New Delhi, March 25: A paper that has labelled alternative medicine therapies for diabetes as "maximum hype, minimum science" has angered ayurveda practitioners, who accuse it of ignoring abundant evidence and decades of research.
The paper by Delhi-based diabetes specialists Anoop Misra and Atul Luthra and nutrition scientist Seema Gulati says there is "scant scientific basis" for the use of ayurvedic therapies for diabetes. It has cited systematic reviews of earlier medical studies on such therapies.
Ayurveda texts and research literature have long documented black plum or jamun, fenugreek seeds (methi) and bitter gourd extracts among plant-based products as useful in controlling blood sugar. Ayurveda proponents describe such extracts as safer than modern medicines.
"The purpose of our paper is not to provoke anyone but to express our concern at a time there is much self-medication for diabetes through such alternative therapies," said Misra, lead author of the paper published yesterday in the journal Lancet: Diabetes-Endocrinology.
"Many people with diabetes may be trying out therapies that do not have adequate scientific justification," Misra, chief of the Fortis Centre for Diabetes, Obesity and Cholesterol in New Delhi, added.
Misra and his colleagues have cited three systematic reviews conducted in 2001, 2004 and 2011 that examined multiple research studies on ayurvedic therapies for diabetes.
Many such studies claim to have demonstrated that ayurvedic medicines lower blood sugar levels. But the systematic reviews have cautioned that these studies appear handicapped by small sample sizes of patients and methodological issues, implying a lack of sufficient evidence to recommend such alternative therapies as routine clinical practice.
For ayurvedic medicines to be routinely prescribed to diabetes patients, Misra and his colleagues said, traditional medicine researchers would need to identify the active ingredients in the herbal products, explain their precise pharmacological actions in the body, and establish efficacy through rigorous testing.
But practitioners of traditional medicine say the paper has disregarded evidence of patients benefiting from traditional remedies and evidence generated through research. They also say that ayurvedic medicine relies on combinations of various herbal products, not single active ingredients.
"Ayurvedic remedies treat the body as a whole through a mix of herbal products, not single compounds," said Prajapati Tripathi, principal of the Dayanand Ayurvedic Medical College at Siwan in Bihar.
"They also have lower levels of side-effects than modern medicines."
The Central Council for Research in Ayurvedic Sciences, an agency under the Union ministry for Ayush (ayurveda, yoga, unani, siddha and homoeopathy), lists the scientific validation of medicines for diabetes, among other illnesses, as its significant achievements.
"It is incorrect to say that ayurveda cannot be used to treat diabetes. We have proven treatments ---- many patients have good sugar control through ayurvedic medicines," said Venu Gopinath Udayakumar, an ayurvedic physician in Malappuram, Kerala, and member of the Central Council for Indian Medicine, which too functions under the ministry for Ayush.
Ayurveda involves the use of formulations containing multiple ingredients, said Gurulinganagouda Patil, principal of the Ayurvedic Medical College in Gadag, Karnataka.
"Trying to isolate a single active ingredient from a herbal product is against the principles of ayurveda," Patil said.
The Indian Council of Medical Research, the country's apex body for promotion of biomedical research, too had in the past supported a few studies that appeared to validate claims about the efficacy of certain traditional plant-based remedies against diabetes.