduced responsiveness of peripheral tissues to circulating insulin, with compensatory hyperinsulinemia and metabolic dysregulation. Mechanisms involved in the pathogenesis commonly include chronic inflammation, oxidative stress, mitochondrial dysfunction, and ectopic fat deposition. While Ayurveda classifies similar metabolic aberrations under Prameha , a spectrum of metabolic disorders causes abnormal carbohydrate and lipid metabolism. The main pathological cause is Agnimandya (lessening of digestive–metabolic activity), resulting in a build-up of Ama (toxic metabolic by-products) followed again by Medodushti (disturbed metabolism of adipose tissue). A 38-year-old male presented with fatigue, heaviness after meals, increased thirst, and gradual weight gain. Laboratory investigations revealed elevated fasting insulin and increased Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). The patient underwent a 12-week Ayurvedic intervention consisting of Deepana-Pachana therapy (digestive-metabolic stimulation), herbal medications, dietary regulation, and lifestyle modification. After 12 weeks of treatment, fasting blood glucose decreased from 112 mg/dL to 96 mg/dL, fasting insulin decreased from 24 μIU/mL to 14 μIU/mL, and HOMA-IR improved from 6.6 to 3.3. Reduction in body mass index and waist circumference was also observed. An Agni -centered Ayurvedic therapeutic approach demonstrated improvement in metabolic parameters associated with insulin resistance. Further controlled studies are necessary to validate these observations.