Integrative approaches to Diabetes Management

[Full title: Integrative approaches to Diabetes Management: Evaluating the Impact of Naturopathy, Diet, Yoga, and Herbal Therapy Compared to Conventional Treatments]

[Find the meaning and references behind the names: Long, Ayu, Nil, Med]

Journal of Ayurveda and Integrated Medical Sciences 2025 Volume 10 Number 3 MARCH E-ISSN:2456-3110 Review Article Diabetes Management Publisher www.maharshicharaka.in Integrative approaches to Diabetes Management: Evaluating the Impact of Naturopathy, Diet, Yoga, and Herbal Therapy Compared to Conventional Treatments Upadhyay RT 1* , Upadhyay AK 2 DOI:10.21760/jaims.10.3.29 1* Ruchita T Upadhyay, Naturopathy and Yogic Science Expert, Ashwamedha Health and Wellness Institute, Kankhal, Haridwar, Uttarakhand, India 2 Avnish K Upadhyay, Senior Consultant, Rishikul Campus Hospital, Uttarakhand Ayurved University, Haridwar, Uttarakhand, India Diabetes mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia, insulin resistance, and progressive multi-organ complications. Conventional treatment strategies predominantly rely on pharmacological interventions, such as insulin therapy and oral hypoglycemic agents, which effectively regulate blood glucose levels but may be associated with adverse effects, medication dependency, and limited long-term sustainability. In contrast, complementary and alternative medicine (CAM), including naturopathy, dietary interventions, yoga, and herbal therapy, has emerged as a promising adjunct or alternative approach, addressing the underlying metabolic imbalances and promoting holistic well-being. This review critically examines the scientific evidence supporting CAM therapies in diabetes management, comparing their efficacy with conventional treatments. Studies suggest that yoga enhances insulin sensitivity, herbal formulations regulate glucose metabolism, and naturopathic approaches, including hydrotherapy and detoxification, contribute to glycemic stability. Additionally, dietary interventions such as the Mediterranean and lowglycemic diets have shown significant potential in reducing HbA 1 c levels and improving lipid profiles. Despite promising outcomes, challenges such as standardization, regulatory oversight, and patient adherence remain barriers to widespread integration into mainstream diabetes care. Future research should focus on large-scale clinical trials, mechanistic studies, and integrative treatment models to validate and optimize the role of CAM in diabetes management. A multidisciplinary approach combining evidence-based conventional treatments with scientifically validated CAM therapies may offer a more comprehensive and sustainable diabetes care strategy Keywords: Diabetes Mellitus, Naturopathy, Herbal Medicine, Yoga, Integrative Medicine Corresponding Author How to Cite this Article To Browse Ruchita T Upadhyay, Naturopathy and Yogic Science Expert, Ashwamedha Health and Wellness Institute, Kankhal, Haridwar, Uttarakhand, India Email: Upadhyay RT, Upadhyay AK, Integrative approaches to Diabetes Management: Evaluating the Impact of Naturopathy, Diet, Yoga, and Herbal Therapy Compared to Conventional Treatments . J Ayu Int Med Sci. 2025;10(3):184-193 Available From https://jaims.in/jaims/article/view/4106/ Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted 2025-02-13 2025-02-27 2025-03-07 2025-03-17 2025-03-27 Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note None Nil Not required 11.63 © 2025 by Upadhyay RT, Upadhyay AK and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0] J Ayu Int Med Sci 2025 ; 10 ( 3 ) 184

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Introduction Diabetes mellitus is a growing global health concern, affecting millions of individuals worldwide. Conventional medical treatments aim to regulate blood glucose levels and prevent complications, but long-term reliance on medications can lead to side effects and reduced efficacy over time. Alternative therapies such as naturopathy, diet-based interventions, yoga, and herbal remedies offer potential adjunctive or alternative treatments for diabetes management. This paper reviews the scientific literature on these alternative approaches and compares their effectiveness with conventional treatments. Diabetes mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both [1 ] The prevalence of diabetes has increased significantly worldwide, with Type 2 Diabetes