Hello dr Prabat  

                          In response  to ur ques. about Madhumeha I want to tell you that its not always true that each  time madhumeha is followed after untreated pittaj & kaphaj  prameha .If you are of Vataj prakriti& on that you are doing Vat promoting Ahara vihara & you have Vishamagni you are bound to develop Madhumeha. More over if it developed after  untreated pramehas how could you interpret that it is the same way when patient doesnt come to you in early stage.

.directly madhumeha can occur due to vata avarna