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      Therapeutic Role of Yoga in Type 2 Diabetes

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          Abstract

          Yoga originated in India more than 5,000 years ago and is a means of balancing and harmonizing the body, mind, and emotions. Yoga practice is useful in the management of various lifestyle diseases, including type 2 diabetes. Psycho-neuro-endocrine and immune mechanisms are involved in the beneficial effects of yoga on diabetes. Incorporation of yoga practice in daily life helps to attain glycaemic control and reduces the risk of complications in people with diabetes. In this review, we briefly describe the role of various yoga practices in the management of diabetes based on evidence from various clinical studies.

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          The health benefits of yoga and exercise: a review of comparison studies.

          Alyson Ross, Sue Thomas (2010)
          Exercise is considered an acceptable method for improving and maintaining physical and emotional health. A growing body of evidence supports the belief that yoga benefits physical and mental health via down-regulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). The purpose of this article is to provide a scholarly review of the literature regarding research studies comparing the effects of yoga and exercise on a variety of health outcomes and health conditions. Using PubMed((R)) and the key word "yoga," a comprehensive search of the research literature from core scientific and nursing journals yielded 81 studies that met inclusion criteria. These studies subsequently were classified as uncontrolled (n = 30), wait list controlled (n = 16), or comparison (n = 35). The most common comparison intervention (n = 10) involved exercise. These studies were included in this review. In the studies reviewed, yoga interventions appeared to be equal or superior to exercise in nearly every outcome measured except those involving physical fitness. The studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and diseased populations, yoga may be as effective as or better than exercise at improving a variety of health-related outcome measures. Future clinical trials are needed to examine the distinctions between exercise and yoga, particularly how the two modalities may differ in their effects on the SNS/HPA axis. Additional studies using rigorous methodologies are needed to examine the health benefits of the various types of yoga.
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            Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II--clinical applications and guidelines.

            Richard P. Brown, Patricia Gerbarg (2005)
            Yogic breathing is a unique method for balancing the autonomic nervous system and influencing psychologic and stress-related disorders. Part I of this series presented a neurophysiologic theory of the effects of Sudarshan Kriya Yoga (SKY). Part II will review clinical studies, our own clinical observations, and guidelines for the safe and effective use of yoga breath techniques in a wide range of clinical conditions. Although more clinical studies are needed to document the benefits of programs that combine pranayama (yogic breathing) asanas (yoga postures), and meditation, there is sufficient evidence to consider Sudarshan Kriya Yoga to be a beneficial, low-risk, low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder (PTSD), depression, stress-related medical illnesses, substance abuse, and rehabilitation of criminal offenders. SKY has been used as a public health intervention to alleviate PTSD in survivors of mass disasters. Yoga techniques enhance well-being, mood, attention, mental focus, and stress tolerance. Proper training by a skilled teacher and a 30-minute practice every day will maximize the benefits. Health care providers play a crucial role in encouraging patients to maintain their yoga practices.
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              Effects of yoga on cardiovascular disease risk factors: a systematic review and meta-analysis.

              Holger Cramer, Romy Lauche, Heidemarie Haller … (2014)
              The aim of this review was to systematically assess and meta-analyze the effects of yoga on modifiable biological cardiovascular disease risk factors in the general population and in high-risk disease groups. MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through August 2013 for randomized controlled trials (RCTs) on yoga for predefined cardiovascular risk factors in healthy participants, non-diabetic participants with high risk for cardiovascular disease, or participants with type 2 diabetes mellitus. Risk of bias was assessed using the Cochrane risk of bias tool. Forty-four RCTs with a total of 3168 participants were included. Risk of bias was high or unclear for most RCTs. Relative to usual care or no intervention, yoga improved systolic (mean difference (MD)=-5.85 mm Hg; 95% confidence interval (CI)=-8.81, -2.89) and diastolic blood pressure (MD=-4.12 mm Hg; 95%CI=-6.55, -1.69), heart rate (MD=-6.59 bpm; 95%CI=-12.89, -0.28), respiratory rate (MD=-0.93 breaths/min; 95%CI=-1.70, -0.15), waist circumference (MD=-1.95 cm; 95%CI=-3.01, -0.89), waist/hip ratio (MD=-0.02; 95%CI=-0.03, -0.00), total cholesterol (MD=-13.09 mg/dl; 95%CI=-19.60, -6.59), HDL (MD=2.94 mg/dl; 95%CI=0.57, 5.31), VLDL (MD=-5.70 mg/dl; 95%CI=-7.36, -4.03), triglycerides (MD=-20.97 mg/dl; 95%CI=-28.61, -13.32), HbA1c (MD=-0.45%; 95%CI=-0.87, -0.02), and insulin resistance (MD=-0.19; 95%CI=-0.30, -0.08). Relative to exercise, yoga improved HDL (MD=3.70 mg/dl; 95%CI=1.14, 6.26). This meta-analysis revealed evidence for clinically important effects of yoga on most biological cardiovascular disease risk factors. Despite methodological drawbacks of the included studies, yoga can be considered as an ancillary intervention for the general population and for patients with increased risk of cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Endocrinol Metab (Seoul)
                Journal ID (iso-abbrev): Endocrinol Metab (Seoul)
                Journal ID (publisher-id): ENM
                Title: Endocrinology and Metabolism
                Publisher: Korean Endocrine Society
                ISSN (Print): 2093-596X
                ISSN (Electronic): 2093-5978
                Publication date (Print): September 2018
                Publication date (Electronic): 14 August 2018
                Volume: 33
                Issue: 3
                Pages: 307-317
                Affiliations
                [1 ]Department of General Medicine, Government Medical College, Kozhikode, India.
                [2 ]Department of Internal Medicine, Badr Al Samaa Hospital, Barka, Oman.
                [3 ]Padma Yog Sadhana, A Unit of Terna Public Charitable Trust, Navi Mumbai, India.
                [4 ]Joshi Clinic, Lilavati Hospital and Bhatia Hospital, Mumbai, India.
                Author notes
                Corresponding author: Arkiath Veettil Raveendran. Department of Internal Medicine, Badr Al Samaa Hospital, Barka, Oman. Tel: +968-92065598, Fax: +968-26884918, raveendranav@ 123456yahoo.co.in
                Author information
                https://orcid.org/0000-0003-3051-7505
                Article
                DOI: 10.3803/EnM.2018.33.3.307
                PMC ID: 6145966
                PubMed ID: 30112866
                SO-VID: 2e44e420-2a88-4795-a629-114f11bd72b4
                Copyright © Copyright © 2018 Korean Endocrine Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 February 2018
                Date revision received : 11 April 2018
                Date accepted : 09 May 2018
                Categories
                Subject: Review Article

                Keywords: yoga,diabetes mellitus,yoga asana,pranayama,meditation
                Data availability:
                Keywords: yoga, diabetes mellitus, yoga asana, pranayama, meditation

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