Background: Type 2 Diabetes Mellitus (T2DM) constitutes a major public health crisis in India, with 101 million patients as of 2023. Conventional pharmacotherapy, while effective in glycemic control, is constrained by polypharmacy, medication non-adherence (11-68%), and failure to address underlying metabolic derangements. Ayurvedic Basti therapy - per-rectal administration of medicated preparations -is classically indicated in Prameha (diabetes) and has emerging mechanistic support through gut-metabolic axis modulation, but robust multi-patient retrospective outcome data remain limited.