1
|
Kumar R, Dhamija P, Vardhan G, Kant R, Singh Y, Yadav RK, Rudra B, Pathania M. Evaluating Yoga-Based Intervention Versus the American Diabetes Association Exercise Regimen in Conjunction With Standard Care for Autonomic Neuropathy in Diabetes Mellitus: An Exploratory Clinical Trial. Cureus 2024; 16:e61329. [PMID: 38947647 PMCID: PMC11213716 DOI: 10.7759/cureus.61329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
INTRODUCTION Diabetic autonomic neuropathy (DAN) is a prevalent yet often overlooked complication of diabetes mellitus (DM), impacting multiple organs and substantially elevating the risk of morbidity and mortality. This study aimed to assess the effectiveness of yoga-based intervention (YBI) compared to the American Diabetes Association exercise regimen (ADA Ex. Regime) and standard care for treating autonomic neuropathy in type 2 DM. METHODS This open-label exploratory clinical trial featured two parallel study arms: Group A (Intervention), which received YBI alongside standard care, and Group B, which adhered to the ADA Ex. Regime in conjunction with standard care. A total of 80 participants aged 35-60, diagnosed with type 2 DM and autonomic neuropathy, were equally allocated to both groups. Data collection included nerve conduction velocity (NCV) tests, autonomic function tests (AFTs), as well as evaluations of depression and quality of life. RESULTS YBI demonstrated a drop in parasympathetic tone compared to the ADA Ex. Regime. Following a six-month intervention, the sympathetic activity indicator (SD2) exhibited a significantly lower value in the YBI group than in the ADA Ex. Regime group, indicating a positive effect (p < 0.05), while the ADA Ex. Regime showed more improvement in certain areas of NCV (e.g., left and right peroneal NCV, right and left peroneal F-latency), notable differences were observed in alkaline phosphatase levels, depression scores, and WHO-5 wellness, all reaching statistical significance at p < 0.05. CONCLUSIONS The study findings observed that a 24-week YBI significantly reduced in symptoms of diabetic neuropathy and stress. Although the ADA Ex. Regime demonstrated greater improvement in specific aspects of NCV compared to YBI, YBI outperformed the ADA Ex. Regime in enhancing WHO-5 wellness and reducing depression symptoms.
Collapse
Affiliation(s)
- Ramesh Kumar
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Puneet Dhamija
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Gyan Vardhan
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Ravi Kant
- General Medicine, All India Institute of Medical Sciences, Rishikesh, IND
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Yogesh Singh
- Physiology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Raj Kumar Yadav
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Rishikesh, IND
| | | | - Monika Pathania
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| |
Collapse
|
2
|
Saboo N, Kacker S. A Study on Yoga-Based Lifestyle Intervention versus Dietary Intervention Alone on Cardiometabolic Risk Factors among People with Prediabetes. Ann Afr Med 2024; 23:202-212. [PMID: 39028170 PMCID: PMC11210738 DOI: 10.4103/aam.aam_56_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Prediabetes is presented as a metabolic state that predisposes persons to a greater risk of diabetes progression in the future. Prediabetes is an intervening stage between normoglycemia and diabetes with impaired fasting glucose and impaired glucose tolerance. This study aimed to compare the effect of the yoga-based lifestyle intervention (including diet) versus dietary intervention (DI) alone on cardiometabolic parameters namely fasting blood glucose (FBG), glycated hemoglobin (HbA1C), lipid profile; triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), heart rate variability (HRV), and carotid intima-media thickness (CIMT) among people with prediabetes. METHODS A randomized controlled study was conducted on 250 people with prediabetes who were randomly allocated by computer-generated methods to the yoga-based lifestyle intervention (including diet) (n = 125) and DI alone (n = 125) groups. Yoga sessions were approximately 45 min 6 days a week over a period of 6 months. Assessments were made at baseline and after 6 months of intervention. RESULTS Post-intervention comparison of cardiometabolic parameters in yoga-based lifestyle intervention (including diet) versus DI alone showed a significant decline in body mass index (P = 0.0002), waist-hip ratio (P = 0.0001), systolic blood pressure (P = 0.0001), diastolic blood pressure (P = 0.0001), perceived stress score (P = 0.0001), FBG (P = 0.0001), HbA1C (P = 0.0001), lipid profile; TG (P = 0.008), LDL (P = 0.0001), VLDL (P = 0.0001), HRV (P = 0.0001), CIMT (P = 0.02) and a nonsignificant decline in, TC (P = 0.22), HDL (P = 0.211), FFQ (P = 0.164). CONCLUSION The finding of this study suggests that a 24-week yoga-based lifestyle intervention which includes diet significantly decreased cardiometabolic parameters compared to DI alone among people with prediabetes.
