Diabetes mellitus, Ayurveda, and yoga

Mind-Body Intervention for Diabetic Neuropathy: A Pilot Study on Yoga's Effects on Muscle Strength, Proprioception, Fear of Falling, Pain, and Quality of Life

OBJECTIVE

The aim of this study was to investigate the effects of an 8-week yoga intervention on muscle strength, proprioception, pain, concerns about falling, and quality of life in individuals diagnosed with diabetic neuropathy.

METHODS

A quasi-experimental design incorporating a pretest-posttest methodology and a control group was implemented in the present study. A total of 30 patients who were diagnosed with type 2 diabetes and neuropathy were recruited and randomly assigned to intervention (n = 15) or non-exercise control (n = 15). Yoga sessions were conducted for a duration of 60 min on three occasions per week, with participants requested to practice at home on other days.

RESULTS

The results showed significant main effects of time on the muscle strength (both flexor and extensor muscles, p < .001, ηp2 = 0.652 and p < .001, ηp2 = 0.539, respectively), proprioception error (p < .001, ηp2 = 0.807), pain intensity (p < .001, ηp2 = 0.538), concerns about falling (p < .001, ηp2 = 0.700), and overall score of quality of life (p < .001, ηp2 = 0.475). Moreover, there were significant group-by-time interactions for all variables (p < .001 for all).

CONCLUSION

The study reveals that yoga intervention can be an effective alternative therapeutic approach to medication for individuals with diabetic neuropathy. Yet, future studies are needed on a larger sample size to strengthen the present understanding of the advantageous impact of yoga intervention in this population.

Current Landscape of Various Techniques and Methods of Gene Therapy through CRISPR Cas9 along with its Pharmacological and Interventional Therapies in the Treatment of Type 2 Diabetes Mellitus

BACKGROUND

Type 2 diabetes mellitus (T2DM) is frequently referred to as a "lifestyle illness". In 2000, India (31.7 million) had the greatest global prevalence of diabetes mellitus, followed by China (20.8 million), the United States (17.7 million), and other countries. In recent years, the treatment of gene therapy (T2DM) has attracted intensive interest.

OBJECTIVE

We aimed to critically review the literature on the various techniques and methods, which may be a possible novel approach through the gene therapy CRISPR Cas9 and some other gene editing techniques for T2DM. Interventional and pharmacological approaches for the treatment of T2DM were also included to identify novel therapies for its treatment.

METHOD

An extensive literature survey was done on databases like PubMed, Elsevier, Science Direct and Springer.

CONCLUSION

It can be concluded from the study that recent advancements in gene-editing technologies, such as CRISPR Cas9, have opened new avenues for the development of novel therapeutic approaches for T2DM. CRISPR Cas9 is a powerful tool that enables precise and targeted modifications of the genome.

Development of Sham Yoga Poses to Assess the Benefits of Yoga in Future Randomized Controlled Trial Studies

Background: Although research has demonstrated the benefits of yoga to people who have been diagnosed with diabetes or at risk of diabetes, studies have not confirmed these effects can be ascribed to the specific features of the traditional postures, called asanas. Instead, the effects of asanas could be ascribed to the increase in cardiovascular activity and expenditure of energy or to the expectation of health benefits. Therefore, to establish whether asanas are beneficial, researchers need to design a control condition in which participants complete activities, called sham poses, that are equivalent to traditional asanas in physical activity and expectation of benefits. Objectives: The aim of this research was to design an appropriate suite of sham poses and to demonstrate these poses and traditional asanas are equivalent in energy expenditure, cardiovascular response, and expectations of health benefits. Methods: Twenty healthy men at medium to high risk of developing diabetes volunteered to partake in the current study. These men completed two sessions that comprised traditional asanas and two sessions that comprised sham poses—poses that utilize the same muscle groups as the asanas and were assigned fictitious Sanskrit labels. Before and after each session, heart rate, blood pressure, blood glucose levels, triglycerides levels, and oxygen saturation were measured to gauge the intensity of exercise. After each session, using a standard measure, participants also indicated the degree to which they expected the poses to improve health. Results: The degree to which the sessions affected the physiological measures (for example, pre-exercise, the heart rate for yoga and sham was 71.06 ± 4.79 and 73.88 ± 6.05, respectively, and post-exercise, the heart rate was 70.19 ± 6.16 and 73 ± 7.55, respectively) and the expectations of health improvements did not differ between the traditional asanas and the sham poses. Likewise, the degree to which each session influenced these physiological measures was negligible in both conditions. Conclusions: This study developed a series of poses that elicit similar physiological and psychological effect as traditional yoga asanas. These poses can be used in an active control group in future randomized trial studies that are designed to assess the benefits of asanas.

