NEED FOR THE STUDY 

Hyperglycaemia is high glucose concentration in the blood, often associated with diabetes, It is a disorder of abnormal carbohydrate metabolism due to absolute or relative insulin deficiency or resistance1. Diabetes is one of the 9th leading cause for death globally, hence the attention of the people is dragging towards the ayurveda due to their poor life style, metabolic errors. globally 463 million individuals have T2 DM and in India 88 million,  Among those 45.6% are aware of diabetes, 36.1% are on treatment and 5.7% are under control. Nearly 25 million people are at risk of developing diabetes. Hence the prevalence of diabetes in India is 11.3%2. 

              Madhumeha3 is vatapradhana tridoshaja vyadhi, ama meda kleda dusti expressed in the platform of rakta dusti in the context of vidhishonitiya adhyaya, is most clinical phase to understand treatable hyperglycemia.  

  Stress4 is emotional or physical tension,in which dopamine, serotonin,epinephrine, glucagon, growth hormone and cortisol play a role in blood sugar levels. When stressed, the body prepares itself by ensuring that enough sugar or energy is readily available. Insulin levels fall, glucagon and epinephrine levels rise and more glucose is released from the liver. At the same time, growth hormone and cortisol levels rise, which causes body tissues (muscle and fat) to be less sensitive to insulin. As a result more glucose is available in the blood stream. 

            There is a limitation for different OHAs targeting on glucose metabolism and improve the insulin action. But in  case of stress, it is very difficult to manage with only OHA. ayurveda has many procedures to reduce the stress. Rasayana and  Nasya are  the easiest way to practice in daily routine. Trans nasal insulin delivery is new trend . so there is a scope for research. 

Sanjeevini Vati5 having Vatsanabha which promotes srava, ballataka, Vacha,triphala  and other drugs which   are having property of hypoglycaemic action,  vacha  is having anti stress action. Pancha nimba ghanavati6 having the action of rasayana, rakta shodhaka, dhatvagni Deepana, Pachana  kledahara effect. Kadaradi Kashaya having mehahara,kledahara effect. 

Medhya chatushka Ghrita7 (guduchi,madhuyasti,pandukaparni,shankapushpi) having proven antistress, anti-inflammatory, nootropic, activity. which is administered through nasika. mandookaparni and guduchi have hypoglycemic activity 

Hence the research question is whether an oral and trans nasal drug delivery may reduce the stress induced Hyperglycaemia or not so with alternate hypothesis  the study entitled, “AN OPEN LABELLED RCT STUDY TO ASSESS COMBINED EFFECT OF SANJIVINIVATI AND PANCHANIMBA GHANAVATI WITH KADARADI KASHAYA ANUPANA AND MEDHYACHATUSHKA GHRITA PRATIMARSHA NASYA (TRANSNASAL DRUG DELIVERY) IN STRESS INDUCED HYPERGLYCAEMIA (MADHUMEHA) is undertaken 

 HYPOTHESIS: