The benficial effect of yoga in diabetes

Abstract

Twenty NIDDM subjects (mild to moderate diabetics) in the age group of 30-60 years were selected from the out patient clinic of G.T.B. hospital. They were on a 40 days yoga asana regime under the supervision of a yoga expert. 13 specific Yoga asanas < or = done by Type 2 Diabetes Patients included. Surya Namaskar, Trikonasana, Tadasana, Sukhasana, Padmasana, Bhastrika Pranayama, Pashimottanasana, Ardhmatsyendrasana, Pawanmuktasana, Bhujangasana, Vajrasana, Dhanurasana and Shavasana are beneficial for diabetes mellitus. Serum insulin, plasma fasting and one hour postprandial blood glucose levels and anthropometric parameters were measured before and after yoga asanas. The results indicate that there was significant decrease in fasting glucose levels from basal 208.3 +/- 20.0 to 171.7 +/- 19.5 mg/dl and one hour postprandial blood glucose levels decreased from 295.3 +/- 22.0 to 269.7 +/- 19.9 mg/dl. The exact mechanism as to how these postures and controlled breathing interact with somatoendocrine 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.

Full text

Original Article
Nepal
Medical
College
Journal
2005;
7(2):
145-147
The
beneficial
effect
of
Yoga
in
diabetes
Varun
Malhotra,' Savita Singh.,
Om
Prakash Tandon and Suman Bala Sharma'
and
Guru
Tegh
Bahadur
Hospital,
Delhi-95.
Nepal.
e-mail:
dr_varun@yahoo.com
'Department of Physiology,
Department
of
Physiology, 'Department of Biochemistry, University College of Medical Sciences
Corresponding
author:
Varun Malhotra, Assistant Professor, Department
of
Physiology,
P.O.
Box 155, MCOMS. Pokhara.
ABSTRACT
Twenty
NIDDM
subjects
(mild
to
moderate
diabetics) in the age group
of
30
60 years were selectedd
from
the
out
patient
clinic
of
G.T.B. hospital.
They
were
on
a
40
days
yoga
asana regime
under
the
supervision
of
a
voga
expert.
13
specific
Yoga
asanas
done
by
Type 2
Diabetes
Patients
included.
Surva
Namaskar,
Trikonasana.
Tadas
ana,
Sukhasana,
Padmasana,
Bhastrika
Pranayama.
Pashimottanasana.
Ardhmatsyendrasana,
Pawanmuktasana,
Bhujangasana,
Vajrasana,
Dhanurasana
and
Shavasana
are
beneficial
for
diabetes
mellitus.
Serum
insulin,
plasma
fasting
and
one
hour
postprandial
blood
glucose
levels
and
anthropometric
parameters
were
measured
before
and
after
yoga
asanas.
The
results
indicate
that
there
was
significant
decrease
in
fasting
glucose
levels
from
basal
208.3
20.0
to
171.7+19.5
mg/dl
and
one
hour
postprandial
blood
glucose
levels
decreased
from
295.3
+ 22.0 to
269.7
+
19.9
mg/dl.
The
exact
mechanism
as
to
how
these postures
and
controlled
breathing
interact
with
somatoendocrine
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.
Keywords:
Yoga
asanas,
Type
2
diabetes,
plasma
glucose,
serum
insulin levels.
INTRODUCTION
Diabetes mellitus
is
characterized by hyperglycemia
that
is
closely
related
to
insulin
resistance
syndrome
of
obesity.'
Exercise
in
diabetic
patients
can
improve
MATERIALS
AND
METHODS
Twenty
men
and
women
of
NIDDM
(miid
to
moderate
diabetics)
in
the
age
group
of
30-60
years
were
selected
from
the
out
patient
clinic
of
G.T.B.
hospital for the
present
study.
All
the
patients
were
non-smokers,
middle
class, literate
and
were
on
anti-
diabetic
drugs
and
diet
control
(duration
1 -
10
years).
None
of
the
patients
had
apparent
cardiac,
renal,
hepatic,
retinal
or
any
other
complication.
Written
consent
was
taken
from
them.
These
were
ruled
out
by
a
baseline
ECG.
KFT,
LFT
and
opthamological
investigation.
insulin
sensitivity,
glycemic
control
and
lipid
profile.
However
the
level
of
physical
training
recommended
for
NIDDM
patients
to
lower
plasma
glucose
levels,
decrease
obesity
and
improve
insulin
sensitivity i.e.
50-70.0%
of
maximum
aerobic
capacity lasting
30
minutes,
three
or
five
times
a
week
are
not
feasible
in
many
patients
because
of
age,
obesity,
cardiovascular disease and other problems." Long
term
motivation
and
compliance
are
also
poor
in
such
Every
one
received
personalised
attention
and
supervision
of
a yoga expert during yoga sessions,
carried out in the cardio-respiratory laboratory
in
Physiology
department
in the
moming
time
(30-40
min)
every
day
for
40
days.
Patients
were
kept
on
the
same
drug
and
diet
control
through
out
the
study
before and after yoga therapy.
cases.
The importance
of
finding other avenues
of
treatment
for
ensuring a
permanent
cure
of
diabetes
can
not
be
over-emphasized.
Yoga
has
aroused
a
hope
for the
diabetic
patients
to
remain
free
from
disease
and
drugs.
Yoga
is
the
science
of
self-realization.
Significant
physical,
physiological, psychological
and
endocrinal
changes
have
been
reported
following
various Yogic regimes over a period
of
time.
Limited recorded evidences show the positive impact
ofyogic
postures
and
breathing
exercises
in
diabetes.
13
specific
Yoga
asanass
done
by
Type
2
Diabetes
Patients
viz. Surya Namaskar,
Trikonasana,
Tadasana,
Sukhasana,
Padmasana,
Bhastrika
Pranayama,
Ardhmatsyendrasana,
Bhujangasana,
Vajrasana,
Dhanurasana
and
Shavasana
are
beneficial
for
diabetes
mellitus
The
asanas
are
described0
with
their duration"
in
Table.1
Pashimottanasana.
Pawanmuktasana.
The
exact
mechanism
as
to
how
these
postures
with
somato-endocrine
mechanism
affecting
insulin
kinetics
still
remains
to
be
worked
out.
It
was
therefore
endeavored
to
scientifically study
the
role
of
yoga
in
modifying
the
insulin
kinetics
and
anthropometric
parameters
in
diabetic
patients.
Weight
was
measured
by
a
Avery
weighing
scale
height
by
a
stadiometer.
Waist
hip
ratio
as
145

