Background: This paper review different approach about Prameha and Diabetes mellitus, its pathopysiology, and treatment principles. Also reveals whether we are treating patients or only Hyperglycemia. With some alteration of the definition, the attempt is made to reconcile the conflicting evidence with the current conceptual scheme. Aim: To reconcile the contradictory facts with the existing conceptual scheme of Ayurveda w.s.r. to Prameha and diabetes mellitus. Methodology: The data contents have to be classified as the pathophysiology of Prameha and its treatment principles, and interpreted in terms of the western system of Medicine. Such a comprehensive collection of data has made from Brihatrai and Laghutraisamhita. Structured as- Prameha as Error in metabolism. Drugs/ Kalpas indicated in Prameha and their significance. Myth and Facts about Prameha and Diabetes Mellitus. Results: Prameha is a metabolic disorder and it can be definitely cure by following Ayurvedic conducts as doing corrections in diet and lifestyle. Conclusions: 1. Prameha is a more broad term over Diabetes Mellitus. 2. Popular modern belief in treating hyperglycemia with hypoglycemic drugs is not followed in Ayurveda to treat Prameha. 3. Pramehas treatment may not be essentially mean to have hypoglycemic effects only.