Mellitus (T 2 DM) being the most common form, often associated with obesity, sedentary lifestyle, and poor dietary habits [2] Conventional treatments for diabetes include pharmacotherapy, insulin therapy, and lifestyle modifications; however, these approaches often come with limitations such as side effects, cost, and patient non-compliance [3] Alternative and complementary therapies, including naturopathy, yoga, and dietary interventions, have gained attention for their potential to improve glycemic control and overall well-being in diabetic patients [4 ] Studies suggest that Yoga and Pranayama (regulated breathing techniques) significantly impact lipid metabolism, reducing oxidative stress and improving insulin sensitivity in diabetic individuals [5 ][6] Meta-analyses indicate that yoga interventions lead to reductions in fasting plasma glucose and glycated hemoglobin (HbA 1 c) levels, demonstrating their effectiveness as adjunctive therapies for diabetes management [7 ] Naturopathy emphasizes a holistic approach by incorporating dietary modifications, naturopathy, and herbal medicine, which have shown promising results in diabetes management [8] Research highlights the potential benefits of plant-based diets and phytochemicals in improving insulin sensitivity and preventing diabetes-related complications [9] A growing body of evidence supports that whole-food, plant-based nutrition improves metabolic markers such as blood glucose, cholesterol levels, and inflammatory responses in diabetic patients [10 ][11 ] Several clinical studies have reported significant improvements in glycemic control among patients who adopted a naturopathic approach combined with conventional therapies [12 ] Furthermore, emerging research suggests that stem cell therapy, when integrated with naturopathy, offer long-term solutions for diabetes management and beta-cell regeneration [13] Plant-based diets, naturopathy, yoga, and complementary medicine have shown potential in managing type 2 diabetes by improving glycemic control, insulin sensitivity, and overall metabolic health. Research highlights the benefits of plant-derived phytochemicals, dietary modifications, and holistic interventions such as Pranayama and Yogasana in reducing diabetes-related complications. Studies on naturopathic treatments demonstrate significant improvements in HbA 1 c levels, weight management, and quality of life, with long-term benefits observed in some cases. Integrative approaches combining yoga and naturopathy have been particularly effective in enhancing metabolic outcomes. A randomized trial further supports role of naturopathic interventions in diabetes management, emphasizing their positive impact on health & well-being [14–21] The use of natural products, including herbal medicine and bioactive compounds from plants, has been widely explored for their antidiabetic properties, showing potential in reducing insulin resistance and improving pancreatic function. In light of these findings, the integration of alternative therapies with conventional diabetes management strategies could provide a more comprehensive approach to controlling the disease. This review aims to explore the effectiveness of naturopathy, yoga, and plant-based dietary interventions in diabetes management while highlighting recent advancements in these fields. The review will also address the role of natural phytochemicals and future therapeutic interventions, including regenerative medicine and holistic lifestyle modifications Methodology Study Design This review follows a systematic and comparative approach, analyzing peer-reviewed literature, clinical trials, meta-analyses, and mechanistic studies on the role of naturopathy, diet, yoga, and herbal therapy in diabetes management Ruchita TU et al. Integrative approaches to Diabetes Management J Ayu Int Med Sci 2025 ; 10 ( 3 ) 185

[Find the meaning and references behind the names: Low, Sun, Prithvi, Rich]

