{"id":2313,"date":"2020-09-17T14:33:44","date_gmt":"2020-09-17T14:33:44","guid":{"rendered":"https:\/\/ayurvedanetworkbhu.com\/?p=2313"},"modified":"2022-03-12T10:14:00","modified_gmt":"2022-03-12T10:14:00","slug":"lecture-on-adhyashan-a-key-factor-in-insulin-resistance-by-dr-amit-nakanekar","status":"publish","type":"post","link":"https:\/\/ayurvedanetworkbhu.com\/?p=2313","title":{"rendered":"Module on “Adhyashan – A Key factor in Insulin Resistance” by- Dr. Amit Nakanekar"},"content":{"rendered":"

<\/iframe><\/p>\n <\/p>\n<h1>Adhyashan: A Key Factor in Insulin Resistance<\/strong><\/h1>\nDr. Amit Nakanekar<\/strong>, \nMD (Ayu.), Ph.D., Assistant Professor, \nDepartment of Kaychikitsa, Government Ayurveda College, Nagpur<\/p>\n <\/p>\nInsulin resistance is the phenomenon by which the cell inhibits the entry of insulin molecules inside the cell. This is responsible for defective insulin action. For many hormones in the body, the two types of the phenomenon are- resistance and assistance. Resistance will oppose the entry of a particular molecule inside the cell, while assistance will provide entry of molecule inside the cell by some receptor mechanism. Therefore, to understand this concept it is very important to know how insulin resistance can happen inside the body. Impairment of insulin signal transduction enzymes, proteins leads to insulin resistance. Insulin resistance at the level of hepatocytes increases blood glucose level which leads to decreased uptake of glucose at the adipose tissue level and skeletal muscle level. [1]<\/sup><\/p>\nAyurveda<\/em> concept of digestion is nicely explained by Charaka<\/em> in Grahanichikitsa<\/em> Addhyaya<\/em>. Agni <\/em>(metabolic power) is Addhisthan <\/em>(site) for digestion. Agni<\/em> is situated in Grahani <\/em>above the umbilicus. The function of Grahani<\/em> is to hold the food till it gets digested and release this food after digestion. [2] <\/sup><\/p>\nIf the Agni<\/em> is weak, indigested food moves in to forward direction without proper digestion. There are three types of defective eating, all these three types of defective eating can create diseases that are difficult to treat. These defective types of eating are Adhyashan<\/em>, Vishamashan, <\/em>and Samashan<\/em> which means it is a mixture of a healthy and unhealthy diet. When healthy and unhealthy diet both are mixed together and eaten is called as Samashan.<\/em> Pathya<\/em> and Apathya<\/em> diet mixed together causes diseases. Vishamashan<\/em> means taking more or less food than the requirement, also taken at inappropriate timings. Food is taken at inappropriate timings that is before the feeling of hunger or not taking food in spite of it. Adhyashan<\/em> means eating before the digestion of a meal, eating again in a very short time after the meals. [3]<\/sup><\/p>\nFood consists of Six Rasas<\/em> (Madhura<\/em>-sweet, Amla<\/em>-sour, Lavana,Katu , Tikta, Kashay<\/em>). During digestion, food has to pass through the phases of digestion namely Madhur, Amla, <\/em>and Katu Avasthapak<\/em>. Every Rasa<\/em> turns to be Madhur Rasa<\/em> in the first AvasthaPak <\/em>(Madhur avasthapak -1st<\/sup> stage of digestion) and it increases the Kapha<\/em>. If food intake is done before the end of the first Avasthapak,<\/em> the duration of Madhur<\/em> Avasthapak<\/em> will be prolonged. [4]<\/sup> If it continued like this, the whole body will be exposed to Madhurata <\/em>(Sweetness-increased blood sugar level) for a longer duration. It will show the symptoms of Madhur<\/em> Rasa<\/em> Ati<\/em> Yoga<\/em> (symptoms of excessive intake of sweet). These are Sthaulya<\/em>(obesity), Agnisad<\/em>, Guruta<\/em>(Heaviness in the body), Alasaka<\/em> (excessive indigested food), Atinidra<\/em>(excessive sleep), Shwas<\/em>(Respiratory diseases), Prameha<\/em>(Diabetes), Galroga<\/em>(Throat diseases), Visangyata<\/em>, Alasya<\/em>, Galagand<\/em>(Goitre), Arbuda<\/em>(tumor), Gandamala<\/em>(Thyroiditis), Udarda<\/em>, Kasa<\/em>(Cough), Krimi<\/em>(worm infestation).