Yoga as Complementary Therapy for Managing Type 2 Diabetes: What Do the Studies Say?
Type 2 Diabetes Mellitus (T2DM) is a prevalent chronic condition that affects millions of people worldwide. Its management is essential to reduce longstanding complications including retinopathy and nephropathy. Additionally, we know that poor glycemic control is directly related to increased relative risk of cardiovascular-related morbidity and mortality. In recent years, complementary therapies have gained attention as potential strategies to help manage T2DM. We will explore two review articles, published in 2018 and 2022 respectively, that explore the benefits of yoga practice as an adjunct to conventional management of T2DM.
The 2018 systematic review and meta-analysis conducted by Jayawardena et al. examined the effectiveness of yoga in comparison to physical exercise for T2DM management. They analyzed a total of eight studies involving 842 participants, all adults, who were assigned to either a yoga or exercise intervention group. Most of the research was conducted in India, with study durations ranging from 40 days to 9 months. While in most cases, the yoga interventions included breathing exercises, physical postures, and relaxation practices, the exercise interventions varied between studies, which complicates the comparability of the results.
The findings demonstrated significant reductions in measures of glycemic control and body mass index in the yoga group as compared to the exercise group. Specifically, the yoga group exhibited reductions in fasting blood glucose by 15.16mg/dl; postprandial blood glucose by 18.29mg/dl; HgbA1C by 0.39%, and BMI by 0.71kg/m2 compared to the exercise group. No significant differences were observed in lipid parameters or blood pressure. This could be since the participants in the studies were already within normal limits or on lipid-lowering medication at the outset.
These results highlight the potential of yoga as a complementary approach to traditional treatment regimens for glycemic control in patients with T2DM, although it is important to note that the studies exhibited heterogeneity, which may affect the generalizability of the results.
The 2022 systematic review and meta-analysis conducted by Chen et al. aimed to further investigate the impact of yoga on T2DM management. They reviewed 13 randomized controlled trials, focusing on HgbA1c, fasting blood glucose (FBG), postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), and body mass index (BMI). This review included a total of 1335 participants, all adult T2DM patients without complications, divided between the yoga intervention and control groups. The participants engaged in yoga sessions lasting 45 to 120 minutes per day, 1 to 7 days per week, over durations of 10 to 24 weeks. Results from this analysis demonstrated significant differences for HgbA1c, FBG, PPBG, and TG between the yoga intervention and the control groups. No significant differences were noted in TC and BMI.
The results from this study reinforce the potential of yoga as an adjunct to pharmaceutical treatments in the management of T2DM, at least for glycemic control in short-term durations. Further studies will prove beneficial to evaluate long term management with yoga as a complementary therapy. Additionally, variability among the studies included also affects the generalizability of these results.
The systematic reviews and meta-analyses discussed in this article provide valuable insights into the potential benefits of yoga as a complementary approach to managing T2DM. Both studies show that yoga can be a promising addition to conventional treatments, particularly in terms of glycemic control. However, it's important to recognize the variability in results due to differences in study design, interventions, and participant characteristics. These findings should encourage further research into the specific components of yoga that are most effective for T2DM management, as well as its long-term impact on patient outcomes when used as a complementary and integrative approach to their disease management.
Resources:
Jayawardena R, Ranasinghe P, Chathuranga T, Atapattu PM, Misra A. The benefits of yoga practice compared to physical exercise in the management of type 2 Diabetes Mellitus: A systematic review and meta-analysis. Diabetes Metab Syndr. 2018 Sep;12(5):795-805. doi: 10.1016/j.dsx.2018.04.008. Epub 2018 Apr 18. PMID: 29685823.
Chen S, Deng S, Liu Y, Yin T. Effects of Yoga on Blood Glucose and Lipid Profile of Type 2 Diabetes Patients Without Complications: A Systematic Review and Meta-Analysis. Front Sports Act Living. 2022 Jun 23;4:900815. doi: 10.3389/fspor.2022.900815. PMID: 35813055; PMCID: PMC9259958.