Metabolic Vipaka

Abstract

Diabetes management should focus on biopsychosocial aspects and comprehensive care. The philosophical tenets of Buddhism can be a source of inspiration for both the individual with diabetes and health care provider. Buddhism preaches the immutable relationship between action and outcomes. This has a corollary in diabetes care; optimized metabolic control in diabetes is associated with improved short- and long-term outcomes and a legacy effect. Buddhism emphasizes on maintaining a “middle path.” When applied to diabetes care, this would mean avoiding both extremes of hyperglycemia and hypoglycemia and optimization of metabolic health while minimizing treatment-emergent adverse events. Mindfulness meditation-based stress reduction strategies may further improve not only psychological health but also biophysical outcomes in diabetes and merit further research.

Keywords

biopsychosocial diabetes management - metabolic karma - metabolic vipaka - mindfulness meditation

• References

• 1 Kalra S, Priya G, Grewal E. et al. Lessons for the health care practitioner from Buddhism. Indian J Endocrinol Metab 2018; 22 (06) 812-817
• 2 Kalra S, Priya G, Grewal E. et al. Diabetes management and the Buddhist philosophy: toward holistic care. Indian J Endocrinol Metab 2018; 22 (06) 806-811
• 3 Schnell O, Rydén L, Standl E, Ceriello A. D&CVD EASD Study Group. Updates on cardiovascular outcome trials in diabetes. Cardiovasc Diabetol 2017; 16 (01) 128
• 4 John M, Gopalakrishnan UnnikrishnanA, Kalra S, Nair T. Cardiovascular outcome trials for anti-diabetes medication: a holy grail of drug development?. Indian Heart J 2016; 68 (04) 564-571
• 5 Ihnat MA, Thorpe JE, Ceriello A. Hypothesis: the ‘metabolic memory’, the new challenge of diabetes. Diabet Med 2007; 24 (06) 582-586
• 6 Chalmers J, Cooper ME. UKPDS and the legacy effect. N Engl J Med 2008; 359 (15) 1618-1620
• 7 Thomas MC. Glycemic exposure, glycemic control, and metabolic karma in diabetic complications. Adv Chronic Kidney Dis 2014; 21 (03) 311-317
• 8 Kalra B, Joshi A, Kalra S. et al. Coping with Illness: insight from the Bhagavad Gita. Indian J Endocrinol Metab 2018; 22 (04) 560-564
• 9 Kalra S, Joshi A, Kalra B. et al. Bhagavad Gita for the physician. Indian J Endocrinol Metab 2017; 21 (06) 893-897
• 10 Priya G, Kalra S, Dardi IK. et al. Diabetes care: inspiration from Sikhism. Indian J Endocrinol Metab 2017; 21 (03) 453-459
• 11 Niazi AK, Kalra S. Patient centered care in Islam: distinguishing between religious and sociocultural factors. J Diabetes Metab Disord 2013; 12 (01) 30
• 12 Kalra S, Ved J, Baruah MP. Diabetes destiny in our hands: Achieving metabolic karma. Indian J Endocrinol Metab 2017; 21 (03) 482-483
• 13 Kalra S, Kawatra P. Metabolic karma in diabetes care: medico-philosophical reflections. Indian J Endocrinol Metab 2017; 21 (04) 643-644
• 14 Cooper ME, El-Osta A, Allen TJ, Watson AMD, Thomas MC, Jandeleit-Dahm KAM. Metabolic Karma—the atherogenic legacy of diabetes: The 2017 Edwin Bierman Award Lecture. Diabetes 2018; 67 (05) 785-790
• 15 Gæde P, Oellgaard J, Carstensen B. et al. Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial. Diabetologia 2016; 59 (11) 2298-2307
• 16 Priya G, Kalra S. Mind-body interactions and mindfulness meditation in diabetes. Eur Endocrinol 2018; 14 (01) 35-41