Type 2 Diabetes Mellitus (T2DM) is a growing metabolic disorder with rising global prevalence. Conventional pharmacological management, while effective, is often associated with long-term side effects and medication dependence. Ayurveda offers a holistic approach to Prameha (diabetes) through multi-modal interventions. This study evaluates clinical outcomes of an integrated Ayurvedic protocol combining individualized Panchakarma therapies, oral herbal medications, and a structured low-calorie diet in patients with T2DM. This retrospective observational study analyzed data from 29 patients (21 males, 8 females; mean age 45.4 ± 11.3 years) diagnosed with T2DM, treated at the Kharadi branch of a specialised Ayurvedic diabetes management clinic. Patients received one of two Panchakarma-based care plans — CDC-SP therapy (BMI ≥ 23) or CDC-KP therapy (BMI < 23) — comprising Snehan, Swedan, and Basti. All patients were concurrently prescribed oral herbal medications and an 800 kcal Prameha Diet Box. Statistically significant improvements were observed across all measured parameters (p < 0.001). Mean HbA1c decreased from 10.02% to 7.27% (Δ = −2.75%). Mean RBS declined from 226.4 to 141.5 mg/dL (Δ = −85.0). Body weight reduced by 6.2 kg, BMI by 4.32 kg/m², and abdominal girth by 7.1 cm. Systolic blood pressure improved by 12.9 mmHg and diastolic by 4.8 mmHg. The integrated multi-modal Ayurvedic intervention demonstrated clinically meaningful and statistically significant improvements in glycaemic control, anthropometric indices, and blood pressure in T2DM patients. Prospective controlled studies with larger sample sizes are warranted to confirm these findings.