Homoeopathy in the management of type 2 diabetes mellitus

Dr A M Anusha

ABSTRACT
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia. It can occur due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. Type 1 diabetes mellitus is characterized by autoimmune destruction of insulin-producing beta cells in the islets of the pancreas, which causes absolute deficiency of insulin. In Type 2 Diabates Mellitus, there is diminished response to insulin, and is defined as insulin resistance. The associated risk factors include obesity, weight gain, sedentary lifestyle, diet, excessive alcohol, smoking. A 33-year-old male with obesity presented with easy fatigability and burning in B /L soles since 3 months. After a thorough clinical evaluation, repertorization, referring to materia medica Lycopodium was prescribed as the remedy.

Key words: Type 2 diabetes mellitus, Lycopodium clavatum, Homoeopathy

INTRODUCTION
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. It can occur due to impaired insulin secretion, resistance to peripheral actions of insulin, or both.¹ Type 1 diabetes mellitus (juvenile-onset or insulin-dependent), is characterized by autoimmune destruction of insulin-producing beta cells in the islets of the pancreas, which causes absolute deficiency of insulin. In type 2 Diabetes Mellitus (adult-onset or non-insulin-dependent), insulin secretion is inadequate. The associated risk factors include obesity, weight gain, sedentary lifestyle, diet, excessive alcohol, smoking.²

According to the International Diabetes Federation (IDF), approximately 415 million adults between the ages of 20 to 79 years had diabetes mellitus in 2015. Diabetes Mellitus is proving to be a global public health burden as this number is expected to rise to another 200 million by 2040.¹

Individuals suffering from type 2 Diabetes Mellitus may present with symptomatic hyperglycemia that is with urinary frequency, polyuria, polydipsia, weakness, fatigue but are often asymptomatic, and it is detected only on routine testing.² Poorly managed cases can lead to microvascular or macrovascular complications like neuropathy, nephropathy and retinopathy. ³

CASE REPORT

• Name – Mr V
• Age – 33 years
• Sex- Male
• Occupation- Engineer
• Marital status- Unmarried
• Religion- Hindu
• Address- Basaveshwara Nagar, Bengaluru
• Date – 19/01/2023

Presenting Complaint
C/o easy fatigability and burning in the B/L soles since 3 months

History of Presenting Complaint
Patient was apparently well 3 months back. He gradually started with easy fatigability, which gradually progressed. Complaint is aggravated on exertion, and is slightly better on rest. He also has burning in the B/L soles which is aggravated in the night. There is itching in the genital region along with the complaints. Patient has a history of smoking for 10 years.

There is no h/o palpitation, chest pain, giddiness, headache, nausea, vomiting, restlessness, tremors, tingling, numbness in the extremities.

Location	Sensation	Modalities	Accompaniments
1.General Since 3 months Gradual onset and progression 2. Extremities B/L sole region Since 3 months Gradual onset and progression	Easy fatigability+2 Burning+2	< Exertion+3 >Rest+1 <night+1	Itching+1 in the genital region

Past History :Nothing significant

Family History : Elder brother – Type 2 diabetes mellitus

Personal History

• Diet- Mixed
• Appetite- Good
• Hunger – Good
• Thirst – 1-2 L/ day
• Desire- spicy+1
• Aversion – Nil
• Urine – 4-5 times / day
• Bowel movement – 1 time/ day, no difficulty
• Perspiration – generalized
• Sleep – good
• Dreams – Unremembered
• Thermals – Ambithermal

Addiction-

Smoking =

• started at the age of 21 years, stopped 1 year back
• 7-8 cigarettes/ day

Life space investigations
Patient belongs to middle socio- economic family. His Father is a businessman and mother is a housewife. He has 1 elder brother who is also an engineer. They are a joint family. His childhood was uneventful, was very good at studies. He got a job in a reputed company immediately after his studies.

As a person, he is very dedicated towards his work, gets irritated if work is not done on time.

