Diabetes is a global endemic with an exponential increase in numbers with 30 million people in 1985, whereas, 415 million in 2015. Diabetes was well described, classified and provided valuable guidance for the prevention and treatment by renowned Ayurveda physicians in 100-600BC. Ayurveda attributes multi-factorial diabetic etiology and described as Diabetes one among the eight major diseases (asthamahagada). For the first time, Ayurveda described association of Staulya (Obesity) with Diabetes mellitus and classified Diabetes as Sahaja Prameha and JatahPrameha correlate with type 1whereas, ApatthyanimittajaPremeha correlate with type 2 diabetes. Madhumeha is a subtype of VatajaPrameha that can occur as the mature stage of type 2 diabetes. W.H.O identified one particular type of diabetes due to malnutrition related diabetes mellitus (MRDM), Ayurveda classified this phenomenon as Krisha Premeha resultant of starvation, excessive intake of dry, bitter and astringent diet. According to modern medicine, Diabetes mellitus is a group of metabolic diseases marked by high level of blood glucose resulting from defects in insulin production. The treatment options were caloric restriction and physical activity to burn excessive blood glucose and fat deposition. However, Charaka Samhita and Susrutha Samhita reported diabetes (Madhumeha) with key symptoms including “bahumutra” (polyuria or frequent urination), Trishna(polydipsia or increased thirst) and (polyphagia or increased hunger). Ayurveda strongly suggested to avoid sedentary living including sleeping in day time, lack of exercise, laziness, sedentary habits, consumes food and drinks which are cold, unctuous, sweet and fatty. According to Ayurveda the line of treatment of prameha is dependent on lifestyle of the person, along with medication and diet, the patient is also advised to lead a healthy lifestyle and live an active life this strongly correlates with modern medical management of diabetes. Different treatment and diet options were suggested to Sthulya (Obese) and Krisha (Asthenic). The treatment in Ayurveda mainly based on proper utilization of excess fat including shodhana (purification process), apatarpana (reduction in body weight by way of diet control or drugs), vyayama (exercise), Langhana (fasting), diet control and cleansing therapies such as vamana (induction of emesis) virecana (induction of purgation) basti (applicatin of medicine through the anal route – in specific conditions) and physical exercise especially adhawa (walking).The suggested treatment options for Krisha type is increasing stamina and vitality by way of tonics (brimhana) diet, medicines and the patient should not be given excessive langhana or apatarpana(starvation). The role of ahara(diet) and vihara (life style) are equally or even more important in diabetes to control blood sugar levels and hence several dietary options were suggested that include but not limited to special and specific cereal, pulses, vegetables, fruits, nuts, meats, wine and oil. The some of the medicines suggested in Ayurveda are Nisamalaka,Darvyadi Kashayam, Chandraprabha vati, Vasantakusumakara ras, IME9 etc. These concepts are proven scientific and correlated with modern science and it is high time to present our heritage in the prevention and management of diabetes.