Varun
Malhotra
aDle-1:
Name
and
duration
of
various
asanas
included
in
yoga
exercises
S.
No.
Name
Surya
Namaskar-l
Tadasan
Trikonasan
Sukhasana
Padmasana
Bhastrika
Pranyama
Pashimottanasana
Ardhmatsyendrasana
Vajrasana
Pawanmukthasana
Bhujangasana
Dhanurasana
Shavasana
Duration
S-/
turns
of
each,
cach
pose
being
maintained
for
10
seconds
minute
to
one
minute,
adding
minute
per
week
minute
for
each
side.
adding
minute
per
week
minute
to
one
minute,
adding
minute
per
Week
minute
to
one
minute,
adding
minute
per
week
5-15
minute
per
day
minute
for
each
side,
adding
minute
per
week
minute
for
each
side,
adding
minute
per
week
minute
to
one
minute,
adding
"
minute
per
week
minute
for
each
side,
adding"
minute
per
week
10
-
3-7
turns
of
each, each pose being maintained
for
10
sëConds
3-7
turns
of
each,
each
pose
being
maintained
for
10
seconds
2-10
minutes,
adding
2
minutes
per
weck
12.
13.
calculated after
measuring
waist,
hip
circumference
by
a
measuring
tape.
BMI
and
Lean
body
mass
were
calculated
by
using
standard formulas.
Serum
insulin
was
measured
by
ELISA-kit
method.
The
parameters
were
measured
again
after
40
days
of
yoga.
So
the
same
patients
served
as
their
own
control.
RESULTS
Graph
2:
Blood
Glucose
2953
269.7
300
2083
250
71.7
200
ng
1
S0
FBG
DPBG
Height (Ht.) remained same
at
152.4+0.9
cm.
There
were
decreases
in parameters
of
Weight
(Wt.) from
62.94
2.4
kg
to
62.17
+
2.2
kg,
Waist
Hip
Ratio
(WHR)
of
14
subjects
from 0.93
+0.1
to
0.88
0.1,
and
BMI
from
26.81
0.9
kg/
m>
to
26.49
0.9
kg
/m.
Lean
Body
Mass
increased
from
66.53
2.5
kg
to
66.69
+2.4
kg.
The
result
of
WHR
is significant
at
p
value
of
0.005.
Remaining
results
are
insignificant.
The
trend
of
these
parameters
is
shown
in Fig.
1.
100
Before & After
Yoga
also decreased from 295.3 +
22.0
in
mg/
dl
to
269.7
+
19.9
in
mg/
dl
at
p value
of
0.059.
The trend
of
these
parameters
is
shown in
Fig.
2.
Serum
insulin
levels increased from
13.9+4.9
m
IU
ml
to
19.7
+4.8
m
IU/ml
in
four
NIDDM
subjects
with
BMI<25
at
p value
of
0.079.
It decreased from
36.1
11.3
m
IU/
ml
to
11.0+2.0
m
IU/
ml
in
seven
NIDDM
subjects
with
Body
Mass
Index
>25.
After
yoga
regime,
high
levels
of
serum
insulin
were
brought
to
within normal levels in obese NIDDM.
DISCUSSiON
Yoga
has aroused a
hope
for
the
diabetic
patients
to
remain free from disease and
drugs.
After yoga
asanas
regime
a
significant
decrease in waist
hip
ratio
occurred
in
our
patients.
Yoga
helped
in
reducing
the
insulin resistance
by
reducing
fat
from
waist,
changing
central
obesity
to
peripheral
obesity.
There
was
also a noticeable decrease in
body
mass
index
and
increase in lean
body
mass.
There
was
a
decrease
in
fasting
blood
glucose
(FBG)
from
208.3
+
20.0
in mg/
dl
to
171.7+
19.5 in
mg
/
dl,
which
is
significant
at
p
value
of
0.001.
Postprandial Blood Glucose (PPG) after one hour
Gaph
1:
VWaist
Hip
Ratio
0.93
0.94
0.92
0.9
0.88
0.861
0.84
88
2
Before & Atter
l'oga
146

Nepal
Medical
College
Journal
cam
lor
statitical
analy,
thc hospital lab
ervic
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for
ncasung
plasma
ylucone,
Amin
Shah
for
hclping
wth
collection
of
the refercnces and the
paticnts
without
wlhose coopcsation
this
study
would
not havc been complctcd.
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also
occurred
significant
fall
in
the
fasting
blood
glucose
and
one
hour
postprandial
blood
glucose
after
40
days
of
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thank
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for
providing
us
with
the
insulin
assay
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Indrayan
and
his
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147