Unraveling the Layers: How the Koshas & Chakras of Well-Being Illuminate a Path for Integrative + Whole-Person Care for Diabetes
Living with Type 1 Diabetes (T1D) is an intricate dance between self-awareness, adaptability, and resilience. It is a relentless condition that demands constant vigilance and impacts every facet of life. In yoga philosophy, the koshas—five interconnected layers of existence—offer a framework that helps illustrate how T1D is not merely a physiological condition but one that reverberates through life's mental, emotional, energetic, and even spiritual dimensions. Likewise, Dr. Suzie Carmack’s Chakras of Well-Being provides an integrative approach to understanding how various domains of life interact, reinforcing the reality that T1D is both affected by and affects every layer of our existence.
The Koshas: A Blueprint for Understanding T1D’s Holistic Impact
In yoga philosophy, the koshas are described as five layers of being, moving from the physical body to the more subtle aspects of mind and spirit:
Annamaya Kosha (Physical Body): This is the most apparent level affected by T1D. The body becomes dependent on exogenous insulin, requiring continuous management of blood glucose levels through constant monitoring and precise calculations for insulin dosing to create a synergistic effect between insulin and the other 40+ variables that affect blood glucose levels. Chronic inflammation, complications, and other co-existing conditions further stress the physical layer.
Pranamaya Kosha (Energy Body): Prana, or life force energy, is regulated through breath and the nervous system. For someone with T1D, variability in blood sugar levels can create energy fluctuations, often resulting in extreme fatigue. Additionally, the body is constantly engaged in a stress response due to constant monitoring, data and decision fatigue, and fluctuating glucose levels, keeping the autonomic nervous system in a state of high alert.
Manomaya Kosha (Mental and Emotional Body): Studies have estimated that people managing T1D make 180 more daily decisions than those not managing life with diabetes. It is also estimated that people managing T1D receive about 6000 data points daily. This is a perfect storm for data fatigue, mental overwhelm, and emotional distress. The constant calculations, decision-making, and unpredictability contribute to a wide range of mental and emotional overwhelm, causing anxiety, burnout, depression, and many other mental and emotional coping strategies. This chronic state of mental and emotional stress influences both how we manage blood sugar and blood sugar variability, due to the internal relationship between hormones, neurotransmitters, and blood sugar. It is a relentless cycle.
Vijnanamaya Kosha (Wisdom Body): This Kosha represents self-awareness and the intuitive body. Although people with T1D develop a heightened sense of bodily awareness, chronic stress and overstimulation create turbulence and disconnection in the Vijnanamaya Kosha that interferes with a person’s ability to trust and recognize their body's signals and intuition, both consciously, and subconsciously. Too much noise —stress and overstimulation — consistently and over time, is trauma to the nervous system. The impact of consistent trauma to the nervous system without healing intervention, not only paves the way for systemic disruption, disconnection, and dis-ease due to the complex interconnectedness of human physiology, but also shows the direct relationship between energetic discord in one area of the body manifesting as physical disease or inflammation.
Anandamaya Kosha (Bliss Body): At the deepest layer, T1D can feel like a barrier to WHOLE-istic well-being. However, it can inversely provide a path to WHOLE-istic and spiritual wellbeing, illuminating the areas that need our attention. This innermost sheath, the Anandamaya Kosha, represents the homecoming to the Spiritual Self. Consistency and commitment to yoga philosophy, practices, and lifestyle help to foster Self-awareness, clear energetic pathways, and create an internal environment for continued healing and harmony, allowing us to experience Wholeness in the duality of our human experience with diabetes, but not defined by it.
Chakras of Well-Being: A Multidimensional Perspective
Dr. Suzie Carmack’s Chakras of Well-Being provides another holistic framework that aligns with the koshas. Her model integrates physical, financial, social, mental, emotional, and purpose dimensions of wellness and wellbeing, further demonstrating how T1D is inextricably linked to every part of life.
Physical Well-Being: The tip of the iceberg.
Emotional and Mental Well-Being: The immensity of the iceberg beneath the surface.
Social Well-Being: Not directly addressed through the Kosha framework, T1D also impacts relationships in ways many don’t realize or cannot comprehend until they’re experiencing its effects. Sometimes, it is the stigma of an invisible condition, the isolation in both the lived and loved experience, and the disconnection it can create within families, communities, and other social dynamics.
Financial Well-Being: The economic burden of T1D is immense. Insulin, medical devices, and healthcare costs create significant financial strain, reinforcing the urgent need for health equity and accessibility. This dimension of well-being also includes the amount of time and energy that people living with T1D expend in managing the condition, dealing with health insurance, time in doctor’s appointments, grocery shopping for hypo snacks, visiting the pharmacy, etc. Dividing Financial Well-Being into three layers — time, talent, and treasure — helps to understand the “whole-istic” impact of T1D in the financial domain.
Purpose Well-Being: Purpose well-being addresses how people tell and integrate their story to themselves and the world around them. This layer of well-being overlaps with the Anandamaya Kosha addressing wholeness in the duality of our human experience with diabetes, but not defined by it.
The Chronic Stress Loop and the Case for Integrative Healthcare
When T1D affects every layer of the body but only addresses one layer in T1D management, the body remains in a chronic stress state, further exacerbating insulin resistance and inflammatory responses. This creates a vicious cycle in which stress worsens diabetes management and diabetes management fuels stress.
An integrative and holistic healthcare approach—one that addresses each Kosha layer and Chakra of Well-Being—can help break the cycle of chronic stress and trauma to the internal systems, physically and energetically. By acknowledging the full spectrum of the human experience and the needs within, rather than focusing solely on glucose management, we can create a more sustainable model for diabetes care.
The Economic Impact of Integrative Healthcare
Like a human body with T1D, our healthcare systems are a complex and interwoven matrix of dis-ease. Incorporating holistic modalities to transition to an integrative healthcare model is not just about personal well-being—it also has a significant economic and systemic impact. Research suggests integrative approaches reduce hospitalizations and improve overall quality of life for the lived, loved, and laboured experience — those working within diabetes healthcare and industry.
Health equity is critical in this transition. When access to holistic care is limited to those with financial privilege, we perpetuate systemic disparities. Advocacy for policy changes, insurance coverage for complementary therapies, and increased education around integrative care must be prioritized to ensure all individuals, regardless of socioeconomic status, can benefit.
Conclusion: A Call for a Holistic Paradigm Shift
Understanding T1D through the lens of the koshas and chakras of well-being reveals an undeniable truth—this condition is more than just a physical diagnosis. It affects every aspect of life, and in turn, every aspect of life affects diabetes management. Without an integrative and equitable approach to healthcare, those living with T1D are left to navigate an unsustainable system that fails to address the full spectrum of their needs.
By advocating for a healthcare paradigm that embraces holistic and integrative approaches using blueprints like the Chakras of Wellbeing and Koshas Framework, we move toward a future where T1D management addresses the whole human experience for whole-person health + wellness. The time to bridge the gap between traditional medicine and whole-person care is now.
