Yoga and Diabetes

Research evidence

• Sahay (1986) demonstrated a significant reduction in fasting and post prandial glucose levels, insulin glucose ratio, and reduction in oral glycemic agents and insulin requirements after yoga breathing practices called Pranayama.
• Monro et all (1992) in their study on Yoga therapy for NIDDM have shown that the yoga group improved significantly in their fasting glucose levels as well as HbA1C levels.
• Few subjects even reduced their tablets after practice of Yoga over a period of 12 weeks.
• Yoga therapy (Khalsa, 2004) is a relatively novel and emerging clinical discipline within the broad category of mind-body medicine, whose growth is consistent with the burgeoning popularity of yoga in the West and the increasing worldwide use of alternative medicine.
• Observations on blood glucose and glucose tolerance by oral glucose tolerance test (OGTT) after 40 days of yoga therapy in 149 noninsulin-dependent diabetics (NIDDM) showed a fair to good response to the yoga therapy in 104 patients.
• There was a significant reduction in hyperglycemia and area index total (AIT) with decrease in oral hypoglycemia and AIT with decrease in oral hypoglycemic drugs required for maintenance of normoglycemia (Jain et al., 1993).
• Another study on 19 non - insulin dependent diabetes subjects with in the age group of 30-60 years showed a significant reduction in Fasting & postprandial glucose level, glycosylated hemoglobin level and oxidative stress level measured by serum malondialdehyde (MDA) level following 40 days of daily 30-40 minutes of Yoga practice (Singh Set al., 2001).
• Another study with similar parameters on lipid profile and oxidative stress on 77 type 2 diabetes patients also showed significant improvement in glycemic index, lipid profile and significant reduction in MDA and significant increase in Super oxide dismutase levels following six months of Hatha yoga (Gordon LA et al., 2008).
• In another similar type of study on twenty Type 2 diabetic subjects between the age group of 30-60 years were practiced 40 days of Yoga asanas (30-40 minutes every day) and the results showed beneficial effect on glycaemic control and improve nerve function in mild to moderate type 2 diabetes with sub-clinical Neuropathy (Malhotra et al., 2002).
• In another study on role of yoga in modifying certain cardiovascular functions in type 2 diabetes patients showed better glycaemic control and stable autonomic functions (Singh, 2004).
• A 10 day (pre and post design) (Bijlani et al., 2005) study has shown the impact of a brief life style intervention based on yoga on some of the biochemical indicators of risk for cardiovascular disease and diabetes mellitus at Integral Health Clinic (IHC), an outpatient facility which conducts 8 - day life style modification programs based on yoga for prevention and management of chronic disease with an intervention of asanas (postures), pranayama (breathing exercises), relaxation techniques, group support, individualized advice, lectures and films on the philosophy of yoga and the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness.
• As a result, fasting plasma glucose, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, very LDL cholesterol, the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol, and total triglycerides were significantly lower, and HDL cholesterol significantly higher, on the last day of the course compared to the first day of the course.
• The changes were more marked in subjects with hyperglycemia or hypercholesterolemia, observations suggested that a short lifestyle modification and stress management education program lead to favorable metabolic effects within a period of 9 days.
• In another study, twenty NIDDM subjects (mild to moderate diabetics) in the age group of 30-60 years were, from the outpatient clinic of a hospital for a 40 days yoga asana for patients with type 2 Diabetes which included, Surya Namaskar, Trikonasana, Tadasana, Sukhasana, Padmasana , Bhastrika Pranayama, Paschimottanasana, Ardhmatsyendrasana, Pawanmuktasana, Bhujangasana, Vajrasana, Dhanurasana and Shavasana. Results indicated that there was significant decrease in fasting glucose levels and postprandial blood glucose levels.
• The exact mechanism as to how these postures and controlled breathing interact with somato endocrine mechanism affecting insulin kinetics was worked out.
• A significant decrease in waist-hip ratio and changes in insulin levels were also observed, suggesting a positive effect of yoga asanas on glucose utilisation and fat redistribution in NIDDM. Yoga asanas may be used as an adjunct with diet and drugs in the management of type 2 diabetes (Malhotra et al., 2005).
• A review article in 2006 by lnnes KE et al identified 25 eligible studies investigating the influence of yoga-based interventions on physiologic/anthropometric indices of DM 2 and/or related clinical outcomes, including 15 uncontrolled clinical trials, 6 NRCTs and 4 RCTs documented an improvement in markers of insulin resistance following the practice of yoga either alone or in combination with other therapies. Interventions ranged in length from 8 days to 12 months and also demonstrated significant positive changes in blood lipid levels following yoga-based interventions that ranged from 8 days to 3 months in duration.
• Observed improvements in blood lipid fractions included reductions in cholesterol, triglycerides, low density lipoprotein (LDL) and very LDL levels increases in high density lipoprotein (HDL) levels and reduced LDL/HDL ratio relative to baseline levels and/or control values.
• The review article also showed reduction in body weight reductions in waist/hip ratio and/or improvements in body composition following yoga-based interventions ranging from 40 days to 12 months data also suggest that yoga-based interventions may also have beneficial effects on coagulation profiles and oxidative stress, Sympathetic activation and lung function in adults with DM 2 (Innes KE et al., 2007).
• Recent studies have also shown significant improvement in the risk factors for type 2 diabetes such as weight, blood pressure, insulin, triglycerides and exercise self-e cacy following 3 months of weekly twice yoga program compared to educational group (Yang K et al., 2009), significant reduction in blood glucose levels following 3 months of yoga nidra practice (Amita Set al., 2009) and significant improvement in the cognitive brain function as assessed by p3 event related evoked potential (ERP) following forty five days of yoga practice Compared to control group (Kuizom T et al., 2010).
• A study published in 2008 by Bazzano LA et al, showed that consumption of green leafy vegetables and fruits lowers the hazard of diabetes and consumption of fruit juices may increase the hazard of diabetes among 71,346 female nurses aged 38-63 years followed for 18 years (Bazzano LA et al., 2008).
• Recent unpublished prospective randomized control study under the grant in aid from CCRYN on 302 patients with type 2 DM (215 male, 87 female), aged between 53-58 years.
• The results of the study showed significant reduction in glycemic index (FBS, Glycated hemoglobin), insulin resistance, lipid profile along with significant reduction in psychological parameters such as anxiety, depression and significant improvement in quality of life in the Yoga based life style change program over a period of one year Compared to supervised physical exercise based lifestyle modification program (Nagarathna R et al., Effect of Yoga based lifestyle intervention in preventive diabetology and Cardiology-Final report).

Source : Yoga based life style module for diabetic

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