Yoga-based lifestyle treatment and composite treatment goals in Type 2 Diabetes in a rural South Indian setup- a retrospective study

Culturally Tailored Dietary Interventions for Improving Glycaemic Control and Preventing Complications in South Asians with Type 2 Diabetes: Success and Future Implications

Glycaemic control is the basis of type 2 diabetes mellitus (T2DM) management and is crucial for preventing diabetes microvascular and macrovascular complications. The South Asian population is at higher risk of T2DM and resultant cardiovascular disease, peripheral vascular disease and death compared to Caucasians. Effective diabetes care has been deemed challenging in this population, but little is known about the usefulness of lifestyle interventions in improving glycaemic control and reducing complications. This narrative review aims to explore the efficacy of lifestyle interventions targeted to South Asians with T2DM in inducing clinically relevant improvements in HbA1c levels at such levels that reduce the risk of diabetes complications. A search of the literature using six databases (MEDLINE (EBSCOhost), PubMed, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus) identified dietary-based, physical-activity-based and education-based interventions that aimed to manage T2DM in South Asians. Results showed that dietary and physical activity interventions (duration 3-12 months) have been effective in generating a clinically relevant decrease in HbA1c levels (≥0.5%) in South Asians with T2DM and could potentially assist in reducing diabetes complications. Education-based interventions produced small effects on glycaemic control. These outcomes support the development of comparable longer-term randomised clinical trials combining dietary and physical activity interventions with the aim to provide further evidence on specific interventions that can lower complications and ensure effective diabetes care in a high-risk population.

Goal Setting and Health-Related Outcomes in Chronic Diseases: A Systematic Review and Meta-Analysis of the Literature From 2000 to 2020

Identifying and synthesizing recent empirical research on goal setting among adults with chronic disease is the focus of this article. The article has two phases: Phase 1, a thematic analysis with machine reading of the data and manual thematic analysis, and Phase 2, a quantitative meta-analysis. Qualitative, quantitative, and mixed-method studies are included in Phase 1 (99 papers). Phase 2 includes only quantitative studies (75 papers). Five main themes are identified: (a) the effect of goal characteristics on health-related outcomes, (b) the effect of goal setting on health-related outcomes, (c) the effect of goal achievement on health-related outcomes, (d) goal alignment between patients and health care service providers, and (e) individual and collaborative goal setting of patients and health care service providers. The meta-analysis reveals considerable evidence of an association between goal setting and health-related outcomes.

The Effect of Yoga on the Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Objectives

Yoga is a mind-body stress-relieving exercise that increases mental and physical health, which may have a role in the improvement of metabolic disorders. The present study has reviewed the effect of yoga on lipid profiles as a systematic review and meta-analysis.

Methods

We evaluated the available randomized controlled trials on the effects of yoga-based programs, and lipid profiles by searching PubMed/Medline, Scopus, Web of Science, and the Cochrane central register of control trials up to January 2022. Both fixed and random effect analyses were used to find the relationships. Subgroup analysis was performed based on the continent, duration of the included studies, gender, and health condition of participants to discover the sources of heterogeneity.

Result

Fifty-three studies were included in the current systematic review and meta-analysis with a total sample size of 13,191. There was a striking association between yoga and total cholesterol (−10.31 mg/dl; 95% CI: −14.16, −6.45; I² = 82.5%, P < 0.001), low-density lipoprotein cholesterol (−8.64 mg/dl; 95% CI: −12.03, −5.25; I² = 75.0%, P < 0.001), high-density lipoprotein cholesterol (1.98 mg/dl; 95% CI: 0.81, 3.14; I² = 91.6%, P < 0.001), triglycerides (−13.50 mg/dl; 95% CI: −20.09, −6.92; I² = 90.7%, P < 0.001) and very low-density lipoprotein (−3.94 mg/dl; 95%CI: −6.31, −1.56; I² = 72.2%, P < 0.001).

Conclusion

It seems yoga interventions had a substantial effect on lipid profiles, however, more qualified trials or cohort studies are needed to conclude exactly.

