About Author

Correspondence Address

Dr Kundan Wasnik
BAMS MD (Kayachikitsa)
Assistant Professor, Shri Ayurved Mahavidyalaya Nagpur
Contact No. : 9175073644, Email : kuindanwasnik@gmail.com

Date of Acceptance : 29 Sep 2026

Date of Publication : 30 Sep 2026

Article ID : SD-IJAY_196

How to cite this article : http://doi.org/10.55552/SDNJAY.2026.4302

Abstract

Diabetes mellitus is a rapidly escalating global health concern, primarily attributed to sedentary lifestyle, psychological stress, and unhealthy dietary habits. Despite the availability of a wide range of pharmacological interventions in contemporary medicine, their long-term use is frequently associated with adverse effects and suboptimal patient satisfaction. According to the World Health Organization, the global prevalence of diabetes has increased markedly from 108 million in 1980 to 422 million in 2014, underscoring the need for more comprehensive and sustainable management approaches.

Modern medical strategies largely focus on achieving target-oriented glycemic control; however, recent evidence emphasizes the importance of a multidimensional approach for improved long-term outcomes. In Ayurveda, diabetes is correlated with Prameha, a group of metabolic disorders classified under Anushangi Vyadhi (chronic and relapsing conditions). Ayurvedic management adopts a holistic and individualized approach, considering etiological factors (Nidana), clinical features (Lakshana), pathogenesis (Samprapti), systemic involvement, and the strength of both the patient (Rogi Bala) and disease (Vyadhi Bala).

Classical Ayurvedic literature describes numerous formulations for the management of Prameha. Among these, Mamajjaka Ghana Vati has gained considerable attention due to its diverse pharmacological properties, including antioxidant, antihyperlipidemic, nephroprotective, and ulcer-healing activities. These properties may contribute not only to glycemic control but also to the prevention and management of diabetic complications.

Considering the challenges in selecting appropriate therapeutic interventions for newly diagnosed diabetic patients, the present review aims to critically evaluate Mamajjaka Ghana Vati with respect to its pharmacological profile, mechanism of action, and clinical efficacy based on available scientific evidence.

Key words – Diabetes, Prameha, Mamajjaka Ghana Vati, Anti-oxidant, Anti-hyperlipidemia, nephroprotective

Introduction

Diabetes mellitus is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action or both. India is widely considered the "Diabetes Capital of the World," with an estimated 100 million+ people living with diabetes and another 135+ million pre-diabetic, accounting for over 17% of global cases.^[1,2] According to the World Health Organization (WHO), noncommunicable diseases (NCDs) accounted for 74% of deaths globally in 2019, of which, diabetes resulted in 1.6 million deaths, thus becoming the ninth leading cause of death globally.^[3] In Ayurvedic literature the disease Prameha (_͠ DM) is described as one of the ‘Mahagada’ means difficult to treat by Sushrutacharya.

The increasing prevalence of the disease is attributed to genetic predisposition and lifestyle changes associated with modernization, including reduced physical activity, heightened stress, and sedentary behavior. Diabetes has a profound systemic impact, resulting in a broad spectrum of macrovascular and microvascular complications, with mortality representing one of the most serious outcomes. Moreover, emerging evidence suggests its association with nontraditional complications such as mental health disorders, cancer, disability, and liver disease.^[4] TMany oral hypoglycemic drugs available in the market and having many side effects like hypoglycemia, weight gain, gastrointestinal disturbance, lactic acidosis and fluid retention.^[5]

In Ayurveda, Prameha (correlated with diabetes mellitus) is considered a Tridoshaja Vyadhi, wherein all three Doshas are involved, with predominant vitiation of Kapha Dosha. The etiological factors (Nidana) primarily contribute to Kapha Prakopa and subsequent metabolic derangement. The major causative factors include excessive intake of Kapha-promoting Ahara such as Gramya, Audaka, and Anupa Mamsa (meat of domesticated, aquatic, and marshy animals), along with their derivatives like milk and curd. Consumption of Naveen Dhanya (newly harvested grains), Guda Vikruta Ahara (jaggery-based preparations), and other heavy, unctuous, and difficult-to-digest foods further aggravate Kapha Dosha. Additionally, Vihara factors such as sedentary lifestyle (Avyayama), excessive sleep (Ati Nidra), and lack of physical activity significantly contribute to disease manifestation.^[6] The pathological process is initiated by the derangement of Meda and Mamsa Dhatu, resulting in their Abaddha (loose and unstructured) state. This facilitates the association of Bahudrava Kapha with these tissues. The vitiated Kapha, owing to its similar properties (Samanya Guna), spreads throughout the body and combines with Meda Dhatu, followed by Mamsa Dhatu, both of which are already increased due to continuous exposure to etiological factors.

