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Effectiveness of Yoga for Patients With Diabetes Mellitus


Affiliations
1 Swami Vivekananda Yoga Anusandhana Samsthana, Vivekananda Road, Kalluballu Post, Anekal Tq, Jigani 560 105, India
2 NIMHANS Integrated Centre for Yoga, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
3 Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
 

Diabetes mellitus is a multifactorial metabolic disorder which requires lifestyle interventions for its management. A number of controlled yoga trials in last few years have observed lifestyle interventions especially yoga to be efficacious in the management of diabetes. The aim of this study is to systematically review the research conducted in the field to understand the effectiveness of yoga on diabetes mellitus. A systematic search was done using search engines such as PubMed, Google Scholar, Cochrane Library, MEDLINE, CAMbase, PsycINFO and IndMED. A total of 212 articles were selected, of which 166 were excluded and 46 controlled trials (CTs) were included in the review. Among the 46 CTs, 31 studies were categorized based on the primary outcome variables, 10 were based on the secondary outcome variables and 5 studies were control studies. Risk of bias assessment was conducted on all the studies. The review demonstrates significant improvement due to yoga practice in the primary outcome measures such as blood glucose levels along with secondary outcome measures such as cardiac autonomic variables, lipid profile, liver enzymes, respiratory variables, quality of life, anxiety and depression. Thus yoga has not only been found to be beneficial for improved glycaemic control, but also for the wide variety of symptoms associated with the diabetes. Despite this evidence, it is worth mentioning that further gold standard randomized controlled trials are warranted with more specific sets of practice, to prescribe yoga especially as an alternative treatment for the management of diabetes.

Keywords

Controlled Trials, Diabetes Mellitus, Primary and Secondary Outcome Variables, Yoga.
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  • WHO/NCD/NCS/99.2, Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO Consultation, World Health Organization, Geneva, 1999.

  • Wild, S., Roglic, G., Green, A., Sicree, R. and King, H., Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care, 2004, 27(5), 1047–1053.

  • Tuomilehto, J. et al., Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med., 2001, 344(18), 1343–1350.

  • Ching, S. M., Zakaria, Z. A., Paimin, F. and Jalalian, M., Complementary alternative medicine use among patients with type 2 diabetes mellitus in the primary care setting: a cross-sectional study in Malaysia. BMC Complement Altern. Med., 2013, 26(13), 148; doi: 10.1186/1472-6882-13-148.

  • Malhotra, V. et al., Effect of yoga asanas on nerve conduction in type 2 diabetes. Indian J. Physiol. Pharmacol., 2002, 46, 298–306.

  • Malhotra, V., Singh, S., Tandon, O. P. and Sharma, S. B., The beneficial effect of yoga in diabetes. Nepal Med. Coll. J., 2005, 7(2), 145–147.

  • Manyam, B. V. and Sahay, B. K., Lifestyle modification in management of diabetes mellitus. J. Indian Med. Assoc., 2002, 100, 178–180.

  • Kumar, V. et al., Role of yoga for patients with type II diabetes mellitus: a systematic review and meta-analysis. Complement. Ther. Med., 2016, 25, 104–112.

  • Pandey, A., Tripathi, P., Pandey, R., Srivastava, R. and Goswami, S., Alternative therapies useful in the management of diabetes: a systematic review. J. Pharm. Bioall Sci., 2011, 3(4), 504–512.

  • Yang, K., A review of yoga programs for four leading risk factors of chronic diseases. Evid.-based Complement. Altern. Med., 2007, 4, 487–491.

  • Liberati, A. et al., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 2009, 339, 2700.

  • Higgins, J., Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011; www.cochrnae-handbook.org

  • Abirami, P. and Raj, J., Impact of yoga on blood glucose level among mothers with gestational diabetes mellitus at government hospital, Tambaram, Chennai, Tamil Nadu. Indian J. Health Wellbeing, 2013, 4, 99.

  • Amita, S., Prabhakar, S., Manoj, I., Harminder, S. and Pavan, T., Effect of yoga-nidra on blood glucose level in diabetic patients. Indian J. Physiol. Pharmacol., 2009, 53, 97–101.

  • Arjunan. D. B. and Rajam. A., Effect of simplified Kundalini Yoga (Sky) meditation, exercise and Kayakalpa Yoga on blood sugar levels of diabetic patients. Aayvagam Int. J. Multidisc. Res., 2013, 1(4), 6–13.