A Comprehensive Review of Yoga Research in 2020

Objectives: Accumulated evidence garnered in the last few decades has highlighted the role of yoga in health and disease. The overwhelming mortality and morbidity mediated by noncommunicable epidemics such as heart disease and cancer have fostered a search for mechanisms to attenuate them. Despite overwhelming success in acute care, the efficacy of modern medicines has been limited on this front. Yoga is one of the integrative therapies that has come to light as having a substantial role in preventing and mitigating such disorders. It thus seems trite to analyze and discuss the research advancements in yoga for 2020. The present review attempts to distill recent research highlights from voluminous literature generated in 2020. Methods: This review was conducted on the articles published or assigned to an issue in 2020. The authors searched the PubMed database for clinical studies published in the English language, using yoga (including meditation) as the intervention, and having an adequate description of the intervention. Then, they extracted data from each study into a standardized Google sheet. Results: A total of 1149 citations were retrieved in the initial search. Of these, 46 studies met eligibility criteria and were finally included. The studies were predominantly on mental health and neuropsychology, addressing various issues such as anxiety, postural balance, migraine, academic performance, and childhood neglect. Anxiety, stress, and depression were other common denominators. Eight studies were on cardiorespiratory systems, including exercise capacity, cardiac rehabilitation, myocardial infarction, and hypertension. Three studies were on diabetes, evaluating the effect of yoga. Five studies focused on cognition, health status, and autonomic regulation and few others included cancers, infertility, ulcerative colitis, urinary incontinence, restless leg syndrome, rheumatoid arthritis, chronic pain, and metabolic syndrome. Finally, most studies were on noncommunicable diseases with one exception, human immunodeficiency virus; two randomized controlled trials were dedicated to it. Conclusions: Yoga has been studied under a wide variety of clinicopathological conditions in the year 2020. This landscape review intends to provide an idea of the role of yoga in various clinical conditions and its future therapeutic implications.

Effect of Community-Based Structured Yoga Program on Hba1c Level among Type 2 Diabetes Mellitus Patients: An Interventional Study

CONTEXT

In view of the rising burden of type 2 diabetes mellitus (DM) cases in India, there is an urgent need for an effective, low-cost, sustainable intervention controlling diabetes thus preventing complications.

AIMS

This study aimed to assess the effect of structured yoga programs on diabetes.

SUBJECTS AND METHODS

This was a community-based interventional study that was conducted in an urban resettlement colony of Delhi, India. Known diabetes patients with glycated hemoglobin (Hb1Ac) ≥6.5% were enrolled from 12 randomly selected blocks of the community with a sample size of 192 in each intervention and wait-listed control arm. The intervention was structured yoga of 50 min daily, 2 consecutive weeks in a nearby park and health center followed by twice a week home practice up to the 3^rd month. The primary outcome measure was HbA1c% and secondary outcome measures were lipid profile and fasting blood glucose.

STATISTICAL ANALYSIS USED

Aper-protocol analysis was done. Mean, standard deviation (SD), and 95% confidence interval were estimated. The level of significance was considered for 0.05.

RESULTS

There was a significant decrease of Hb1Ac (0.5%, SD = 1.5, P = 0.02), total cholesterol (11.7 mg/dl, SD = 40.5, P < 0.01), and low-density lipoprotein (3.2 mg/dl, SD = 37.4, P < 0.01) from baseline to end line in the intervention group. These changes in intervention group were also significantly different from the change in the wait-listed control group. The other variables did not change significantly.

CONCLUSIONS

It revealed that structured yoga program improved glycemic outcome and lipid profile of individuals in a community-based setting. Yoga can be a feasible strategy to control hyperglycemia, lipid levels, and can help better control type 2 DM.

Yoga as a holistic approach for stress management in Oral Cancer patients. A prospective study

Background and Aims:

Oral cancer has been ranked as the sixth most common cancer globally. It has been reported to be increasing in incidence especially, in the southern parts of Asia which chiefly includes, India. Diagnosis of oral cancer is followed by a vigorous and highly morbid treatment protocol which drastically impacts the patient's quality of life. This in turn can cause extreme stress in a person. This study aimed to assess the impact of the practice of Yoga on stress levels in cancer patients.

Materials and Methods:

A total of 200 subjects diagnosed with oral cancer were selected for this study. Their stress levels were scored both before and after initiating the practice of Yogic exercises in a one-month interval using a questionnaire. Obtained scores were entered in Microsoft Excel 2007 worksheet and an unpaired t-test was applied. P values of less than 0.05 and 0.001 were considered statistically significant and extremely significant, respectively.

Results:

Study results showed a reduction in stress level scores (48 ± 0.99 to 37 ± 5.2) after adopting yoga for one month. An extremely significant P value of less than 0.001 was obtained.

Conclusion:

It can be concluded from this study that yoga is an effective method in reducing stress levels in individuals diagnosed with oral cancer.