Data Sources and Selection Criteria Databases searched: PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, and Cochrane Library Ethical Considerations Since this is a review-based study, no direct human or animal subjects were involved All data were obtained from publicly available scientific literature, ensuring ethical compliance with academic integrity standards Naturopathy and Diabetes Management Naturopathy emphasizes a holistic approach, utilizing lifestyle changes, five element therapy, And detoxification methods to regulate blood sugar levels. Studies have shown that naturopathic interventions improve glycemic control, reduce oxidative stress, and enhance overall well-being in diabetic patients. A prospective cohort study indicated that patients undergoing naturopathy and yoga therapy showed significant reductions in HbA 1 c levels and insulin dependence compared to those on conventional medication alone. Integrating Five Elements Therapy into diabetes management offers a holistic approach that aligns with the body's physical, biochemical parameters and natural balance [22] . Below is a detailed table outlining each element's role, corresponding naturopathic applications, scientific insights, and relevant references [Table - 1]: Element Physiological Function Role in Diabetes Management Naturopathic Applications Duration of Application Demographic Considerations Earth (Prithvi) Stability, structural integrity, musculoskeletal support Supports pancreatic function, improves digestion Mud Therapy: Mineral-rich mud packs on the abdomen to stimulate pancreatic function Mud therapy: 20-30 minutes, 3-5 times per week Ideal for diabetics with neuropathy & digestive issues. Avoid mud therapy in cold weather for individuals with circulation problems Water (Jala) Detoxification, circulation, joint lubrication Enhances hydration, supports kidney function, aids in glucose metabolite detoxification Hydrotherapy: Warm baths, cold compresses to boost circulation & metabolism Hydrotherapy: 15-30 minutes daily Beneficial for diabetics with circulatory issues & fluid retention Fire (Agni) Metabolism, thermoregulation, enzymatic activity Governs digestion, enhances enzymatic activity, and improves glucose metabolism Sun Therapy (Heliotherapy): Sun exposure increases vitamin D levels, boosting insulin sensitivity Sun therapy: 15-20 minutes of morning sun exposure daily Recommended for obese diabetics & those with vitamin D deficiency. Avoid excessive sun exposure for those with photosensitivity or heat intolerance Air (Vayu) Oxygenation, neural function, movement Enhances oxygen supply, improves nerve function, and prevents diabetic neuropathy Breathing Techniques (Pranayama): Enhances oxygenation & reduces stressinduced insulin resistance Pranayama: 10-15 minutes daily Ideal for working professionals, elderly diabetics & those with neuropathy Intense breathing techniques should be avoided by hypertensive individuals Space (Akasha) Cellular communication, energy flow, homeostasis Regulates intercellular signaling, reduces stress-related insulin resistance Meditation & Sound Therapy: Lowers stress hormones (cortisol) linked to insulin resistance. Fasting Therapy: Intermittent fasting for blood sugar stabilization Meditation: 15-30 minutes daily. Fasting therapy: Once a week or intermittent fasting Ideal for stress-induced diabetes & metabolic syndrome Fasting is not advised for insulindependent diabetics Dietary Interventions Diet plays a crucial role in diabetes management. Plant-based diets, low-glycemic-index foods, and carbohydrate-controlled meal plans have been effective in maintaining stable blood glucose levels. Research indicates that Mediterranean and vegan diets can significantly reduce HbA 1 c levels and improve insulin sensitivity. Comparatively, conventional treatment focuses on dietary guidelines but often incorporates pharmacological support to achieve glycemic control [23 ] Here is a comprehensive table outlining specific diets for diabetes management, including their therapeutic effects, recommended duration, contraindications, and scientific insights [Table – 2]: Ruchita TU et al. Integrative approaches to Diabetes Management J Ayu Int Med Sci 2025 ; 10 ( 3 ) 186

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Foot Notes: Mediterranean & Vegan Diets: Ideal for long-term diabetes management with strong evidence supporting reduced HbA 1 c and better insulin function. Low-Carb & Keto Diets: Effective for rapid glycemic control but should be monitored for potential risks. DASH: Beneficial for metabolic improvements, especially in prediabetes and insulin resistance. Paleo Diet: Shows promising effects on glucose metabolism, but requires modifications for nutrient balance Yoga and Diabetes Control Yoga, an ancient practice involving physical postures, Breathing exercises, and meditation, has been widely studied for its impact on diabetes. Yoga practices enhance pancreatic function, improve insulin sensitivity, and lower stress-induced hyperglycemia Meta-analyses suggest that patients practicing yoga show marked improvements in fasting plasma glucose and HbA 1 c levels, comparable to those on standard diabetic medications [29] A comprehensive table on Yoga and Diabetes Control, detailing specific yoga practices, their therapeutic effects, recommended duration, contraindications, and scientific insights [Table – 3]: Diet Type Therapeutic Effects Recommended Duration Contraindications Scientific Insights & References Mediterranean Diet (Rich in healthy fats, whole grains, lean protein, nuts, and vegetables) Reduces HbA 1 c levels Improves insulin sensitivity Lowers cardiovascular risk Long-term lifestyle adoption Not ideal for those with nut or seafood allergies May require modification for kidney patients due to protein intake Studies shown to decrease HbA 1 c levels (Nutrients, 2020)[24] Vegan Diet (Plant-based, avoiding all animal products, rich in fiber and antioxidants) Enhances glycemic control Reduces oxidative stress Lowers cholesterol levels Long-term lifestyle adaptation Risk of B 12 deficiency May not suit individuals needing high protein intake Research indicates fasting blood glucose reduction by 20% and HbA 1 c drop by 0.4-0.8% (Nutrients, 2023)[25] Low-Carbohydrate Diet (Restricts refined carbs, focusing on proteins, fats, and non-starchy vegetables) Lowers postprandial glucose spikes Aids in weight management Improves metabolic syndrome Short-term (3-6 months) or cyclical Not recommended for type 1 diabetics Can cause ketoacidosis in extreme cases A meta-analysis found that low-carb diets reduce HbA 1 c by 0.5-1.3% (Metabolites, 2023) [26] Ketogenic Diet (High fat, very low carb, moderate protein) Drastically lowers blood sugar levels Enhances fat metabolism May reduce insulin dependency Short-term (up to 6 months) Risk of ketoacidosis in insulindependent diabetics Can cause electrolyte imbalance Studies show that HbA 1 c reductions of 1- 1.5% are common, but long-term safety is debated (Explor Foods Foodomics, 2024)[27] Paleo Diet (Focuses on lean meats, fish, fruits, vegetables, nuts, and seeds, avoiding processed foods) Reduces inflammation Improves insulin resistance Lowers triglyceride levels Short to medium term (3-6 months) May cause calcium deficiency Not ideal for people with kidney disease Found to lower HbA 1 c by 0.5-1.0%, though long-term sustainability is debated (J Diabetes Sci Technol. 2009) [28] Yoga Practice Therapeutic Effects Recommended Duration Contraindications Scientific Insights & References Asanas (Physical Postures) Stimulates the pancreas, improving insulin secretion Enhances glucose metabolism and peripheral insulin sensitivity Reduces obesityrelated insulin resistance 30-45 minutes daily Avoid intense postures in diabetic neuropathy or hypertension A meta-analysis found that yoga reduces fasting glucose by 20-30 mg/dL and HbA 1 c by 0.5-1.0% (Endocrinol Metab (Seoul). 2018) [29] Pranayama (Breathing Exercises) Reduces stress-induced hyperglycemia Enhances oxygenation and detoxification Lowers cortisol and improves autonomic nervous system function 10-20 minutes daily Not advised for individuals with severe respiratory issues Studies show significant reductions in fasting glucose and cortisol levels, improving insulin regulation (Rambam Maimonides Med J. 2022) [30] Surya Namaskar (Sun Salutation) Improves metabolism and weight control Boosts circulation and insulin function Enhances cardiovascular health 5-10 rounds daily Avoid in hypertension, joint pain, or cardiovascular conditions Research indicates that regular practice lowers HbA 1 c by 0.7-1.2% in Type 2 diabetics (J Ayurveda Integr Med. 2022)[31] Meditation and Mindfulness Enhances emotional stability and reduces anxiety Lowers blood pressure and heart rate variability Supports long-term diabetes management 10-15 minutes daily Not recommended for those with severe mental health conditions without supervision Mindfulness-based interventions improve HbA 1 c levels and stress-induced glucose spikes (Diabetes Spectr. 2009)[32] Ruchita TU et al. Integrative approaches to Diabetes Management J Ayu Int Med Sci 2025 ; 10 ( 3 ) 187

[Find the meaning and references behind the names: Seed, Vera, Giri, Melon]