  • Beenarani, K. and Sreekumaran, E., Management of elevated liver enzymes in geriatric diabetes by yogic practice. Int. Multidisci. Res. J., 2012, 2(8), 27–31; ISSN: 2231-6302; available online: http://irjs.info/.

  • Bhardwaj, D., Agnihotri, V. K. and Pandya, P., A comparative study of yoga and ayurvedic intervention in the management of type 2 diabetes mellitus. Int. J. Sci. Consci., 2015, 1, 37–44.

  • Cokolic, M., Stangler Herodez, S., Sternad, S. and Krebs, S., The inhibitory effect of laughter yoga on the increase in postprandial blood glucose in type 2 diabetic patients. Diabetol. Croat., 2013, 42, 54–58.

  • Dash, S. and Thakur, A. K., Effect of yoga in patient’s with type I diabetes mellitus. J. Evol. Med. Dent. Sci., 2014, 3, 1642–1655.

  • Deshmukh, S. and Bedekar, N., Yoga therapy as potential treatment for type II diabetic patients. Am. J. Diabetes, Obesity Metab., 2015, 2(1), 1–7; http://ivyunion.org/index.php/aajdom/index

  • Gordon, L. et al., Effect of yoga and traditional physical exercise on hormones and percentage insulin binding receptor in patients with type 2 diabetes, Department of Medicine, University Hospital of the West Indies, Kingston 7, Jamaica Department of Basic Medical Science. Am. J. Biochem. Biotechnol., 2008, 4, 35–42.

  • Karthikeyan, J., Effect of yoga and aerobic training on bio chemical variables in middle aged diabetic patients. Int. J. Sci. Cult. Sport, 2015, 3(2), 13–20.

  • Mondal, S., Kundu, B. and Saha, S., Blood sugar and lipid profile adaptations to yoga therapy. J. Yoga Phys. Ther., 2014, 4, 175; doi:10.4172/2157-7595.1000175.

  • Nagarathna, R. et al., Efficacy of yoga based lifestyle modification program on medication score and lipid profile in type 2 diabetes – a randomized control study. Int. J. Diabetes Dev. Ctries., 2012, 32, 122–130.

  • Popli, U., Subbe, C. P., Research letter – the role of yoga as a lifestyle results of a pilot study. Altern. Ther., 2014, 20, 24–26.

  • Bharatha Priya, K. and Gopinath, R., Effect of yogic practices and physical exercises on blood glucose and high density lipoproteins among diabetes patients. Int. J. Health Phys. Educ. Comput. Sci. Sport, 2012, 5, 30–32.

  • Rast, S. D., Hojjati, Z. and Shabani, R., The effect of yoga training on lipid profile and blood glucose in type II diabetic females. 2013, 4, 128–133.

  • Rajani, S. N., Indla, Y. R. and Archana, R., Role of yoga on cardic autonomic function tests and cognition in type 2 diabetes. Int. J. Res. Ayurveda Pharm., 2015, 6, 764–766.

  • Singh, S., Kyizom, T., Singh, K. P., Tandon, O. P. and Madhu, S. V., Influence of pranayamas and yoga-asanas on serum insulin, blood glucose and lipid profile in type 2 diabetes. Indian J. Clin. Biochem., 2008, 23, 365–368.

  • Singh, V. P., Khandelwal, B. and Sherpa, N. T., Effect of yoga and music therapy with standard diabetes care in type II diabetes mellitus – a randomized control study. Int J. Adv. Res., 2015, 3(6), 386–399.

  • Thangapandiyan, G. S. and Mahaboobjan, D. A., Effect of yoga on glycaemic level: a pilot, randomized, comparative study between walking and yoga in adult male with type 2 diabetes mellitus. Int. J. Manage. Soc. Sci. Res. Rev., 2015, 1, 253–257.

  • Arab-Sheibani, K., Alipor, A., Poursharifi, H. and Zare, H., The impact of mindfulness-based cognitive therapy (MBCT) on mental and physical well-being indicators in patients with type 2 diabetes. Zahedan J. Res. Med. Sci., 2013, 16, 19–23.

  • Giri, M. K. W., Artanayasa, W. I. and Putra, A., Effect of yoga on atherosclerosis risk in type 2 diabetes. The 1st international conference on innovative research across disciplines. J. Chem. Inf. Model., 2015, 53, 147–152

  • Hartmann, M. et al., Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger diabetes and stress-study). Diabetes Care, 2012, 35, 945–947.

