Diabetes mellitus, a life style disease affecting 8.3% of the adult population of the world and increasing at an alarming rate, is one of the most common non-communicable diseases of current era. The burden of this disease is immense owing to transition in lifestyle and dietary habits, ageing of the population and urbanization in the setting of a genetically predisposed environment. The prevalence of diabetes in India has remained at 11.8% in the last four years, according to the National Diabetes and Diabetic Retinopathy Survey report released by the health and family welfare ministry. The World Health Organization (WHO) estimated the global prevalence of diabetes among adults over 18 years of age as 8.5% in 2014. There are estimated 72.96 million cases of diabetes in adult population of India. The prevalence in urban areas ranges between 10.9% and 14.2% and prevalence in rural India was 3.0-7.8% among population aged 20 years and above with a much higher prevalence among individuals aged over 50 years (INDIAB Study). The term ‘Prameha’ is originated from two words, ‘Pra’ means abundant, and ‘Meha’ means ‘To pass the large quantity of Urine’. The main presenting symptom of the disease is excess and sweet urine. The complex nature of ‘Prameha’ was well understood in the ancient time, hence the disease is included in the â€˜Maha Roga’. Unlike other diseases which have usually one type of pathogenesis, Prameha/Madhumeha has four different pathogenesis. Although, Prameha is classification of diseases presenting with polyuria, in practice, often it equated with Diabetes owing to its high incidence. Never the less it is also called as Madhumeha. Prabhutatva and Avilatva are the two cardinal features of Pramehas. Prameha is a complex syndrome encompassing Obesity, Metabolic Syndrome and Diabetes Mellitus. All Prameha ultimately convert into Madhumeha. Thus, Madhumeha is an advanced stage of Prameha. The terms Prameha and Madhumeha are to be considered synonymous in context of diabetes. Ayurveda considers Prameha, as a disease of Medadhatu (Body Fats or adipose tissue) Dushti with additional derangement in Mansadhatu (muscle tissue), Kleda, Rasadhatu, Raktadhatu, Majja, Shukra etc. Ayurvedic line of Treatment starts from correction of Medadhatu Dushti (Deranged Adipose Tissue), which is responsible for further Pathophysiology of Prameha.