This interaction leads to excessive formation and accumulation of Kleda (pathological body fluid). Subsequently, due to the influence of gravity and the obstructive effect of Meda and Kleda, the Mutravaha Srotas (urinary channels) become vitiated and obstructed, resulting in abnormal urinary manifestations characteristic of Prameha.

Thus, the disease manifests through the interplay of Nidana, Dosha, and Dushya, with predominance of Kapha Dosha in its Drava state. Based on the dominance of specific Doshas, different clinical types of Prameha are observed. This Ayurvedic understanding closely parallels the modern concept of diabetes mellitus, particularly Type 2 diabetes, where lifestyle factors, metabolic dysfunction, and systemic involvement play a crucial role.^[7] Without Bahu Abaddha nature of Meda and Mansa i.e., derangement of body structure there is no combination of Bahudrava Kapha to manifestation of Prameha.^[8] 

Kaphaja Prameha is considered Sadhya (curable), whereas Pittaja Prameha is Krichra Sadhya (difficult to cure). Therefore, therapeutic interventions aimed at breaking the Samprapti (pathogenesis) of Kapha–Pittaja Prameha are of significant clinical importance.^[9] Mamajjaka Ghana Vati, possessing Kapha–Pitta Shamana properties, may play a vital role in the management of Prameha. Owing to its potential to target the underlying Dosha imbalance, it can be considered as one of the drugs of choice, particularly in the early stages of the disease. Hence, the present review is undertaken to evaluate the therapeutic utility of Mamajjaka Ghana Vati in the management of Prameha.

Discussion

The present integrative review of classical Ayurvedic literature and contemporary scientific evidence indicates that Mamajjaka Ghana Vati possesses significant therapeutic potential in the management of Prameha (Type 2 Diabetes Mellitus). The formulation, primarily derived from Mamajjaka (Enicostemma littorale), is described in Ayurvedic texts as possessing Tikta Rasa, Laghu–Ruksha Guna, and Sheeta Veerya, which contribute to its Kapha–Pitta Shamana properties and make it particularly effective in Kapha–Pittaja Prameha.

From an Ayurvedic perspective, Prameha is a Tridoshaja Vyadhi with predominant involvement of Kapha Dosha, characterized by chronicity and a tendency to progress into Madhumeha if inadequately managed. The disease involves derangement of Meda, Mamsa, and Kleda, along with impairment of Dhatvagni. Clinical features such as Bahuabaddha Meda–Mamsa, Sharirika Kleda Vriddhi, Prabhuta Mutrata, Avila Mutrata, and Pipasa reflect the underlying metabolic dysfunction. In this context, Mamajjaka Ghana Vati, owing to its Deepana, Pachana, Lekhana, Grahi, and Pramehaghna properties, acts at multiple levels of Samprapti, correcting Dhatvagni Mandya, reducing Abaddha Meda, and facilitating Kleda Shoshana.

The predominance of Tikta and Katu Rasa, along with Laghu and Ruksha Guna, contributes to stabilization of Kapha and Pitta Dosha, reduction of excessive Meda Dhatu, and restoration of metabolic homeostasis. Additionally, its Yakrutottejaka (hepatostimulatory) effect may play a significant role in correcting metabolic disturbances, given the central role of hepatic function in glucose and lipid metabolism.

From a modern biomedical perspective, Mamajjaka Ghana Vati demonstrates multifaceted pharmacological actions, including antihyperglycemic, antihyperlipidemic, antioxidant, and anti-inflammatory effects. Bioactive constituents such as swertiamarin, flavonoids, saponins, and alkaloids present in Mamajjaka contribute to improved glucose utilization, enhanced insulin sensitivity, and reduction of oxidative stress, a key factor implicated in β-cell dysfunction and diabetic complications.

Clinical and Experimental Evidence

Multiple studies support the therapeutic efficacy of Mamajjaka Ghana Vati and its ingredients:

• A study conducted by CCRAS reported significant symptomatic relief, with 99.9% improvement in polydipsia, followed by reduction in giddiness (86.3%), polyphagia (82.5%), fatigue (81%), body ache (79%), and visual disturbances (78.5%). Additionally, improvement in quality of life (QOL) was observed using SF-36 assessment, although changes in blood glucose levels were comparatively modest. 
• Clinical observations by Amarnath Shukla demonstrated improvement in classical Prameha Lakshanas, including Prabhuta Mutrata (64.10%), Pipasa (59.25%), and

Kshudha (50%). Objective parameters showed reduction in fasting blood sugar (53.12%) and postprandial blood sugar (52.94%), with enhanced outcomes following Shodhana therapy. 