  • Jyotsna, V. et al., Comprehensive yogic breathing program improves quality of life in patients with diabetes. Indian J. Endocrinol. Metab., 2012, 16, 423.

  • Kerr, D. et al., An Eastern art form for a Western disease: randomised controlled trial of yoga in patients with poorly controlled insulin‐treated diabetes. Pract. Diabetes Int., 2002, 19, 164–166.

  • McDermott, K. A. et al., A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial. BMC Complement. Altern. Med., 2014, 14, 1.

  • Skoro-Kondza, L., Tai, S. S., Gadelrab, R., Drincevic, D. and Greenhalgh, T., Community based yoga classes for type 2 diabetes: an exploratory randomised controlled trial. BMC Health Serv. Res., 2009, 9, 33.

  • Tovote, K. A. et al., Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care, 2014, 37, 2427–2434.

  • Tovote, K. A. et al., Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial. Psychother. Psychosom., 2015, 84, 186–187.

  • van Son, J. et al., The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA1c in outpatients with diabetes (DiaMind): a randomized controlled trial. Diabetes Care, 2013, 36, 823–830.

  • van Son, J., Nyklíček, I., Popa, V. J., Blonk, M. C., Erdtsieck, R. J. and Pouwer, F., Mindfulness-based cognitive therapy for people with diabetes and emotional problems: long-term follow-up findings from the DiaMind randomized controlled trial. J. Psychosom. Res., 2014, 77(1), 81–84; doi:10.1016/j.jpsychores.2014.03.013.

  • Santhakumari, R., Reddy, I. Y. and Archana, R., Role of yoga in alienating the memory decline and frontal lobe metabolite changes in type 2 diabetes. Int. J. Res. Ayurveda Pharm., 2016, 7, 78–81.

  • Bhavanani, A. B., Madanmohan, Sanjay, Z. and Basavaraddi, I. V., Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Indian J. Physiol. Pharmacol., 2012, 56, 273–278.

  • Jayanti, A. and Kohli, G. K., Efficacy of yoga, diet and exercise based lifestyle modification program on adjustment of body mass index in type-Ll diabetes mellitus, 18–24.

  • Jyotsna, V. P. et al., Cardiac autonomic function in patients with diabetes improves with practice of comprehensive yogic breathing program. Indian J. Endocrinol. Metab., 2013, 17(3), 480–485; doi:10.4103/2230-8210.111645.

  • Miller, C. K., Kristeller, J. L., Headings, A. and Nagaraja, H., Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes a randomized controlled trial. Health Educ. Behav., 2014, 41, 145–154.

  • Rahmani, S., Zahirrodin, A., Moradi, M., Hoveida, S. and Nejati, S., Examining the effectiveness of mindfulness-based stress reduction program and conscious yoga on quality of life in patients with diabetes type 2. Iran. J. Diabetes Obes., 2015, 6, 168–175.

  • Schroevers, M. J. et al., Individual mindfulness-based cognitive therapy for people with diabetes: a pilot randomized controlled trial. Mindfulness, 2015, 6, 99–110.

  • Shantakumari, N. and Sequeira, S., Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia. Indian Heart J., 2013, 65, 127–131.

  • Tiwari, S., Tiwari, S., Gehlot, S. and Singh, G., Outcome of breathing exercise (pranayam) on spirometric parameters in type 2 diabetic individuals: a clinical study. J. Stress Physiol. Biochem., 2012, 8, 218–225.

  • Verma, M. K., Biswas, D. A., Tripathi, S. and Verma, N. S., Role of autogenic relaxation in management of diabetic cardiovascular autonomic neuropathy in type II diabetes mellitus patients. Int. J. Res. Med. Sci., 2016, 4, 1193–1199.

  • Son, J., Nyklicek, I., Pop, V. J. M. and Pouwer, F., Testing the effectiveness of a mindfulness-based intervention to reduce emotional distress in outpatients with diabetes (DiaMind): design of a randomized controlled trial. BMC Public Health, 2011, 11, 1.

  • Streeter, C. C. et al., Yoga asana sessions increase brain GABA levels: a pilot study. J. Altern. Complement. Med., 2007, 13, 419–426.

  • Kyizom, T., Singh, S., Singh, K. P., Tandon, O. P. and Kumar, R., Effect of pranayama and yoga-asana on cognitive brain functions in type 2 diabetes-P3 event related evoked potential (ERP). Indian J. Med. Res., 2010, 131, 636–640.

