Friends of Tibet Foundation for the Wellbeing

Wellbeing Holistic Guide - I
Diabetes Mellitus: A Tibetan Perspective
Published by: Friends of Tibet Research Centre
Questions: Suresh Babu (Friends of Tibet Foundation for the Wellbeing)
Answers: Dr Dorjee Rapten Neshar (Tibetan Medical & Astrological Institute of HH the Dalai Lama)

Tibetan Medical Thangka


DOWNLOAD: Wellbeing Holistic Guide 1 (Diabetes Mellitus): English | Malayalam

Diabetes History
Diabetes has been recognised as a medical problem for thousands of years. In Ancient Egypt a condition characterised by frequent urination, excessive thirst and weight loss was described in hieroglyphics on papyrus; what today we would call Type I Diabetes. Astute physicians at that time prescribed diet of whole grains to limit the symptoms, a revelation modern researchers are finally rediscovering more than 3,000 years later.

The first clinical test of Diabetes was devised in Ancient India, where patients exhibiting the common Diabetes symptoms described above had their urine analysed with the help of ants. If the sugar-loving ants came rushing to the urine, a diagnosis of "Madhumeha" was given, which translates to "Honey Urine." Diabetes elevates levels of glucose in the urine, as well as in the blood, as the renal system (kidneys) works to expel the excess glucose from the body. Now instead of ants we use methods like A1C tests to diagnose Diabetes.

The distinction between Type I and Type II Diabetes was first recognised in India and China around 2,000 years ago, and the causal relationship between obesity and Type II Diabetes was also noted since the symptoms of Type II Diabetes occurred mostly in overweight, affluent, adult individuals. Due to the modern world's propensity for eating cheap processed foods and being sedentary, Type II Diabetes is no longer a "disease of affluence" and has now become more prevalent in poorer communities and cultures.

The word "Diabetes" comes from Ancient Greece and means "to pass through," in reference to the associated frequent urination, and the belief of Greek physicians that Diabetes was a disease of the kidneys. Furthermore, "Mellitus" means "honeyed" in Greek, so the clinical term "Diabetes Mellitus" describes something similar to the "Madhumeha" diagnosis in Ancient India. (Source: Defeat Diabetes Foundation, Florida, USA)

How Diabetes is described and diagnosed under Sowa-Rigpa (Science of Healing), commonly known as the Tibetan System of Medicine? How does this ancient medical system deal with it?

Diabetes is explained under the chapters of twenty different types of dispersed disorder. It is called Chinni za-khu meaning frequent urination which is associated with bodily fluid that melts and feeds on bodily essence. It is divided into twenty different types based on the three humoral energies of our body system: rLung (pronounced as Loong); mKrispa (pronounced as Tri-pa) and Badh-kan (pronounced as Be-kan). Among them, Badh-kan Za-khu appears to be more common and popularly associated with what Allopaths describe as Diabetes Mellitus. Brdang-Dra-wa, one among the sub-types of Badh-kan Za-khu can be mostly associated with Type II Diabetes.

Though it is diagnosed both through pulse and urine analysis, examination of urine is more pertinent in the confirmation of Diabetes. Tibetan Medical System emphasise more on correcting diet and life-style factors in dealing with this disease. A heavy diet is discouraged while light and more dried type of food is encouraged. Good amount of physical exercises is particularly advised.

Diabetes — what was once known as a disease of the elderly rich, has now grown to alarming proportions, making India the Diabetes capital of the world — prevalent across all age groups of persons! In your opinion, how did this happen?

To put it in context — Diabetes is actually a kind of ailment which can be grouped under the category of diseases with low metabolic activity. Once you understand this you can understand the main cause of Diabetes. When we say metabolic activity, the related aspects that must be considered are food, digestion, digestive systems, digestive juices, absorption, assimilation etc. One must also understand that all our internal organs are interdependent and need to work in harmony with all the systems to function efficiently. Any dysfunction or malfunction of any one system affects other systems sooner or later.

For proper digestion, glucose from heavy as well as light food must be smoothly absorbed and assimilated into the blood. Improper diet, like food with high content of sugar, oil, dairy products, maida, atta, pulses, lactose etc. known as heavy foods create indigestion. These are mostly the ingredients in convenience foods like fast food, junk food, chemical and synthetic beverages, cakes, pastries etc. Excessive intake of these foods creates heaviness in stomach and the digestive system gets affected.

Consequently, when these foods enter your daily diet on a regular basis, the result is the formation of excess sugar in the body, bringing down metabolic activity and this in turn affects insulin generation and regulation in the liver. This function is managed by the Pancreas gland. This gland loses its ability to secrete or excrete the required insulin to control the high sugar level in the body entering the bloodstream through food.

As a result, we see that it is not only rich but also the common people including children become victims of low metabolic activities ultimately leading to be Diabetes patients. Once you understand the main reason for Diabetes, with proper dietary habits, physical activities, regular exercises, life-style regulation etc, the disease can be prevented or controlled. Another reason for this disease is high and uncontrolled levels of stress, tension, worries and emotional suppression. These also aggravate low metabolism and must be efficiently managed in order to prevent Diabetes.

Why is Diabetes being considered as a chronic disease in modern medical circles?