• A study by Umesh Upadhyay reported significant reduction in blood glucose levels (from 205.4 ± 10.2 mg/dl to 150.6 ± 6.8 mg/dl), along with improvement in serum insulin, lipid profile, blood pressure, and renal parameters. Reduction in glucosuria and improvement in HDL levels further indicate metabolic correction. 
• Experimental studies have demonstrated that Enicostemma littorale enhances insulin secretion, possibly through β-cell stimulation and increased insulin gene expression, along with improved peripheral glucose utilization. 
• The antioxidant properties of the formulation help counter oxidative stress, a major contributor to diabetic complications, thereby providing protective effects against neuropathy, nephropathy, and hepatopathy. 

Mechanism of Action

1. Ayurvedic Perspective

The action of Mamajjaka Ghana Vati can be understood through its effects on Dosha, Dushya, Agni, and Srotas:

• Kapha–Pitta Shamana: Balances the important causative Dosha involved in Prameha 
• Kleda Shoshana: Reduces pathological fluid accumulation 
• Meda Dhatu Shamana: Corrects lipid metabolism and reduces adiposity 
• Agni Deepana: Improves metabolic activity at Jatharagni and Dhatvagni levels 
• Srotoshodhana: Removes obstruction in Mutravaha Srotas 
• Rasayana Effect: Improves Ojas and overall tissue integrity 
• Yakrutottejaka: Improves the function of liver to corrects metabolism

It is also effective in Madhumeha, particularly in Avaranajanya Samprapti, where Kapha– Pitta obstruction plays a key role.

2. Modern Scientific Perspective

The pharmacological mechanisms include:

• Antihyperglycemic action: Enhances glucose uptake and reduces hepatic glucose output 
• Insulinotropic effect: Stimulates insulin secretion and improves β-cell function 
• Insulin sensitization: Reduces insulin resistance 
• Enzyme inhibition: Decreases α-amylase and α-glucosidase activity 
• Antioxidant action: Reduces oxidative stress and cellular damage 
• Anti-inflammatory effect: Modulates chronic inflammation 
• Hypolipidemic activity: Improves lipid profile and reduces cardiovascular risk  •           Organ protection: Prevents hepatic and renal damage 

Role of Individual Ingredients

• Mamajjaka (Enicostemma littorale): Antihyperglycemic, insulinotropic, antioxidant; improves lipid metabolism (swertiamarin-mediated action) 
• Katuki (Picrorhiza kurroa): Hepatoprotective, hypolipidemic; enhances insulin secretion and liver function 
• Ativisha (Aconitum heterophyllum): Reduces Meda and Kapha; exhibits nephroprotective and anti-inflammatory actions 
• Pippali (Piper longum): Rasayana, enhances bioavailability, improves glucose utilization, and corrects Dhatu metabolism 

Comparison with Standard Antidiabetic Drugs

The management of Type 2 Diabetes Mellitus using conventional pharmacotherapy primarily involves agents such as metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, and insulin, which act through specific biochemical pathways to achieve glycemic control. While these drugs are effective in lowering blood glucose levels, their long-term use is often associated with limitations such as adverse effects, risk of hypoglycemia, reduced patient compliance, and limited impact on disease progression and associated metabolic disturbances.

In contrast, Mamajjaka Ghana Vati offers a multidimensional and systems-based approach, targeting the underlying Samprapti of Prameha. Unlike conventional drugs that act on isolated pathways, this formulation modulates Dosha, Dushya, Agni, and Srotas, thereby addressing both metabolic dysfunction and systemic imbalance. While drugs such as metformin primarily reduce hepatic glucose production and improve insulin sensitivity, and sulfonylureas stimulate insulin secretion, they do not adequately address associated conditions such as dyslipidemia, oxidative stress, and tissue-level derangements.

Mamajjaka Ghana Vati, on the other hand, demonstrates simultaneous antihyperglycemic, antihyperlipidemic, antioxidant, and anti-inflammatory actions, offering broader metabolic correction. Additionally, its ability to correct Dhatvagni Mandya and Kleda Vriddhi parallels modern concepts of metabolic dysfunction and fluid imbalance, thereby targeting the core pathology of insulin resistance.

Clinical evidence suggests that while conventional drugs may provide rapid glycemic control, Mamajjaka Ghana Vati offers gradual and sustained improvement, particularly in subjective symptoms and quality of life. However, it is important to note that its glucose-lowering effect may be less pronounced when used as monotherapy in advanced cases, indicating its optimal role in early-stage disease or as an adjunct to conventional therapy.

Moreover, the safety profile of Mamajjaka Ghana Vati appears favorable, with minimal reported adverse effects, in contrast to gastrointestinal disturbances, hypoglycemia, and other side effects associated with modern antidiabetic drugs.

Conclusion

Thus, the evidence suggests that Mamajjaka Ghana Vati provides a holistic and integrative therapeutic approach, aligning with both Ayurvedic principles and modern pathophysiological understanding. Its incorporation into diabetes management, particularly in early-stage disease and metabolic syndrome, may enhance clinical outcomes, reduce complications, and improve patient quality of life.

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