Foot Notes: Asanas & Surya Namaskar : Improve pancreatic function, insulin sensitivity, and glucose metabolism. Pranayama & Shavasana : Reduce stress-related hyperglycemia and cortisol levels, crucial for diabetes management. Meditation & Mindfulness: Aid in long-term glycemic control by addressing emotional and psychological factors. Contraindications: Certain Yoga poses should be avoided by patients with cardiovascular issues, joint pain, or spinal conditions Herbal Therapy in Diabetes Several medicinal plants, such as bitter melon ( Momordica charantia ), Fenugreek ( Trigonella foenum-graecum ), and cinnamon ( Cinnamomum verum ), have demonstrated hypoglycemic effects. Clinical studies support the use of these herbs in lowering blood glucose levels, improving lipid profiles, and reducing inflammation. While herbal therapy provides a natural alternative, its efficacy varies depending on dosage and individual patient response Conventional treatments, in contrast, offer standardized medication with well-documented efficacy but potential adverse effects. Here is a comprehensive table combining both sets of herbal therapies for diabetes management, along with their therapeutic effects, recommended dosages, contraindications, and scientific insights [Table – 4] Herb Therapeutic Effects Recommended Dosage Contraindications Scientific Insights & References Jamun Giri (Syzygium cumini) Lowers blood glucose levels Enhances insulin sensitivity Rich in antioxidants 1-3 grams of seed powder daily Caution during pregnancy and breastfeeding May cause allergic reactions in some individuals Studies show significant reduction in fasting blood glucose levels. (Molecules, 2022)[33] Karela (Momordica charantia) Reduces blood glucose levels Enhances insulin secretion Improves glucose uptake 50-100 ml fresh juice or 900 mg fruit extract daily Avoid during pregnancy May cause gastrointestinal discomfort Regular use has been linked to significant improvements in fasting glucose levels (Food Science and Biotechnology, 2022)[34] Gudmar (Gymnema sylvestre) Stimulates insulin secretion Regenerates pancreatic beta cells Reduces intestinal glucose absorption 400 mg leaf extract daily Not recommended during pregnancy or lactation May enhance the effects of other glucose-lowering medications Clinical trials report significant reductions in fasting blood glucose and HbA 1 c levels. (J Endocrinol, 1999)[35] Neem (Azadirachta indica) Helps regulate blood sugar Improves insulin sensitivity Possesses antiinflammatory properties 2-5 ml neem oil or 1-2 grams of leaf powder daily Not recommended for pregnant women Risk of liver toxicity in some individuals Research indicates reductions in blood glucose levels and improvements in insulin sensitivity.[36] Kutki (Picrorhiza kurroa) Lowers blood glucose levels Improves liver function Rich in antioxidants 400-600 mg root extract daily Avoid during pregnancy and lactation May cause gastrointestinal discomfort Studies have shown reductions in blood glucose levels and improved liver enzyme activity.[37] Daru Haldi (Berberis aristata) Lowers fasting blood glucose and HbA 1 c Improves lipid profile 500 mg, 2-3 times daily May cause gastrointestinal discomfort Potential interactions with medications Studies suggest effects comparable to metformin in glycemic control.[38] Indrayan (Citrullus colocynthis) Lowers blood glucose levels Improves lipid profile Has anti-inflammatory properties 300 mg fruit powder daily Avoid during pregnancy and lactation Risk of toxicity at high doses Research indicates improvements in blood sugar and lipid levels.[39] Methi - Fenugreek (Trigonella foenum-graecum) Improves insulin sensitivity Lowers postprandial glucose levels Reduces cholesterol levels 5-10 grams of powdered seeds daily, divided into two doses May cause gastrointestinal symptoms Not recommended during pregnancy Meta-analysis shows a reduction in HbA 1 c by approximately 0.85%.[40] Dalchini - Cinnamon (Cinnamomum verum) Enhances insulin receptor function Lowers fasting blood glucose Reduces triglycerides and LDL cholesterol 1-6 grams of cinnamon powder daily May cause liver issues in high doses Not recommended for individuals with liver disease Some studies report a decrease in HbA 1 c by up to 0.5%, though results are mixed.[41] Aloe Vera (Aloe barbadensis miller) Lowers fasting blood glucose Improves HbA 1 c levels Enhances insulin sensitivity 1 tablespoon of aloe vera gel daily May cause gastrointestinal discomfort Not recommended during pregnancy Research indicates a reduction in HbA 1 c by approximately 0.99%.[42] Ruchita TU et al. Integrative approaches to Diabetes Management J Ayu Int Med Sci 2025 ; 10 ( 3 ) 188

