Prameha, described in Ayurvedic classics as a Tridoshaja disorder with predominant Kapha and Meda dushti, clinically correlates with type 2 diabetes mellitus (T2DM). It presents with Prabhoota Avila Mutrata and systemic features arising from impaired Medo Dhatvagni. While conventional management of T2DM focuses on glycemic control through pharmacotherapy, Ayurveda emphasizes correction of Agni, Lekhana of Meda-Kleda, and restoration of Dhatu metabolism through Shamana chikitsa. The present case study is of 48-year-old male presented with polyuria (Prabhoot mutrata), turbid urine (Avila mutrata), burning sensation in palms/soles, and weakness for 2 months. On the basis of physical findings and investigations the diagnosis of Madhumeha (Type 2 Diabetes Mellitus) was made. The patient received 90 days of exclusive oral Ayurvedic therapy Nishakathkadi Kashaya 15 ml BD, Chandraprabha Vati 500 mg BD and BGR 34 2 tabs BD along with modification of diet and lifestyle. After 3 months, symptoms resolved significantly. This case demonstrates that ayurvedic Shamana Chikitsa targeting Kapha- Meda shamana, Agni Deepana and Pramehaghna action can achieve glycemic control comparable to conventional targets in early – stage T2DM. The findings suggest a potential role for integrative Ayurvedic protocols in T2DM management, warranting further controlled studies.