Diabetes Mellitus Type 2 and Yoga: Electro Photonic Imaging Perspective

Background:

Yoga is the most popular form of alternative medicine for the management of diabetes mellitus type 2. The electro-photonic imaging (EPI) is another contribution from alternative medicine in health monitoring.

Aim:

To evaluate diabetes from EPI perspective.

Objectives:

(1) Compare various EPI parameters in normal, prediabetic and diabetic patients. (2) Find difference in controlled and uncontrolled diabetes. (3) Study the effect of 7 days diabetes-specific yoga program.

Materials and Methods:

For the first objective, there were 102 patients (normal 29, prediabetic 13, diabetic 60). In the second study, there were 60 patients (controlled diabetes 27, uncontrolled diabetes 33). The third study comprised 37 patients. EPI parameters were related to general health as well to specific organs.

Results:

In the first study, significant difference was observed between (1) Diabetics and normal: average intensity 5.978, form coefficient 3.590, immune organs 0.281 all P < 0.001; (2) Diabetics and prediabetics: average intensity 6.676, form coefficient 4.158, immune organs 5.890 P < 0.032; (3) Normal and prediabetes: immune organs (−6.171 P = 000). In the second study, remarkable difference was in the immune organs (0.201, P = 0.031). In the pre- and post-study, the mean difference was: area 630.37, form coefficient 1.78, entropy 0.03, liver 0.24, pancreas 0.17, coronary vessels 0.11, and left kidney 29, with all P < 0.02.

Conclusion:

There is a significant difference in EPI parameters between normal, prediabetics and diabetics, the prominent being average intensity, form coefficient, and immune organs. Between controlled and uncontrolled diabetes, immune organs show significant change. Intervention of yoga results in change in most parameters.

Right Dorsolateral Frontal Lobe N-Acetyl Aspartate and Myoinositol Concentration Estimation in Type 2 Diabetes with Magnetic Resonance Spectroscopy

INTRODUCTION

Chronic hyperglycaemia in type 2 diabetes, effects the central nervous system by altering the concentrations of brain metabolites like N-acetyl aspartate (NAA) and myoinositol (mI), which are indicators of neuronal integrity and glial cell damage respectively. Dorsolateral frontal lobe is associated with aspects of cognition especially right frontal lobe is involved in episodic memory retrieval, ninety percent of the diabetic cases are type 2 in nature globally and yoga is very effective in stabilizing the brain metabolites by bringing the blood glucose levels to near or within the physiological range in type 2 diabetes.

AIM AND OBJECTIVES

The aim of the study was to observe the effects of yogasana and pranayama on glycosilated haemoglobin (HbA1c) levels and right dorsolateral frontal cortical NAA and mI concentration in type 2 diabetic subjects.

MATERIALS AND METHODS

It's a case control study. Sixty eight type 2 diabetic subjects of both the sex, aged between 35-65 years are included in the study, subjects are divided in to test and control group 34 each. Test group subjects did the yogasana and pranayama for a period of 6 months, 6 days in a week, 45-60 minutes daily under the supervision of a qualified yoga teacher. Control group subjects are not on any specific exercise regimen. Both the group subjects are taking oral hypoglycaemic agents. HbA1c levels are measured using the Bio-Rad D-10™ haemoglobin A1c program and Magnetic Resonance Spectroscopy (MRS) is used in assessing the metabolite concentrations.

STATISTICAL ANALYSIS

Analysis of data was done by using unpaired t-test. P-value for HbA1c level is <0.001, which is highly significant statistically. P-value for NAA was < 0.02 and for myoinositol was < 0.01, which are statistically significant.

RESULTS

HbA1c levels in control and test group subjects are 7.7 ± 1.84 and 6.02 ± 0.46 respectively. NAA concentrations in the right dorsolateral frontal lobe of control and test group are 1.44 ± 0.15 and 1.54 ± 0.19 respectively. The mI concentrations in the right dorsolateral frontal lobe of control and test group are 0.61 ± 0.22 and 0.47 ± 0.24 respectively.

CONCLUSION

Yogasana and pranayama minimized the neuronal and glial cellular damage in test group, which is evident by minimal changes in right dorsolateral frontal lobe NAA and mI levels in type 2 diabetic subjects.

