Abstract
Background: Diabetic nephropathy is a leading cause of diabetes mellitus-related to morbidity and mortality. This study explores efficacy of Ayurvedic medicine, Gandira (Coleus forskohlii Willd Briq) moola churna in management of Incipient Diabetic Nephropathy in type 2 diabetes mellitus (T2 DM). Incipient nephropathy is the early stage of nephropathy with low amount of microalbuminuria (30–299 mg/24 hours).
Materials and Methods: Study is a quasi experimental pilot study, single group, pre post design, in which placebo intervention (n=14) was followed by test intervention (n=10). Fourteen patients of T2 DM with microalbuminuria on stable anti diabetic medications in the age group of 30-70 years of either sex were enrolled. Intervention was with placebo (starch) 500mg capsules twice a day for 90 days. Micro albuminuria assessed at 90th day showed to be positive in 10 patients and were diagnosed as early onset diabetic nephropathy and were intervened with Gandira (Coleus forskohlii Willd Briq) moola Churna 2.5gms twice a day with warm water before food for next 90 days. The primary assessment parameter was Urine microalbuminuria and Cystatin-c and secondary assessments were with fasting, post prandial blood sugar other subjective assessments like Atisweda (Excess sweating), Fatigue, Asyamadhuryam (Sweet taste in oral cavity), Karadaha (burning sensation in palm), Padadaha (burning sensation in foot), Jiwhopadeham (Excess tongue secretions), Sheetapriyatwam (liking for cold temperatures), Mukha shosham (Mouth dryness), Gauravata (Heaviness of body). Follow up were done on 30th, 60th, 90th, 120th, 150th and 180th days.
Results: Intervention with Gandira showed significant improvement in primary criteria of Urine microalbuminuria [p <0.001, p=0.003 (90-180 days), p<0.001 (0-180 days)], and Cystatin-c test (p<0.001) and other secondary parameters like Atisweda (p=0.03), Fatigue (p=0.01), Jiwhopadeham (p=0.01), Sheeta priyatwam (p=0.008), Mukha shosha, (p=0.008), Asyamadhuryam (p=0.03), Karadaha (p=0.03), Padadaha (p=0.01), Guravata (p=0.03).
Conclusion: Coleus forskohlli Willd Briq showed beneficial effect in patients of Incipient Diabetic Nephropathy. However limitations of the study are small sample, single group, non randomised design, lack of assessments through GFR and HbA1C

Key words: Incipient Diabetic nephropathy, Type 2 Diabetes mellitus, Coleus forskohlli., Gandira, Micro albuminuria, Cyastatin C