World Journal of Advance
Pharmaceutical Sciences
The leading peer-reviewed journal for Pharmaceutical and Medical Research and Technology
World Journal of Advance
The leading peer-reviewed journal for Pharmaceutical and Medical Research and Technology
Background: Insulin resistance is the foundational metabolic lesion of type 2 diabetes mellitus (T2DM), driving both progressive beta-cell failure and the accumulation of cardiovascular risk factors. Pharmacotherapy addresses symptoms of insulin resistance but does not reverse its root cause — excess adiposity, sedentary muscle metabolism, and chronic low-grade inflammation. Intensive lifestyle interventions combining caloric restriction, exercise, and metabolic therapies have demonstrated T2DM remission, but real-world implementation of multimodal insulin resistance reversal programs remains limited. This study reports outcomes from the Comprehensive Diabetic Care (CDC) program, a structured multimodal intervention combining very-low-calorie dietary modification, structured botanical therapy targeting insulin-signaling pathways, physical conditioning, and antidiabetic medication tapering. Objectives: To evaluate the clinical efficacy of the Comprehensive Diabetic Care (CDC) program — comprising caloric restriction, structured herbal per-rectal therapy (Panchakarma) (structured botanical per-rectal therapy with Gymnema sylvestre, Berberis aristata, and Glycyrrhiza glabra), exercise and yoga — on glycemic control, anthropometric parameters, insulin resistance surrogates, and antidiabetic drug reduction; to quantify the dose-dependent relationship between treatment intensity and outcomes; and to report Oral Glucose Tolerance Test (GTT) outcomes as a remission criterion. Methods: Retrospective observational study of 79 consecutive T2DM patients enrolled in the CDC (Comprehensive Diabetic Care) program at an integrative metabolic clinic in Mumbai, India. The multimodal intervention included: (1) an 800 kcal/day low-carbohydrate, high-protein dietary program (Prameha diet); (2) Panchakarma comprising herbal oleation, medicated sudation, and per-rectal botanical therapy delivering berberine, gymnemic acids, and glycyrrhizin via direct colonic-portal absorption; and (3) individualized yoga and exercise prescription targeting muscle glucose uptake and insulin sensitization. Antidiabetic medications were systematically tapered based on glycemic response. Outcomes included HbA1c, fasting/random blood glucose, weight, BMI, abdominal girth, blood pressure, and heart rate. Treatment intensity was quantified by Panchakarma sessions completed (range 1–20). Pearson correlations and paired t-tests were used. GTT results were documented for 5 patients as a remission criterion.