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Background: Prediabetes is a pathological condition that is characterized by an increase in sugar level within the normal limit and a diagnostic range of diabetes mellitus (DM). Timely untreated prediabetes turns into DM within a year and systemic complications occur, such as retinopathy, nephropathy, neuropathy, etc. During later stages of the disease, all systems of the body are affected. The management of prediabetes includes oral hypoglycemic drugs. Based on signs and symptoms, prediabetes can be correlated to the disease Prameha. Aim and Objectives: Evaluate the efficacy of oral administration of Darvyadi Kwatha (~herbal decoction) with lifestyle modification in prediabetes (Prameha). Materials and Methods: After the approval of Institutional Review Board, Independent Ethics Committee, and clinical trial registration in CTRI, 20 patients suffering with Prameha (~prediabetes) were registered in the clinical trial. Assessment criteria were: reduction in glycated hemoglobin (HBA1c), fasting plasma glucose (FBS), postprandial plasma glucose (PPBS), improvement in Agnibala (~strength of digestion and metabolism), Dehabala (~physical strength), and Satvabala (~mental strength), relief in signs and symptoms of prediabetes, and improvement in quality of life (SF-36 Score). Oral administration of Darvyadi Kwatha and lifestyle modification was given. Assessment was done on the 46th, 76th, 107th, and 120th day and Student paired t-test was used for analysis of data. Results: The outcomes showed a statistically highly significant reduction in assessment parameters (HBA1c [mean ± standard deviation [SD] before treatment [BT] 6.07 ± 0.26 and after treatment [AT] 5.78 ± 0.22] [<0.001], FBS [mean ± SD BT 116.6 ± 12.5 and AT 102.0 ± 0.8.1] [<0.001], and PPBS [mean ± SD BT 168.7 ± 19.7 and AT 118.6 ± 12.0] [<0.001]). Conclusion: This clinical study concludes that Ayurveda medicine (Darvyadi Kwatha and lifestyle modification) is effective in the treatment and prevention of prediabetes turning into DM.

Majority of Type 2 diabetes mellitus (DM) cases are unable to keep plasma glucose levels under control despite adequate medications and follow-up. They are being managed with insulin in contemporary medicine. The WHO estimates that diabetes was the seventh leading cause of death in 2016. Ayurveda literature has emphasized in this regard to cure Madhumeha (~diabetes mellitus) or control blood sugar levels with Panchakarma (~five internal bio-cleansing therapies) treatment. A 64-year-old male suffering from type-2 DM with chief complaints of excessive urination, thirst, pain in both legs, numbness in bilateral feet, and whole-body weakness was presented in the outpatient department of Panchakarma. He was diagnosed as a case of Madhumeha associated with peripheral neuropathy on the basis of clinical presentation and laboratory investigations. He was on allopathic medicines for 10 years. However, the symptoms worsened with time. Management was started, from Deepana (~enhancing metabolic fire) and Pachana (~enhancing digestion) followed by Snehapana (~internal oleation), Sarvanga abhyanga (~external oleation), Vashpa swedana (~whole body steam), Virechana karma, and Samsarjana krama (~special dietetic regimen). The current management showed significant results in reducing blood glucose, levels of hemoglobin A1c, visual analog scale score.

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