Foot Notes: Efficacy: Herbs like Bitter Melon, Gudmar, Daru Haldi, Aloe Vera, and Fenugreek have demonstrated significant reductions in blood glucose and HbA 1 c levels, making them effective for diabetes management. Dosage & Administration: Adhering to the recommended dosage is crucial to maximize benefits and minimize potential side effects. Contraindications: Individuals who are pregnant, lactating, or on multiple medications should consult healthcare providers before using these herbs to avoid adverse effects. Scientific Validation: While many herbs show promising effects, their efficacy may vary based on individual responses. More extensive clinical trials are needed to establish standardized guidelines Comparison with Conventional Treatment Conventional diabetes management includes pharmacotherapy, lifestyle modifications, and patient education. While medications effectively lower blood glucose levels, they may cause side effects such as weight gain, hypoglycemia, and cardiovascular risks. In contrast, naturopathy, diet, yoga, and herbal therapy focus on root causes, offering sustainable and non-invasive management strategies. However, these alternative therapies often require lifestyle commitment and may lack standardized dosage and regulation [47] Discussion Current Status of Alternative Diabetes Management Diabetes requires long-term management, & while conventional treatments like pharmacotherapy & lifestyle modifications help control blood glucose, They often come with side effects such as weight gain and cardiovascular risks. Alternative therapies —including naturopathy, dietary interventions, yoga, and herbal therapy—offer promising solutions by improving insulin sensitivity, pancreatic function, and overall metabolic health. Research supports the benefits of these approaches: Yoga enhances fasting plasma glucose levels, HbA 1 c, and insulin sensitivity. Herbal therapies such as bitter melon, fenugreek, and Jamun Giri show potential in blood sugar regulation, though standardized dosages and long-term effects remain uncertain. Dietary interventions like the Mediterranean and lowcarbohydrate diets significantly reduce HbA 1 c and improve lipid profiles, but adherence varies among patients. Despite these advantages, integration into mainstream diabetes management is limited due to a lack of large-scale clinical trials, standardized protocols, and regulatory concerns. Several barriers hinder the widespread adoption of alternative diabetes treatments. Unlike conventional drugs, alternative therapies lack standardized dosages and protocols, leading to variations in potency due to differences in plant species, extraction methods, and preparation techniques. Many studies are smallscale or observational rather than randomized controlled trials (RCTs), making it difficult to validate efficacy and long-term safety Future Directions in Diabetes Management To enhance the role of alternative therapies in diabetes care, future research should focus on: Isabgol – Psyllium (Plantago ovata) Lowers postprandial glucose levels Improves insulin sensitivity Aids in weight management 10-15 grams of husk daily, taken with water May cause gastrointestinal bloating or gas Ensure adequate water intake to prevent choking Meta-analysis indicates a reduction in HbA 1 c by approximately 0.97%.[43] Nigella (Nigella sativa) Enhances insulin production Reduces fasting blood glucose 1-3 grams of seed powder daily May cause allergic reactions in some individuals Not recommended during pregnancy Studies show a reduction in HbA 1 c by approximately 0.5%.[44] Guduchi (Tinospora cordifolia) Enhances insulin secretion Improves immune function Lowers blood glucose levels 300-600 mg extract daily Avoid in autoimmune disorders Not recommended during pregnancy Research suggests Guduchi helps regulate blood sugar levels and reduces oxidative stress.