Vitals

• BP- 130/70mm Hg
• Pulse – 86 beats/ min
• Respiratory rate- 16 breaths/ min
• Temp – afebrile at the time of examination

Provisional Diagnosis: Type 2 Diabetes Mellitus

 Laboratory Investigation & Findings

19/01/23

• FBS = 561 mg/dl
• PPBS = 510 mg/dl

Clinical Diagnosis: Type 2 Diabetes Mellitus

Classification of Disease: Chronic miasmatic disease

Fundamental and dominant miasm: Sycotic

Analysis of case

Common symptoms	Uncommon symptoms
Easy fatigability+2 < exertion+3 >rest+1 Burning+2 in the B/L soles < night+1 Itching+1 in the genital region	Desire- spicy+1 Thermals- Ambithermal Workoholic+2 Irritable+1 Smoking

Evaluation of symptoms

Mental generals	Physical generals	Characteristic particular
Workoholic+2 Irritable+1	Desire- spicy +1 Thermals – Ambithermal Smoking	Easy fatigability+2 < exertion+3 >rest+1 Burning+2 in the B/L soles < night+1 Itching+1 in the genital region

Totality of symptoms

• Workoholic+2
• Irritable+1
• Desire- spicy+1
• Smoking
• Easy fatigability+2
• < exertion+3
• >rest+1
• Burning+2 in the B/L soles
• < night+1
• Itching+1 in the genital region

 Repertorial approach – Synthesis repertory

 Repertorial Totality –

1. MIND- Industrious
2. MIND- Irritability
3. MALE GENITALIA/SEX – ITCHING
4. EXTREMITIES – PAIN – Feet – Soles – night – burning
5. GENERALS – FOOD and DRINKS – spices – desire
6. GENERALS – REST – amel.
7. GENERALS – TOBACCO – desire for tobacco – smoking; desire for
8. GENERALS – WEAKNESS – exertion – agg.
9. GENERALS – WEARINESS

Repertorization proper

• Lyc 15/9
• Sulph 18/8
• Lach 16/8
• Staph 16/8
• Nux-v 15/8
• Sep 14/8
• Kali-p 11/8
• Phos 16/7
• Calc 14/7
• Nat-m 13/7

Prescription

1. Lycopodium – 200, TID, 3 days
2. NS-6x, BD, 15 days

BASIS OF PRESCRIPTION
Based on analysis of mental generals, physical generals, particulars and reportorial result Lycopodium was coming as the first remedy of choice and was selected for the prescription. 200C potency was chosen based on the susceptibility and nature of the disease. Infrequent repetition was chosen based on seat of the disease and its intensity.

 FOLLOW UP

DATE	SYMPTOMS	PRESCRIPTION
10/02/23	C/o Easy fatigability better C/o burning in the B/L soles- slightly persists C/O itching in the genital region – better No new complaints All generals are good Patient was adviced to repeat blood sugar test	1.     Lycopodium-200, TID, 3 days 2.     NS-6x, BD, 15 days
1/03/23	Complaints better No new complaints All generals are good Investigation reports- FBS= 366 mg/dl PPBS= 601 mg/dl	1.     Lycopodium-200, TID, 3 days 2.     Rubrum- OD, 15 days
29/05/23	Complaints better No new complaints All generals are good Investigation reports- FBS= 122 mg/dl PPBS= 117 mg/dl	1.     Lyco plain, TID, 3 days 2.     Rubrum, OD, 15 days

CONCLUSION
Homoeopathy is a holistic approach which treats the person as a whole. Most of the disorders of the disorders of metabolism, diabetes mellitus stem from affections on mental as well as physical plane. In this case striking physical and mental features were elicited and used to prescribe. There was drastic improvement in patient’s blood glucose levels within 4 months of giving the medicine. Homeopathy can stop the further advancement in the condition and give relief to the patient.

 Conflict Of Interest– Nil

 Funding– Nil

 Consent For Publication– written informed consent was obtained from the patient for publication of this case report.

BIBLIOGRAPHY

1. Goyal R, Singhal M, Jialal I. Type 2 Diabetes. [Updated 2023 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513253/
2. Porter S, Kaplan L, The Merck Manual Of Diagnosis And Therapy, 19th ed. New Jersey: Merck Sharp & Dohme Corp, 2011.
3. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008 Nov;88(11):1254-64. doi: 10.2522/ptj.20080020. Epub 2008 Sep 18. PMID: 18801858; PMCID: PMC3870323.
4. Synthesis Repertory

Dr A M Anusha
PG Scholar, Department of Practice of Medicine
Government Homoeopathic College & Hospital Bangalore- 560079
anusha.ashok97@gmail.com

Under The Guidance Of
Dr Praveen Kumar PD
HOD & Professor
Department Of Practice of Medicine
Government Homoeopathic College & Hospital Bangalore- 560079

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