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Role of yoga in preventing and controlling Type 2 diabetes

Role of yoga in preventing and controlling Type 2 diabetes . Manoj Sharma, MBBS, MCHES, Ph.D., FAAHB Adam Knowlden, MBA, MS, CHES Session 3078, American Public Health Association’s 140 th Annual Meeting Monday , October 29, 2012; 10:30 AM - 11:30 AM. Problem of Type 2 Diabetes mellitus.

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Role of yoga in preventing and controlling Type 2 diabetes

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  1. Role of yoga in preventing and controlling Type 2 diabetes Manoj Sharma, MBBS, MCHES, Ph.D., FAAHB Adam Knowlden, MBA, MS, CHES Session 3078, American Public Health Association’s 140thAnnual Meeting Monday, October 29, 2012; 10:30 AM - 11:30 AM

  2. Problem of Type 2 Diabetes mellitus • Globally diabetes mellitus affects over 311 million people. • In the United States, approximately 25.8 million children and adults (8.3% of the population) have diabetes (90% to 95% have type 2 diabetes mellitus) • Prevalence rates have doubled from 1990 to 2005 • It is estimated that global prevalence would exceed 470 million by 2030

  3. Prevention & control of Type 2 diabetes mellitus • Type 2 diabetes mellitus is a metabolic disorder characterized by insulin resistance and impaired insulin secretion • Number of behavioral interventions have been suggested for preventing and controlling type 2 diabetes mellitus • Increased physical activity • Diet modification • Cessation of smoking • Mind-body interventions including yoga

  4. Yoga & characteristics of yoga users • Yoga is an ancient practice originating in India over 4,000 years ago • Yoga has been demonstrated to reduce stress and induce relaxation • 2002 National Health Interview Survey (NHIS) found about 5.1% of US population or over 14 million people were yoga users • 85% Caucasians • 76% females • Mean age of 39.5 years • A majority of yoga users (61%) felt yoga was important in maintaining health

  5. Stages of Ashtangayoga • Yama: Techniques for successful living in society • Niyama: Techniques for managing and purifying self • Asaana: Postures for physical homeostasis & mental balance • Pranayama: Breathing techniques for physical homeostasis & mental balance • Pratihara: Techniques for developing dispassion toward senses for mental balance and equanimity • Dharana: Concentration techniques for mental balance and equanimity • Dhyana: Meditation techniques for mental balance and equanimity • Samadhi: Universal consciousness

  6. Purpose • The purpose of this study was to review studies that have used yoga in preventing or controlling diabetes and determining whether yoga is beneficial as an alternative and complementary approach for Type 2 diabetes mellitus.

  7. Methods • The method used in this study was a systematic qualitative review of interventions obtained from following databases: • CINAHL (Cumulative Index to Nursing & Allied Health) • MEDLINE • AMED (Allied and Complementary Medicine Database) • Alt HealthWatch • CENTRAL (Cochrane Central register of controlled trials)

  8. Inclusion & exclusion criteria for studies • Inclusion criteria: • (1) interventions targeting the prevention or control of type 2 diabetes mellitus • (2) employing any quantitative design • (3) published in the English language • (4) published between January 1993 and December 2011 • (5) employing yoga asanas, or pranayama, or dhyana as intervention • (6) with biochemical, physiological, anthropometric, or clinical outcomes. • Exclusion criteria: • (1) that did not employ a quantitative design • (2) did not sample diabetic patients with insulin or glucose levels as outcomes or people individuals at risk for diabetes such as those suffering from metabolic syndrome • (3) were not indexed in selected databases

  9. Summary of Results • A total of 17 studies met the inclusion criteria • Of the 17 studies, 11 were conducted in India, four were conducted in the United States, one was conducted in England, and one was conducted in Cuba. • Nine of the 11 interventions measuring fasting blood glucose were able to show significant decrease • Among the identified studies, five employed randomized controlled design, four utilized quasi-experimental design, and seven used pretest-posttest design • 15 of the interventions used yoga asanas, 12 used pranayama, and one each used shatkriyas (cleansing exercises) and yoga nidra (relaxation) • The duration of the yoga interventions ranged from 8 days to 24 weeks

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  18. Discussion & Conclusions • The reviewed interventions did not use behavioral theories. Theory-based frameworks offer the ability to reduce cost, save time, and produce greater behavioral outcomes. • Ideally the interventions should be long term (12-18 months) and employ process evaluations to gauge whether participants adhered to yoga or not • Yoga was found to be cost-effectiveapproach that is free of negative side effects • Yoga-based interventions for the prevention and control of type 2 diabetes mellitus hold promise and must be tested more for efficacy and effectiveness

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