an observational study to explore the … · an observational study to explore the association of...

AN OBSERVATIONAL STUDY TO EXPLORE THE ASSOCIATION OF LIFESTYLE AND DIABETIC RETINOPATHY

K PradeepBSc, MD (Ay), MBA,PGDHSR, PhD Scholar, Assistant Professor, Govt Ayurveda College

Tripunithura, Kerala, India

INTRODUCTIONIn recent years there is a rapid

change in the life style of mankind, whichaltered our traditional style of living, dress-ing, food habits etc. People today eataccording to their convenience withoutappreciating its nutritive value. Most of usare in a hurry and behind something or otherso that we pay less attention to what we eatand its consequences. The human body isthe same as that was thousand years before.But the diseases affecting the humans have

made some remarkable changes since theancient period. Apart from the change in theexternal environment, the change in the lifestyle can be held responsible for this changein the spectrum of diseases that affect thehuman population. As a result of this pivotalrole of life style in causing diseases, a newcategory termed as life style disorders cameinto existence .In fact, the increased quan-tum of stress caused by the current life stylecan be seen as the real culprit in theoccurrence of most of the modern day disor-

Observational Study International Ayurvedic Medical Journal ISSN:2320 5091

ABSTRACTDiabetic retinopathy is a chronic progressive, potentially sight threatening disease of the

retinal microvasculature associated with the prolonged hyperglycemia. The prevalence rate ofdiabetic retinopathy in type 2 DM was reported as 34.1% from south India. The presence of dia-betic retinopathy is directly proportional to the duration of diabetes1. Ayurvedic science is uniqueand has stressed the importance of life style. Modifying the life style will surely help in control-ling diabetes. By modifying the life style of diabetic patients we can delay or control the occur-rence of diabetic Retinopathy. In this study diabetic retinopathy patients was selected andquestionnaire prepared with a focus on life style which may possibly affect the visual healthadversely according to Ayurvedic samhitas. The study was an observational study,50 cases ofalready diagnosed diabetic retinopathy patients was selected and their ahara and vihara was as-sessed using the questionnaire prepared keeping in focus of Achakshushya life style according toAyurvedic samhitas. Similar 50 diabetic patients without retinopathy were selected and their lifestyle assessed using the same questionnaire and compared. In this study it was found that patientswith diabetic retinopathy were leading a life style which was achakshushya (adversely affectingeye health) than those without diabetic retinopathy. As eyes are seats of pitha, pitha vitiatingahara’s and viharas will lead to diseases of eye. Diabetic patients following this type of life stylewill leads to diabetic retinopathy.KEY WORDS: Life style, diabetic Retinopathy, Achakshushya Ahara and vihara

k Pradeep: An Observational Study To Explore The Association Of Life Style And Diabetic Retinopathy

57 www.iamj.in IAMJ: Volume 4; Issue 02; January - 2016

ders. The constant and indiscriminate usageof indriyas evokes various structural andfunctional discrepancies in them. Thus, in awide category of diseases, change in lifestyle can be considered as an importantcausative factor. The importance of the lifestyle factors are increased when we observethat these are modifiable causes in compari-son with some other factors such as geneticfactors which are not modifiable.Ayurvedic science is unique and has stressedthe importance of lifestyle, since ayurveda isnot only for curing diseases but also forprotecting from disease it has explained‘dinacharyaand rtucharya’ in the beginningitself. Unwholesome some food and habitsvitiates doshas and cause chronic disordersin long period of time under favorableconditions. It is difficult to predict the typeof disease they produce because doshas pro-duce a variety of disorders on different or-gans depending in strength and the strengthof the organ or dhatu.We can say thatchronic diseases are due to shortfall in lifestyle and to be easy preventive measure is tofollow healthy diet and habits. InAshtangahrdaya uttarasthana (ch16)Vaghbata explains that Persons who arefond of their eyes though healthy shouldalways adhere to the following ;Grains suchas yava, godhooma, Sali, sashtika, ko-drava,mudga,etc.which are old and whichmitigate kapha and pitta mixed with more ofghee, vegetables and meat of desert animalshaving similar properties ,dadima,sita(sugar) saindhava, triphala, draksha,and rainwater for drinking, the use of um-brella, footwear and resorting to therapies toeliminate the doshas in the proper ways.Heshould avoid suppression of urges, indiges-tion, over-eating, anger, grief, sleeping dur-ing day, keeping awake at night exposure tosunlight, foods and medicines which cause