[5]<\/sup><\/p>\nDiagnostic features of insulin resistance are hyperinsulinemia, hyperglycemia or normoglycemia, and anti-insulin antibodies. The effect of insulin resistance manifests on the heart, brain, kidney, blood vessels, and many more organs. [6]<\/sup><\/p>\nPhysiologically basal insulin secretion level is maintained at 10 \u03bcU \/ml. It is secreted in two phases after meals. Phase 1 Active Phase or 1st<\/sup> phase of glucose-stimulated insulin secretion, influences fasting to feeding duration. In this phase, it works by inhibition of glucose production by hepatocytes, reduced lipolysis, decreased intake of glucose by adipose tissue.1st<\/sup> phase of insulin secretion is quick and 2nd<\/sup> phase is slow and gradually increasing. The second phase which is a passive phase of insulin secretion also inhibits glucose production by hepatocytes up to a lesser extent, but most importantly it increases the utilization of glucose by peripheral tissue. Graph 1 shows the phases of insulin secretion.[7]<\/sup><\/p>\nGraph 1: Phases of insulin secretion after a meal<\/strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3219\" src=\"https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1.png\" alt=\"\" width=\"468\" height=\"310\" srcset=\"https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1.png 873w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1-300x199.png 300w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1-768x509.png 768w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1-160x106.png 160w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1-696x462.png 696w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/1-633x420.png 633w\" sizes=\"auto, (max-width: 468px) 100vw, 468px\" \/><\/p>\n\u00a0Adhyashan<\/em> includes eating before the digestion of a meal, eating again in a very short time after the meals. This means 1st<\/sup> phase of insulin secretion repeatedly occurs before the completion of the second phase of insulin secretion. This cycle goes on repeatedly causing insulin resistance. Graph 2 shows the effect of Adhyashan<\/em> on insulin secretion phases. Adhyashan has some role in the development of insulin resistance and its mechanisms can be correlated with disturbance in phases of insulin secretion leading to insulin resistance.<\/p>\nGraph 2:Possible effect of Adhyashan<\/em> on insulin secretion phases<\/strong><\/p>\n<img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3220\" src=\"https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2.jpg\" alt=\"\" width=\"487\" height=\"264\" srcset=\"https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2.jpg 1018w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2-300x162.jpg 300w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2-768x416.jpg 768w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2-160x87.jpg 160w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2-696x377.jpg 696w, https:\/\/ayurvedanetworkbhu.com\/wp-content\/uploads\/2022\/02\/2-776x420.jpg 776w\" sizes=\"auto, (max-width: 487px) 100vw, 487px\" \/><\/p>\n <\/p>\n<table style=\"height: 3162px;\" width=\"710\">\n<tbody>\n<tr>\n<td width=\"628\">\u00a0MCQs-<\/p>\n1)\u00a0\u00a0 \u0905\u092a\u0915\u094d\u0935\u0902\u00a0\u0927\u093e\u0930\u0924\u094d\u092f\u0928\u094d\u0928\u0902\u00a0\u092a\u0915\u094d\u0935\u0902\u00a0\u0938\u0943\u091c\u0924\u093f\u00a0\u092a\u093e\u0930\u094d\u0936\u094d\u0935\u0924\u0903|<\/strong> \n\u00a0 \u00a0 \u00a0\u0926\u0941\u0930\u094d\u092c\u0932\u093e\u0917\u094d\u0928\u093f\u092c\u0932\u093e \u0926\u0941\u0937\u094d\u091f\u093e\u00a0\u00a0\u0924\u094d\u0935\u093e\u092e\u092e\u0947\u0935 \u0935\u093f\u092e\u0941\u091e\u094d\u091a\u0924\u093f||\u096b\u096d||<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 \u091a.\u091a\u093f. \u0967\u0969<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 \u091a.\u091a\u093f \u0967\u096b<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 \u091a.\u091a\u093f \u0967\u096a<\/p>\n(d)\u00a0\u00a0\u00a0\u00a0 \u091a.\u091a\u093f \u0967\u096c<\/p>\n2)\u00a0\u00a0 Basal level of insulin in the body is\u2026.