Ayurveda, the ancient Indian system of medicine, classifies diseases based on Doshic imbalances. Among these, Prameha is a group of disorders, which bear a resemblance to the modern understanding of Diabetes Mellitus. Prameha is further classified into Sthoola Pramehi (associated with obesity) and Krisha Pramehi (associated with leanness). According to Ayurveda, Sthoola Pramehi results from the imbalance of Kapha and Meda (fat tissue) and the obstruction of normal body channels (Srotas) leading to insulin resistance, a hallmark of Type 2 Diabetes Mellitus. Modern correlations suggest that Sthoola Pramehi is akin to obesity-related diabetes, where the body's cells fail to respond effectively to insulin. Krisha Pramehi (Lean Diabetic) on the other hand, is observed in individuals with a lean body constitution. This condition is associated with the imbalance of Vata and depletion of Dhatus (body tissues), leading to frequent urination, emaciation, and general weakness. Krisha Pramehi aligns more closely with Type1 rather than Type 2 Diabetes Mellitus, where the pancreas produces little or no insulin, necessitating external insulin administration. Both Sthoola and Krisha Pramehi manifest due to improper diet and lifestyle, leading to the accumulation of Ama (toxins) and impaired Agni (digestive fire). This results in altered glucose metabolism and urinary anomalies. Ayurvedic management of Prameha focuses on balancing the Doshas and restoring normal metabolic functions. Sthoola Pramehi is treated with therapies aimed at reducing Kapha and Meda, such as dietary modifications, regular physical activity, and herbal formulations like Nisha Triphala Yoga. Krisha Pramehi management involves strengthening the Dhatus and balancing Vata through nourishing diets, Rasayana (rejuvenative) herbs, and specific Panchakarma procedures.