INTRODUCTION

 Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels. impaired insulin secretion, and increased glucose production. Diabesity, the term coined to show the strong interlink between obesity and diabetes, is the direct co nsequence of the obesity pandemic, and poses significant challenges in the management of the disease. The global prevalence of obesity is increasing rapidly with an exponential rise in incidence of type 2 diabetes mellitus in recent years. The worst metabolic consequence of obesity is type 2 diabetes mellitus , which substantially increases cardiovascular disease-related morbidity and mortality. Other obesity associated comorbidities such as dyslipidemia, hypertension, metabolic-associated fatty liver disease, obstructive sleep apnoea , heart failure, ischaemic heart disease, cancers and osteoarthritis further increase the morbidity, mortality, and health-related quality of life, especially when these patients additionally have T2DM

NEED OF STUDY - The rising prevalence of obesity-induced Type 2 Diabetes Mellitus (T2DM) poses a major global health burden, with increasing incidence in both urban and rural populations. Among various biomarkers, serum adiponectin has gained attention for its anti-inflammatory, insulin- sensitizing, and cardio-protective roles. While conventional treatments focus on glycemic control and metabolic risk reduction, they do not address the underlying pathophysiology from a holistic perspective. Ayurveda, with its comprehensive approach, offers Shodhana therapies (bio-purificatory procedures) like Vamana, Virechana, and Basti, which aim to eliminate the root cause (Dosha-Dushya imbalance), particularly addressing Kapha-Meda Dushti — the core pathology in obesity and diabetes (Sthoulya-Prameha).

OBJECTIVES

PRIMARY OBJECTIVE—

To compare the effect of Vamana, Virechana, and Basti on serum adiponectin levels in patients of t2dm with obesity (sthula pramehi)

 SECONDARY OBJECTIVES-

1.  To assess changes in clinical parameters such as BMI, waist circumference, hip waist ratio.

2.  To assess changes in biochemical parameters like fasting blood sugar , postprandial blood sugar , HbA1c, and lipid profile.

3. To  compare the overall effect of these Panchakarma procedures in improving quality of life and disease outcome.

4. To assess changes in signs and symptoms based on ayurvedic and modern parameter

METHODOLOGY:

This study is a prospective, triple arm interventional clinical trial with an open-label design, conducted over a period of 2.5 years on diagnosed cases of psoriasis, in both outpatient and inpatient departments (OPD & IPD) of the All India Institute of Ayurveda (AIIA).