<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 1\u00b5U\/ml<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 100\u00b5U\/ml<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 10\u00b5U\/ml<\/p>\n(d)\u00a0\u00a0\u00a0\u00a0 0.10\u00b5U\/ml<\/p>\n <\/p>\n3)\u00a0\u00a0 \u092a\u0925\u094d\u092f\u093e\u092a\u0925\u094d\u092f\u092e\u093f\u0939\u0948\u0915\u0924\u094d\u0930 \u092d\u0941\u0915\u094d\u0924\u0902 ….. \u092e\u0924\u092e\u094d||\u0968\u0969\u096b||<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 \u0935\u093f\u0937\u092e\u093e\u0936\u0928<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 \u0905\u0927\u094d\u092f\u0936\u0928<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 \u0938\u092e\u0936\u0928<\/p>\n(d)\u00a0\u00a0\u00a0\u00a0 \u0935\u093f\u0930\u0941\u0926\u094d\u0927\u093e\u0936\u0928<\/p>\n4)\u00a0\u00a0 Process of Digestion is described in which of the following chapter by Charak<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 \u0905\u0930\u094d\u0936<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 \u0905\u0924\u093f\u0938\u093e\u0930<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 \u0917\u094d\u0930\u0939\u0923\u0940<\/p>\n(d)\u00a0\u00a0\u00a0\u00a0 \u0909\u0926\u0930<\/p>\n5)\u00a0\u00a0 First rise of insulin secretion peak occurs in what duration?<\/strong><\/p>\na)\u00a0\u00a0\u00a0\u00a0 0- 5 min<\/p>\nb)\u00a0\u00a0\u00a0\u00a0 5-10 min<\/p>\nc)\u00a0\u00a0\u00a0\u00a0 10-15 min<\/p>\nd)\u00a0\u00a0\u00a0\u00a0 15-20 min<\/p>\n6)\u00a0\u00a0 \u0905\u0927\u094d\u092f\u0936\u0928 may cause\u2026.<\/strong><\/p>\na)\u00a0\u00a0\u00a0\u00a0 Hyperinsulinemia<\/p>\nb)\u00a0\u00a0\u00a0\u00a0 Insulin resistance<\/p>\nc)\u00a0\u00a0\u00a0\u00a0 Both a and b<\/p>\nd)\u00a0\u00a0\u00a0\u00a0 Neither a and b<\/p>\n7)\u00a0\u00a0 Match the pairs<\/strong><\/p>\na)\u00a0\u00a0\u00a0\u00a0 \u092a\u094d\u0930\u0925\u092e \u0905\u0935\u0938\u094d\u0925\u093e\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a01) \u0915\u091f\u0941<\/p>\nb)\u00a0\u00a0\u00a0\u00a0 \u0926\u094d\u0935\u093f\u0924\u0940\u092f \u0905\u0935\u0938\u094d\u0925\u093e\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 2) \u092e\u0927\u0941\u0930<\/p>\nc)\u00a0\u00a0\u00a0\u00a0 \u0924\u0943\u0924\u093f\u092f \u0905\u0935\u0938\u094d\u0925\u093e\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a03) \u0905\u092e\u094d\u0932<\/p>\nA)\u00a0\u00a0\u00a0\u00a0 a (1), b (2), c (3)<\/p>\nB)\u00a0\u00a0\u00a0\u00a0 a (2), b (3), c (1)<\/p>\nC)\u00a0\u00a0\u00a0\u00a0 a (3), b (1), c (2)<\/p>\nD)\u00a0\u00a0\u00a0\u00a0 neither of above<\/p>\n8)\u00a0\u00a0 Which of the following are signs of insulin resistance?<\/strong><\/p>\na)\u00a0\u00a0\u00a0\u00a0 Hyperinsulinemia<\/p>\nb)\u00a0\u00a0\u00a0\u00a0 Hyperglycemia<\/p>\nc)\u00a0\u00a0\u00a0\u00a0 Anti-Insulin antibody<\/p>\nd)\u00a0\u00a0\u00a0\u00a0 All of above<\/p>\n9)\u00a0\u00a0 Match the pairs<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 \u092e\u0927\u0941\u0930 \u0905\u0935\u0938\u094d\u0925\u093e\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u0967) \u0906\u092e\u0936\u092f<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 \u0905\u092e\u094d\u0932 \u0905\u0935\u0938\u094d\u0925\u093e\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u0968) \u0917\u094d\u0930\u0939\u0923\u0940<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 \u0915\u091f\u0941 \u0905\u0935\u0938\u094d\u0925\u093e\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u0969) \u092a\u0915\u094d\u0935\u093e\u0936\u092f<\/p>\nA)\u00a0\u00a0\u00a0\u00a0 a-1, b-2, c-3<\/p>\nB)\u00a0\u00a0\u00a0\u00a0 a-2, b-3, c-1<\/p>\nC)\u00a0\u00a0\u00a0\u00a0 a-3, b-1, c-2<\/p>\nD)\u00a0\u00a0\u00a0\u00a0 neither of above<\/p>\n10) \u092c\u0939\u0941\u092d\u0941\u0915\u094d\u0924\u092e\u0932\u094d\u092a\u092d\u0941\u0915\u094d\u0924\u0902 \u0935\u093e \u0924\u0925\u093e\u093d\u092a\u094d\u0930\u093e\u092a\u094d\u0924\u092e\u0924\u0940\u0924\u0915\u093e\u0932\u0902 \u091a \u092d\u0941\u0915\u094d\u0924\u0902 \u2026\u2026\u092e\u0941\u091a\u094d\u092f\u0924\u0947|<\/strong><\/p>\n(a)\u00a0\u00a0\u00a0\u00a0 \u0905\u0927\u094d\u092f\u0936\u0928<\/p>\n(b)\u00a0\u00a0\u00a0\u00a0 \u0935\u093f\u0937\u092e\u093e\u0936\u0928<\/p>\n(c)\u00a0\u00a0\u00a0\u00a0 \u0938\u092e\u0936\u0928<\/p>\n(d)\u00a0\u00a0\u00a0\u00a0 \u0935\u093f\u0930\u0941\u0926\u094d\u0927\u0936\u0928<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n<table width=\"603\">\n<tbody>\n<tr>\n<td width=\"301\">Question no<\/td>\n<td width=\"301\">Answer<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">1<\/td>\n<td width=\"301\">b<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">2<\/td>\n<td width=\"301\">c<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">3<\/td>\n<td width=\"301\">c<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">4<\/td>\n<td width=\"301\">c<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">5<\/td>\n<td width=\"301\">d<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">6<\/td>\n<td width=\"301\">c<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">7<\/td>\n<td width=\"301\">b<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">8<\/td>\n<td width=\"301\">d<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">9<\/td>\n<td width=\"301\">a<\/td>\n<\/tr>\n<tr>\n<td width=\"301\">10<\/td>\n<td width=\"301\">b<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\nReferences:<\/strong><\/p>\n<ol>\n<li style=\"text-align: justify;\">Yaribeygi, H., Farrokhi, F. R., Butler, A. E., & Sahebkar, A. (2019). Insulin resistance: Review of the underlying molecular mechanisms.\u00a0Journal of cellular physiology<\/em>,\u00a0234<\/em>(6), 8152\u20138161. https:\/\/doi.org\/10.1002\/jcp.27603<\/li>\n<li style=\"text-align: justify;\">Tripathi B., editor.\u00a0Charak Samhita; Varanasi.<\/em>1st<\/sup>ed. Chikitsasthan, Grahani Chikitsa Addhyaya, chapter 15, verse 6, 57 Chaukhamba Surbharti Prakashan; 2013<\/li>\n<li style=\"text-align: justify;\">Sharma S., editor.\u00a0Ashtang sangraha Samhita; Varanasi.<\/em>1st<\/sup>ed. Sutrasthan, Annapanviddhi adhyaya, chapter 10, verse 27 Chaukhamba Surbharti Series; 2016<\/li>\n<li style=\"text-align: justify;\">Tripathi B., editor.\u00a0Charak Samhita; Varanasi.<\/em>1st<\/sup>ed. Chikitsasthan, Grahani Chikitsa Adhyay, chapter 15, verse 9, 10 Chaukhamba Surbharti Prakashan; 2013<\/li>\n<li style=\"text-align: justify;\">Tripathi B., editor.\u00a0Charak Samhita; Varanasi.<\/em>1st<\/sup>ed. Sutrasthan, Aatreyabhadrakapyiaya Adhyaya, chapter 26, verse 41 Chaukhamba Surbharti Prakashan; 2013<\/li>\n<li style=\"text-align: justify;\">Di Pino A, DeFronzo RA. Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents.\u00a0Endocr Rev<\/em>. 2019; 40(6):1447-1467. doi:10.1210\/er.2018-00141<\/li>\n<li style=\"text-align: justify;\">Park SY, Gautier JF, Chon S. Assessment of Insulin Secretion and Insulin Resistance in Human.\u00a0Diabetes Metab J<\/em>. 2021; 45(5):641-654. doi:10.4093\/dmj.2021.0220<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"  Adhyashan: A Key Factor in Insulin Resistance Dr. Amit Nakanekar, MD (Ayu.), Ph.D., Assistant Professor, Department of Kaychikitsa, Government Ayurveda College, Nagpur   Insulin resistance is the phenomenon by which the cell inhibits the entry of insulin molecules inside the cell. This is responsible for defective insulin action. For many hormones in the body, […]<\/p>\n","protected":false},"author":20,"featured_media":3237,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"video","meta":{"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[116,127,34,54],"tags":[],"class_list":["post-2313","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-complete-module","category-dr-amit-nakanekar","category-kaya-chikitsa","category-videos","post_format-post-format-video"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Adhyashan: A Key Factor in Insulin Resistance Dr. Amit Nakanekar, MD (Ayu.), Ph.D., Assistant Professor, Department of Kaychikitsa, Government Ayurveda College, Nagpur Insulin resistance is the phenomenon by which the cell inhibits the entry of insulin molecules inside the cell. This is responsible for defective insulin action. 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