Chronic diseases develop slowly, over time. There are three stages of development — accumulation, aggravation and elevation. It also develops over different seasons because a particular season predominantly affects its development. That is, the disease gets started in one season, accumulates in another season and aggravates in the next season. A diet inappropriate in a particular season is another contributing factor.

For example, we see lots asthmatic patients in winter. Asthma would develop in extreme cold weather. Consequently there would be lesser physical activity in this weather. Along with inappropriate food intake and inadequate digestion, asthma collects and accumulates slowly. In autumn season, the disease would be enhanced. In spring, when the temperatures are higher, the accumulated disease gets more aggravated and elevation of disease happens.

If you observe this pattern and take proper care, you could counter the disease development of chronic diseases with appropriate dietary control, avoidance of heavy, gassy foods, and reduced intake of dairy products, sugar etc and sufficient exercise.

How long the chronic effects would remain?

Of course, the chronic effects cannot go away suddenly or that easily.

Why is Diabetes termed as a silent killer?

It is labeled like that, probably to create some sort of fear psychosis so that patients may live cautiously and carefully. When the sugar level goes out of proportion in the body, the whole body system and organ's functions will show a tendency to slow down. This happens since a large amount of toxins get built up and scattered all over the body.

Consequently strokes, neuropathy, retinopathy etc may occur. Unfortunately, patients die not due to Diabetes but because of such secondary complications. In the Tibetan Medical System there are ten different wounds. Besides natural wounds there are wounds that arise out of Diabetes which are internal, that is deep inside our body. These are very difficult to heal. External wounds like gangrene too are difficult to heal. These may also become fatal.

Is Diabetes incurable?

According to Tibetan Medical System, there is no disease which cannot be cured. In modern medical system, Diabetes is said to be not curable and so require life-long treatment to keep it under control. In Tibetan medicine, cure depends on the patient as well. That is, along with the intake of medicines, patients' participation in maintaining a healthy good life-style, proper food, exercises etc, contribute to the healing process. Sometimes it may take a long time to cure depending on such factors.

What are the general symptoms of Diabetes?

Most important symptom is the excessive presence of sugar in the blood. It comes from a combination of air and water elements, improper intake of diet, excessive sweet, carbohydrates, oil, ground root vegetables, heavy and high calorie, fatty foods etc. All these create sluggishness resulting in the development of tendencies in systems and tissues to fall down. Another symptom is dryness of the mouth. Kidney is the one main organ which gets affected by Diabetes. Patients could directly diagnose this by observing the colour and flow of their urine itself. Moreover, the urine would be thick with different colours and smell. Another common symptom in this case is that when urine is passed, sugar-loving ants gather around the place where it falls.

Would there be any other symptoms which can be termed as warning signals?

Besides the above mentioned symptoms, there are some others which unfortunately people may not be able to sense it easily or rather fail to relate it to Diabetes. When Diabetes develops, skin eruptions which are difficult to heal would occur. Likewise, wounds that do not heal easily is yet another warning signal. Others are improper kinds of urination such as frequent urination, grave urgency in urination etc.

What are its long-term complications?

Diabetic Neuropathy is the most significant complication. Then follows Nephropathy in which kidneys get affected. Retinopathy of the eyes, gangrene development, hypertension, heart diseases, strokes etc are also other long-term complications arising out of Diabetes.

Who are the most risk categories of people prone to Diabetes in modern living conditions?

Generally, Diabetes affects people of all age groups. But the following people are among those who are more prone to become Diabetic in our modern society:

1. People who are obese
2. People who eat more and do less exercise
3. People who are predominantly dependent on a high carbohydrate diet
4. Hereditary factors
5. People under heavy stress condition with irregular diet habits.

Which type of dietary and life-style recommendations are considered important from the Tibetan viewpoint?

For any type of Diabetes, heavy carbohydrate food, root vegetables that grow underground and high starch vegetables, cold and refrigerated food items and sweet foods are strictly discouraged. Light, dried food and green fibrous vegetables are highly recommended. Lifestyle regulations like regular exercise and relaxation techniques like Yoga and meditation to calm the mind are considered very effective in controlling this chronic type of disease.

Under the Tibetan Medical System, what kinds of treatments are favoured for Diabetes with different types?

In Tibetan Medicine, we do not consider much on the numbering of Diabetes like fasting number, post-prandial numbers. We look mainly on the increased, decreased and aggravation of the Nes-pas or the three humoral energies and administer medicines accordingly to balance these Nes-pas. Once we understand the nature of Diabetes of any type and advice proper diet, life-style and medications to counter that very issue which seem to destabilise the body system, the balance is restored and hence the number too falls in line without any suppression.


Sowa-Rigpa (Science of Healing), commonly known as the Tibetan System of Medicine is one of the oldest, living and well-documented medical traditions in the world. It has been originated from Tibet and popularly practised in India, Nepal, Bhutan, Mongolia and Russia. The majority of theory and practice of Sowa-Rigpa is similar to Ayurveda. The first Ayurvedic influence came to Tibet during 3rd century AD but it became popular only after the 7th century with the arrival of Buddhism in Tibet. Thereafter this trend of exportation of Indian medical literature, along with Buddhism and other Indian art and sciences were continued till the early 19th century. India being the birthplace of Buddha and Buddhism has always been a favourite place for Tibetan researchers and scholars for learning Buddhist art, culture and history. (Ministry of AYUSH, Govt of India)

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