The increasing burden of lifestyle disorders, particularly prediabetes and diabetes, is a significant global public health concern. Prediabetes is a precursor to type 2 diabetes and is characterized by elevated blood sugar levels that are not yet high enough for a diabetes diagnosis. It affects millions and carries a high risk of progression if not managed early. In Ayurveda, prameha and its early manifestations (purvarupa avastha) are considered treatable stages.

This randomized controlled clinical trial will evaluate the effectiveness of vamana karma using Madanphala Majja in the management of prameha purvarupa avastha, which corresponds to the prediabetic stage in modern medicine. According to Ayurvedic principles, bahudrava kapha and abaddha meda are the primary pathological factors in prameha. Therefore, Samprapti vighatana should focus on these two components. Shodhana karma eliminates the vitiated dosha through its nearest route; for kapha, this is via urdhvabhaga (oral route), making vamana karma the preferred approach.

Prameha is a metabolic disorder with kapha dominance, and the seat of Kapha is the urdhva amashaya. Thus, vamana karma offers a logical route for kapha expulsion. madanphala is considered a safe and effective vamaka dravya. In this study, eligible participants will be randomly divided into two groups: Group A will undergo vamana with Madanphala Majja yoga, and Group B will receive Vamana with Ikshvaku Madhuyashti kashaya yoga.

Both groups will follow a standardized Panchakarma protocol including Deepana-Pachana, Snehapana, Abhyanga, Swedana, Vamana Karma, and Samsarjana Krama. The primary outcomes will include improvement in subjective symptoms and reduction in HbA1c levels. This study aims to assess whether timely Ayurvedic purification therapy can prevent or delay the progression from prediabetes to type 2 diabetes, thereby contributing to integrative public health strategies.