India towards diabetes control: Key issues

The problem of mass diabetes is steadily increasing everyday. This editorial introduces key issues that need to be addressed to support the effective control of diabetes in India as well as globally. Issues like awareness generation for risk reduction, frequency of monitoring for selected parameters, standards for monitoring chronic complications in patients with diabetes, and current recommended targets of various parameters, amongst others, are presented along with extensions to the vaccinations recommended for diabetic patients.

Effects of Reiki, Yoga, or Meditation on the Physical and Psychological Symptoms of Chemotherapy-Induced Peripheral Neuropathy

Three complementary approaches for managing physical and psychological symptoms related to chemotherapy-induced peripheral neuropathy were evaluated against an education-only control arm. This study included 26 participants who were randomly assigned to weekly, hour-long sessions of yoga, Reiki, meditation, or an educational control experience for 6 weeks. Each participant completed pre–post measures of neurotoxicity, quality of life, psychological distress, and mindfulness. Descriptive analysis of the data indicated that all experimental group participants demonstrated improved within-group scores on quality of life and neurotoxicity outcomes following intervention; however, the improvements were not statistically significant. Neurotoxicity worsened significantly in the control group, but there were no pre–post changes with respect to quality of life, psychological distress, or mindfulness. Effect sizes were large with respect to meditation and mindfulness and with Reiki and psychological distress. Moderate effect sizes with respect to yoga and neurotoxicity and quality of life offer promise for all 3 interventions in managing chemotherapy-induced peripheral neuropathy.

Comprehensive yogic breathing program improves quality of life in patients with diabetes

OBJECTIVE

To assess the effect of a comprehensive yogic breathing program on glycemic control and quality of life (QOL) in patients with diabetes.

MATERIALS AND METHODS

This is a prospective randomized controlled intervention trial. Patients having HbA1c between 6 and 9% for at least 3 months with lifestyle modification and oral antidiabetic medication were included. They were followed-up and randomized at 6 months into two groups: one group receiving standard treatment of diabetes and the other group receiving standard treatment of diabetes and taught and told to regularly practice the comprehensive yogic breathing program (Sudarshan Kriya Yoga and Pranayam). Change in fasting and post-prandial blood sugars, glycated hemoglobin and QOL as assessed by the World Health Organization QOL WHOQOL BREF questionnaire were assessed.

RESULTS

There was a trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group following standard treatment alone, although this was not significant. There was significant improvement in physical, psychological and social domains and total QOL post-intervention in the group practicing the comprehensive yogic breathing program as compared with the group following standard treatment alone.

CONCLUSION

There was significant improvement in the QOL and a non-significant trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group that was following standard treatment alone.

Ayurvedic concept of obesity, metabolic syndrome, and diabetes mellitus

Obesity, metabolic syndrome, and diabetes mellitus are increasing to epidemic proportions globally. There are 400 million clinically obese adults worldwide and there are more than 220 million people who have diabetes. The global impact of these disorders is immense in terms of human suffering and economic burden. There is an urgent need for a more effective understanding of these disease processes and their management, including the use of natural strategies that are affordable and efficacious. The health care system known as Ayurveda has much to offer in this regard. Ayurveda describes a set of complex clinical disorders, collectively called Prameha, that are characterized by frequent abnormal micturition. The clinical conditions associated with Prameha correlate in many ways with obesity, metabolic syndrome, and diabetes mellitus. The etiology, classification, pathogenesis, and management of Prameha are discussed at length and in detail in the Ayurvedic texts. The theoretical background and comprehensive set of strategies Ayurveda utilizes to treat Prameha may be valuable in managing obesity, metabolic syndrome, and diabetes mellitus in an efficacious and cost-effective manner.

Alternative therapies useful in the management of diabetes: A systematic review

Diabetes mellitus is a metabolic disorder in the endocrine system. This dreadful disease is found in all parts of the world and becoming a serious threat of mankind health. There are lots of chemical agents available to control and to treat diabetic patients, but total recovery from diabetes has not been reported up to this date. In addition to adverse effects, drug treatments are not always satisfactory in maintaining euglycemia and avoiding late stage diabetic complications. Alternative to these synthetic agents, plants provided a potential source of hypoglycemic drugs and are widely used in several traditional systems of medicine to prevent diabetes. Several medicinal plants have been investigated for their beneficial effect in different type of diabetes. Other alternative therapies such as dietary supplements, acupuncture, hydrotherapy, and yoga therapies less likely to have the side effects of conventional approaches for diabetes.