[45] Ashwagandha (Withania somnifera) Reduces stress and cortisol levels Enhances insulin sensitivity Lowers fasting blood glucose levels 300–600 mg root extract daily Avoid during pregnancy May lower blood pressure excessively in individuals on antihypertensive medications Clinical studies indicate improved insulin sensitivity and reduced fasting blood glucose. (J Pharmacy Research, 2021)[46] Shilajit (Asphaltum punjabianum) Enhances mitochondrial function and energy levels Improves glucose metabolism Reduces oxidative stress 300–500 mg purified Shilajit extract daily Avoid during pregnancy and lactation May interact with diabetes medications Studies suggest improved glucose metabolism and reduction in fasting blood glucose levels. (J Pharmacy Research, 2021) [46] Ruchita TU et al. Integrative approaches to Diabetes Management Conducting Large-Scale Clinical Trials: Wellstructured RCTs are needed to evaluate the long-term safety and effectiveness of alternative therapies, comparing them directly with conventional treatments J Ayu Int Med Sci 2025 ; 10 ( 3 ) 189

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Conclusion Although alternative diabetes therapies show promise, their full potential remains untapped due to a lack of large-scale research, standardization, and integration with conventional care. Moving forward, multidisciplinary collaborations between medical researchers, nutritionists, and practitioners of traditional medicine will be crucial in establishing a holistic, evidence-based diabetes management model that prioritizes both efficacy and safety. With ongoing research and clinical validation, naturopathy, diet, yoga, and herbal therapy could redefine diabetes care, offering sustainable, noninvasive solutions alongside modern pharmacotherapy References 1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009 Jan;32(Suppl 1):S 62-S 67. doi: 10.2337/dc 09- S 062. PMID: 19118289; PMCID: PMC 2613584 [Crossref][PubMed][Google Scholar] 2. Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes – Global burden of disease and forecasted trends. J Epidemiol Glob Health. 2020 Mar;10(1):107-111. doi: 10.2991/jegh.k.191028.001. PMID: 32175717; PMCID: PMC 7310804 [Crossref][PubMed][Google Scholar] 3. García-Pérez LE, Alvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013 Dec;4(2):175-194. doi: 10.1007/s 13300-013-0034- y. PMID: 23990497; PMCID: PMC 3889324 [Crossref][PubMed][Google Scholar] 4. Tiwari S, Saoji AA, Madle K, Sapkota N, Shashikiran HC, Shetty P. Naturopathy and yoga for improving quality of life in pemphigus vulgaris and managing co-morbid type 2 diabetes: A case report. J Ayurveda Integr Med. 2020;11(2):110-113. doi: 10.1016/j.jaim.2020.01.002 [Crossref][PubMed] [Google Scholar] 5. Venugopal V, Geethanjali S, Poonguzhali S, Padmavathi R, Mahadevan S, Silambanan S, Maheshkumar K. Effect of yoga on oxidative stress in type 2 diabetes mellitus: A systematic review and meta-analysis. Curr Diabetes Rev 2022;18(2):e 050421192663. doi: 10.2174/1573399817666210405104335 [Crossref] [PubMed][Google Scholar] 6. Naturopathic Approaches to Diabetes Management. Available at: https://aanmc org/featured-articles/naturopathic-approaches-todiabetes-management/. . [Crossref][PubMed] [Google Scholar] 7. Pandey A, Tripathi P, Pandey R, Srivastava R, Goswami S. Alternative therapies useful in the management of diabetes: A systematic review. J Pharm Bioallied Sci. 2011;3(4):504-512. doi: 10.4103/0975-7406.90103 [Crossref][PubMed] [Google Scholar] 8. Ghongade S. A study on effect of naturopathy in diabetes control without medicine. J Drug Deliv Ther. 2019;9(5):158-160. doi: 10.22270/jddt.v 9 i 5.3540 [Crossref][PubMed] [Google Scholar] 9. Schultz WM, Varghese T, Heinl RE, Dhindsa DS, Mahlof EN, Cai HC, Southmayd G, Sandesara PB, Eapen DJ, Sperling LS. Natural approaches in diabetes management: A review of diet, exercise, and natural products. Curr Pharm Des 2018;24(1):84-98. doi: 10.2174/1381612822666161216114108 [Crossref] [PubMed][Google Scholar] Ruchita TU et al. Integrative approaches to Diabetes Management Developing Standardized Protocols and Dosages: Establishing clear guidelines for herbal therapy, yoga, and naturopathy can improve their acceptance in mainstream medicine Integrating Alternative Therapies into Conventional Care: A holistic, patient-centered model combining pharmacotherapy with yoga and diet-based interventions may yield better outcomes than medication alone Understanding Mechanistic Pathways: More studies are required to explore how herbal compounds, dietary changes, and yoga influence insulin signaling, oxidative stress, and inflammation. Biochemical and genetic research can also help identify patient subgroups who respond best to these therapies J Ayu Int Med Sci 2025 ; 10 ( 3 ) 190

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