This report summarizes a feasibility study conducted to assess the development and implementation of an evidence-based clinical practice guideline (EB-CPG) for managing Type 2 diabetes mellitus (T2DM) within Ayurvedic centers in Nepal. T2DM is highly prevalent in Nepal, with many patients seeking traditional Ayurvedic treatment. However, variability in clinical practices and concerns about suboptimal care highlight the need for standardized guidelines. Currently, no EB-CPG exists for T2DM in this context, prompting the development of such a guideline and a subsequent feasibility trial to inform future research.
The study employed a two-arm cluster randomized controlled trial involving fourteen Ayurvedic centers, randomized equally into intervention and control groups. Adults with newly diagnosed, treatment-naïve T2DM and HbA1c levels between 6.5% and less than 9% were recruited. Data collection and analysis were blinded to prevent bias. All centers approached agreed to participate, with one center withdrawing before participant enrollment. A total of 121 participants were recruited (60 intervention, 61 control), with an 80% follow-up rate at six months. Practitioners’ adherence to the EB-CPG was moderate, with a median adherence score of 1-2 (partial to adequate). Participants’ medication consumption and days without intake, as per the guideline recommendations, were minimal, indicating good compliance. No serious adverse events occurred during the study period.
Preliminary results indicated potential benefits of the EB-CPG on key clinical outcomes such as HbA1c, fasting plasma glucose, and health-related quality of life, though these findings were not statistically significant. Overall, the feasibility study demonstrated successful recruitment, retention, and adherence, confirming that a larger, definitive trial is feasible and warranted to evaluate the guideline’s effectiveness in improving T2DM management in Ayurvedic practice.
Reference:
Chattopadhyay K, Karki S, Wang H, Regmi P, Gyanwali P, Upadhyay V, Heinrich M, Bista B, Tandon N, Kinra S, Greenfield SM, Biswas TK, Jeemon P, Leonardi-Bee J, Lewis SA, Dhimal M. Diabetes Management by Ayurvedic Practitioners Using a Clinical Guideline Versus Usual Practice: A Feasibility Cluster Randomized Trial in Nepal. J Diabetes Res. 2026;2026(1):e2602864. doi: 10.1155/jdr/2602864. PMID: 42057342; PMCID: PMC13128970.