heart-burn and constipation2.In the centre ofthe feet (soles)are situated two siras (veinsetc) which are greatly connected to the eyes.These transmit the (effect of the) medicinesapplied over the feet in the form of bathing,massage, external application etc to the eyes.These (veins of the feet)vitiated by the accu-mulation of the mala(dirt),assault(by theweapons-stone and other hard sub-stances)and squeezing (and other kinds ofpainful activities) bring about abnormalitiesof the eyes. Hence every person should al-ways make use of the foot wear, massagingwith oil and washing them well3.In Susrutha samhitha the aetiology regard-ing the eye diseases is explained“ushnapithapthasya jalapravesatDurekshanaatswapnaviparyayachaPrasakthasamrodhanakopasokhatklesabhighathadimaidunachaSuktharanalamlakulathamashaNiveshanadwegavinigrahachaSwedadathodhoomanishevanachachardervighathatvamanadiyogatbashpagrahath sookshmanireekshanachanetrevikaranjanayanthidoshah"Entering into reservoirs of water (pond ,riveretc) immediately after getting heated up byexposure ot sunlight ,fire etc. seeing objectspresent very far, avoiding sleep, indulging inbouts of weeping, anger, sorrow andexertion ,(for long periods)injury (toeye),excess of copulation ,consumingsukta(vinegar) aranala(rice-wash)and suchother sours (fermented drinks)foodsprepared from kulatha(horse-gram)masa(black gram)suppressing theurges (of urine, faeces etc) excess sweatinginhaling smoke, controlling bouts of vom-iting or excess of vomiting, controlling oftears, observing minute objects(for longertime)by these causes doshas get aggravatedand produce diseases4.Tridoshas are



responsible for the normal functioning ofthe body, when vitiated they lead todiseases. The vitiation of these doshas areby specific factors for individual organs.The factors responsible for the vitiation ofdoshas in the eye, which causes thederangement of the doshas and leading todiseases are;Ahara viharas manas Roga’sAganthuka,Chikitsa janya5.

AIMS AND OBJECTIVES: To ob-serve the influence of life style inpatients in the occurrence of diabeticretinopathy.

PLAN OF THE STUDY: Study was con-ducted in 50 patients who attended thecamps for eye diseases at Calicut.A surveywas conducted in 50 normal individuals whowere randomly selected in the samegeographical area.Criteria for selectionGroup 1: Healthy individuals with visualacuity 6/6. Age Group 20-60 (sample size50)Group 2: Individuals with diabetic retinopa-thy.Age group 20-60 (sample size 50)Exclusion criteriaGroup 1 : Individuals with any systemic dis-eases as well as those with ocular pathology.Group 2 : Individuals with ocular pathologyother than diabetic retinopathy

Investigations: Only those with Diabeticretinopathy, in whom diagnosis was madeon the basis of test for visual acuity and oph-thalmoscopy, were included in the study.Criteria for assessmenta) Diabetic retinopathy & normal

individuals: Already diagnosed cases ofdiabetic retinopathy were included ingroup 1. In group 2 only normalindividuals with visual acuity of 6/6were selected.

b) Life style : A questionnaire was pre-pared with a focus on the life style whichmay possibly effect the visual health ad-versely

METHOD OF SAMPLING: Purposive sam-plingSTATISTICAL ANALYSIS: According toData collected the results will be evaluatedand the significance of the study will be as-sessed using basic statistical analysis(descriptive statistics) and the relationship ifany in, ahara, vihara in the causation of dia-betic retinopathy will be assessed byappropriate tests like chi-square test andAnova etc.RESULTS AND DISCUSSION: DiabeticPatients following ahara and viharawhich leads to kapha medodushti andAchakshya, causes diabetic Retinopathy.