  • Gordon, L. A. et al., Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement. Altern. Med., 2008, 8, 21.

  • Chung, S.-C., Brooks, M. M., Rai, M., Balk, J. L. and Rai, S., Effect of sahaja yoga meditation on quality of life, anxiety, and blood pressure control. J. Altern. Complement. Med., 2012, 18, 589–596.

  • Aggarwal, R. P. et al., Influence of yogic treatment on quality of life outcomes, glycemic control and risk factors in diabetes mellitus. Int. J. Diabetes Dev. Ctries, 2003, 23, 130–134.

  • Khadijeh Arab-Sheibani, Ahmad Alipor, Hamid Poursharifi and Hossein Zare, The impact of mindfulness-based cognitive therapy (MBCT) on mental and physical well-being indicators in patients with type 2 diabetes. Zahedan J. Res. Med. Sci., 2014, 16(Suppl 1), 19–23.

  • Nagarathna, R. et al., Efficacy of yoga based life style modification program on medication score and lipid profile in type 2 diabetes – a randomized control study. Int. J. Diabetes Dev. Countries, 2012, 32, 122–130; https://doi.org/10.1007/s13410-012-0078-y.

  • Teixeira, E., The effect of mindfulness meditation on painful diabetic peripheral neuropathy in adults older than 50 years. Holist. Nurs. Pract., 2010, 24, 277–283.

  • Malhotra, V., Singh, S., Singh, K. P., Gupta, P., Sharma, S. B., Madhu, S. V. and Tandon, O. P., Study of yoga asanas in assessment of pulmonary function in NIDDM patients. Indian J. Physiol. Pharmacol., 2002, 46(3), 313–320.

  • Malhotra, V. et al., The status of NIDDM patients after yoga asanas: Assessment of important parameters. J. Clin. Diagnostic Res., 2010, 4, 2652–2667.

  • Maras, M. L., Rinke, W. J., Stephens, C. R., Boehm, T. M. and Maras, M. L., Effect of meditation on insulin dependent diabetes mellitus. The Diabetes Educator, 1984; doi:10.1177/014572178-401000104.

  • Singh, S. et al., A preliminary report on the role of yoga asanas on oxidative stress in non-insulin dependent diabetes mellitus. Indian J. Clin. Biochem., 2001, 16, 216–220.


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  • Effectiveness of Yoga for Patients With Diabetes Mellitus

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Authors

Nagendra Ramarao Hongasandra
Swami Vivekananda Yoga Anusandhana Samsthana, Vivekananda Road, Kalluballu Post, Anekal Tq, Jigani 560 105, India
Pooja More
NIMHANS Integrated Centre for Yoga, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
Vinod Kumar
NIMHANS Integrated Centre for Yoga, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
Aarti Jagannathan
Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
Nagarathna Raghuram
Swami Vivekananda Yoga Anusandhana Samsthana, Vivekananda Road, Kalluballu Post, Anekal Tq, Jigani 560 105, India

Abstract


Diabetes mellitus is a multifactorial metabolic disorder which requires lifestyle interventions for its management. A number of controlled yoga trials in last few years have observed lifestyle interventions especially yoga to be efficacious in the management of diabetes. The aim of this study is to systematically review the research conducted in the field to understand the effectiveness of yoga on diabetes mellitus. A systematic search was done using search engines such as PubMed, Google Scholar, Cochrane Library, MEDLINE, CAMbase, PsycINFO and IndMED. A total of 212 articles were selected, of which 166 were excluded and 46 controlled trials (CTs) were included in the review. Among the 46 CTs, 31 studies were categorized based on the primary outcome variables, 10 were based on the secondary outcome variables and 5 studies were control studies. Risk of bias assessment was conducted on all the studies. The review demonstrates significant improvement due to yoga practice in the primary outcome measures such as blood glucose levels along with secondary outcome measures such as cardiac autonomic variables, lipid profile, liver enzymes, respiratory variables, quality of life, anxiety and depression. Thus yoga has not only been found to be beneficial for improved glycaemic control, but also for the wide variety of symptoms associated with the diabetes. Despite this evidence, it is worth mentioning that further gold standard randomized controlled trials are warranted with more specific sets of practice, to prescribe yoga especially as an alternative treatment for the management of diabetes.

Keywords


Controlled Trials, Diabetes Mellitus, Primary and Secondary Outcome Variables, Yoga.

References





DOI: https://doi.org/10.18520/cs%2Fv113%2Fi07%2F1337-1353