Yoga Practice for the Management of Type II Diabetes Mellitus in Adults: A systematic review

The effect of practicing yoga for the management of type II Diabetes was assessed in this systematic review through searching related electronic databases and the grey literature to the end of May 2007 using Ovid. All randomized controlled clinical trials (RCTs) comparing yoga practice with other type of intervention or with regular practice or both, were included regardless of language or type of publication. Each study was assessed for quality by two independent reviewers. Mean difference was used for summarizing the effect of each study outcomes with 95% confidence intervals. Pooling of the studies did not take place due to the wide clinical variation between the studies. Publication bias was assessed by statistical methods. Five trials with 363 participants met the inclusion criteria with medium to high risk of bias and different intervention characteristics. The studies' results show improvement in outcomes among patients with diabetes type II. These improvements were mainly among short term or immediate diabetes outcomes and not all were statistically significant. The results were inconclusive and not significant for the long-term outcomes. No adverse effects were reported in any of the included studies. Short-term benefits for patients with diabetes may be achieved from practicing yoga. Further research is needed in this area. Factors like quality of the trials and other methodological issues should be improved by large randomized control trials with allocation concealment to assess the effectiveness of yoga on diabetes type II. A definitive recommendation for physicians to encourage their patients to practice yoga cannot be reached at present.

Exercise prescription and the patient with type 2 diabetes: a clinical approach to optimizing patient outcomes

PURPOSE

To review the current recommendations for physical activity in type 2 diabetes mellitus (T2DM) and propose methods to optimize compliance, reduce the pharmaceutical burden, and improve the general health and well-being of patients with T2DM.

DATA SOURCES

PubMed, SportDiscus, Ovid MEDLINE, Psychinfo, Web of Science, LexisNexis, and EBM reviews.

CONCLUSIONS

T2DM is a condition in which physical activity has been documented to improve patient outcomes, yet research has noted that healthcare professionals inadequately address this issue, resulting in physical activity being an underutilized therapy.

IMPLICATIONS FOR PRACTICE

An exercise prescription consists of mode (type), frequency, intensity, duration, and progression. Determining the appropriate mode depends upon patient preference and safety issues regarding the state of T2DM or other conditions. Frequency, intensity, and duration are specific to the type of activity and should be tailored to the patient's abilities to safely perform the activity. Finally, the health professional addresses periodic progression in order to maintain the exercise stimulus needed to promote continued health improvements and prevent "plateauing." In this article, on the basis of the current scientific research, we propose recommendations that enable healthcare professionals to advocate for their patients with T2DM by offering safe and effective treatment options.

Contextualizing the effects of yoga therapy on diabetes management: a review of the social determinants of physical activity

This article provides a review of literature both to identify the effects of yoga-based therapy on the management of type 2 diabetes mellitus and to examine the social context of physical activity. Findings from the review indicate that yoga has a positive short-term effect on multiple diabetes-related outcomes; however, long-term effects of yoga therapy on diabetes management remain unclear. The context of the social environment, including interpersonal relationships, community characteristics, and discrimination, influences the adoption and maintenance of health behaviors such as physical activity, including yoga practice. Further research is necessary to determine the extent of this influence.

Use of complementary and alternative medicine among people living with diabetes: literature review

AIM

This paper is a report of a literature review to explore the prevalence of complementary and alternative medicine use amongst people with diabetes to inform nursing practice, education and research.

BACKGROUND

Diabetes mellitus affects the entirety of a person's being and increasingly people use complementary and alternative medicine in conjunction with other medical treatments and lifestyle modifications to manage their condition and improve well-being.

METHODS

The CINAHL, Medline, ProQuest nursing journals and Psych INFO databases were searched for the period 1990-2006 using identified keywords.

RESULTS

A total of 18 studies from nine countries were found. The results suggest that the prevalence of complementary and alternative medicine use among people with diabetes ranges from 17% to 72.8%. The most widely used therapies among diabetic populations are nutritional supplements, herbal medicines, nutritional advice, spiritual healing and relaxation techniques. The characteristics which influence complementary and alternative medicine use are age, duration of diabetes, degree of complications and self-monitoring of blood glucose.

CONCLUSION

Although inconsistency in the definition of complementary and alternative medicine and varying research designs make estimation of usage prevalence difficult, evidence suggests that a high proportion of people with diabetes use these therapies concurrently with conventional healthcare services. Healthcare professionals need to be aware of this issue and may need to incorporate complementary and alternative medicine information into patient assessment and intervention.