Day sleep Diabetic Retinopathy Normal IndividualsNo % No %

Yes 40 80.0 11 22.0

No 10 20.0 39 78.0

Total 50 100.0 50 100.0

Table.1 Majority of the retinopathy patients were doing day sleep, causing kaphamedo dushti.Exercise Diabetic Retinopathy Normal Individuals

No % No %Yes 14 28.0 43 86.0

No 36 72.0 7 14.0

Total 50 100.0 50 100.0

Table.2Lack of proper exercise was observed in most of the diabetic retinopathy patients



Prakriti Diabetic Retinopathy Normal IndividualsNo % No %

vatakapha 15 30.0

kapha pitta 18 36.0 7 14.0

pitta vata 17 34.0 43 86.0

Total 50 100.0 50 100.0

Table3:While analysing prakriti, pittapradhanaprakriti was found to be more susceptible forDiabetic retinopathyHead bath Diabetic Retinopathy Normal Individuals

No % No %cold water 7 14.0 50 100.0

hot water 43 86.0

Total 50 100.0 50 100.0

Table 4:Most of the retinopathy patients were old; they were using hot water for bath

Table 5:Most patients with diabetic retinopathy were not using oil application for headHobbies Diabetic Retinopathy Normal Individuals

No % No %COMPUTER 10 20.0

TV 34 68.0 43 86.0

STICHING 6 12.0 7 14.0

Total 50 100.0 50 100.0

Table 6Most of the retinopathy patients were watching TV for long time.Food Habits Diabetic Retinopathy Normal Individuals

No % No %VEGETERIAN 24 48.0 16 32.0

MIXED 26 52.0 34 68.0

Total 50 100.0 50 100.0

Table 7Curd Diabetic Retinopathy Normal Individuals

No % No %OCASSIONALLY 38 76.0 24 48.0

DAILY 12 24.0 26 52.0

Total 50 100.0 50 100.0

Table 8Bakery Diabetic Retinopathy Normal Individuals

No % No %NO 1 2.0 7 14.0

OCCASSIONALLY 33 66.0 43 86.0

DAILY 16 32.0

Oil Application Diabetic Retinopathy Normal IndividualsNo % No %

yes 22 44.0 43 86.0

no 28 56.0 7 14.0

Total 50 100.0 50 100.0



Total 50 100.0 50 100.0

Table 9: Most of the diabetic patients were using Achakshushyaahara’s like curd, mixed diet, tea,bakery items etc. Along with vihara’s like watching TV, hot water bath leadsto pitta vitiation inthe eyes, and some time along with kapha causing diabetic retinopathy.

Diabetes MellitusAchakshushyaviharas AchakshushyaviharasDay Sleep UshnaaharaLack of Exercise UtklesaaharaHot water bath Amlaahara(curd)Watching TV, computers, mobiles VidahiAharaNo oil application in head

+ PrakritiDiabetic Retinopathy

CONCLUSIONAs eyes are said to be the seats of pitta,

pitta vitiating ahara and viharawill lead todiseases of the eyes i.e., in this study dia-betic retinopathy, Diabetic patients shouldgive importance to their life style, since theyare prone to get diabetic retinopathy.Theyshould avoid vihara like day sleep, lack ofexercise, watching TV, computers, mobilesetc., ahara like vidahi, amla, utklesa,viru-dha, ushna,etc. which are Achakshushyaand which will lead to pitta vitiation and

leads to diabetic retinopathy.REFERENCES1. K. Park, “Preventive And Social Medi-

cine”, 21st Edition, published by M/sBanarsidasBhanot, 2011

2. Arunadattavyakhya,Ashtangahri-daya,Sarvangasundarivyakhya edited byHarisastriparadkarVaidya,chowkhambakrishnadas academy ,Varanasy.2006,utharasthana

3. Arunadattavyakhya,Ashtangahri-daya,Sarvangasundarivyakhya edited byHarisastriparadkarVaidya,chowkhambakrishnadas academy ,Varanasy.2006,sutrasthana

4. Sushruta. SushrutaSamhitaDalhanaCommNibandhasangraha,

ChowkhambhaOrientalia Varanasi,2002SushrutaSamhita, Uttharatantra

5. Arunadattavyakhya,Ashtangahri-daya,Sarvangasundarivyakhya edited byHarisastriparadkarVaidya,chowkhambakrishnadas academy ,Varanasy.2006,sutrasthana

6. V.V.SubrahmanyaSastri’sTridoshatheory

7. Dr.P.KSanthakumari Ophthalmology inAyurveda 1st Edition

8. Parson’s Diseases of Eye 3rd Edition

CORRESPONDING AUTHORDr. Pradeep. KBSc, MD(Ay),MBA,PGDHSR, PhD ScholarAssistant Professor, Govt Ayurveda CollegeTripunithura, Kerala, IndiaEmail: [email protected]

Source of support: NilConflict of interest: None Declared

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