Collapse
Affiliation(s)
- Neha Saboo
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Sudhanshu Kacker
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| |
Collapse
|
3
|
Joshi AM, Raveendran AV, Arumugam M. Therapeutic role of yoga in hypertension. World J Methodol 2024; 14:90127. [PMID: 38577206 PMCID: PMC10989416 DOI: 10.5662/wjm.v14.i1.90127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
Collapse
Affiliation(s)
- Anjali Mangesh Joshi
- Department of Psycho-Oncology, HCG NCHRI Cancer Center, Nagpur 440026, Maharashtra, India
| | - Arkiath Veettil Raveendran
- Department of Internal Medicine, Former Assistant Professor of Medicine, Govt. Medical College, Kozhikode 673010, Kerala, India
| | - Muruganathan Arumugam
- Department of Internal Medicine, Past president API Past Governor American College of Physicians Past President Hypertension Society of India Past Dean Indian College of Physicians, Tirupur 641602, Tamilnadu, India
| |
Collapse
|
4
|
Patil SG, Khode V, Christa E, Desai RM, Chandrasekaran AM, Vadiraja HS, Raghavendra R, Aithal K, Champa R, Deepak KK, Roy A, Kinra S, Dorairaj P. Effect of Yoga on Endothelial Function: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:233-249. [PMID: 37878297 DOI: 10.1089/jicm.2023.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Introduction: Endothelial dysfunction is the initial step in the pathogenesis of atherosclerosis; and it plays a central role in the development of cardiovascular diseases and many types of human diseases (diabetes, kidney failure, cancer, and viral infections). Strategies that are effective in protecting vascular endothelial function and retard or reversing endothelial dysfunction in the early stage appear to be potential in the prevention of vascular, cardiac, and many human diseases. Several studies have been carried out on the effects of yoga on endothelial function, but the results of these studies have not been synthesized. This study aimed at conducting a systematic review and meta-analysis to determine the effectiveness of yoga on endothelial function. Methods: A systematic review and meta-analysis of studies that assessed the effect of yoga practice on vascular endothelial function was done as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scopus, Google Scholar, and Cochrane controlled register of trials (CENTRAL) were searched from inception to August 2022. The search strategy was constructed around yoga-based techniques and endothelial function. All the yoga-based interventional studies on endothelial function or dysfunction were included in this review. A narrative synthesis and descriptive analysis were done due to the diverse methodology of selected studies. We carried out a formal meta-analysis of controlled trials that assessed the effect of yoga on flow-mediated dilatation (FMD), a measure of endothelial function. Results: A total of 18 studies were included for review involving 1043 participants. Yoga training showed improved endothelial function in 12 studies, whereas 6 studies did not find any statistically robust effect. Meta-analysis (n = 395 participants, 6-studies, 7 comparisons) showed an increase in brachial FMD by yoga practice (mean difference = -1.23%; 95% confidence interval -2.23 to -0.23; p = 0.02). The heterogeneity between the studies was 43% (Tau2 = 0.70, χ2 = 10.49). The risk of bias was low to moderate in these studies. No adverse effects were reported. Conclusions: Yoga practice improved endothelial function. Yoga could be a safe and potential integrative medicine to improve endothelial function. However, as the statistical heterogeneity, that is, variation in the FMD among the studies was moderate, large clinical trials are necessary for its clinical recommendations.
Collapse
Affiliation(s)
- Satish G Patil
- Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Vitthal Khode
- Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Edmin Christa
- All India Institute of Medical Sciences, New Delhi, India
- Government Yoga and Naturopathy Medical College & Hospital, Chennai, India
| | - Rathnamala M Desai
- Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | | | | | - Rao Raghavendra
- Central Council for Research in Yoga and Naturopathy, New Delhi, India
| | - Kiran Aithal
- Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - R Champa
- Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | | | - Ambuj Roy
- All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Prabhakaran Dorairaj
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, New Delhi, India
| |
Collapse
|
5
|
Dhali B, Chatterjee S, Sundar Das S, Cruz MD. Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis. J ASEAN Fed Endocr Soc 2023; 38:113-122. [PMID: 38045671 PMCID: PMC10692414 DOI: 10.15605/jafes.038.02.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/18/2023] [Indexed: 12/05/2023] Open
Abstract
Background A daily habit of yogic practice or walking, along with an oral hypoglycemic agent (OHA) could be beneficial for better control of type 2 diabetes mellitus (T2DM). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to find out the efficiency of yoga or walking on glycemic control in T2DM. Methodology The present systematic review and meta-analysis were completed according to the PRISMA guidelines. The risk of bias in included studies was evaluated, by using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analysis was implemented using RevMan software. Forest plots were used to illustrate the study findings and meta-analysis results. Results Sixteen studies were included in this systematic review, where 1820 participants were allocated to one of the following interventions: yoga, walking, and without any regular exercise (control group). Participants were between 17-75 years of age. Compared to the control group, the yoga group had a significant reduction in fasting blood glucose (FBG) by 31.98 mg/dL (95% CI = -47.93 to -16.03), postprandial blood glucose (PPBG) by 25.59 mg/dL (95% CI = -44.00 to -7.18], glycosylated hemoglobin (HbAlc) by 0.73% (95% CI = -1.24 to -0.22), fasting insulin by 7.19 μIU/mL (95% CI = -12.10 to -2.28), and homeostatic model assessment for insulin resistance (HOMA-IR) by 3.87 (95% CI = -8.40 to -0.66). Compared to the control group, the walking group had a significant reduction in FBG by 12.37 mg/dL (95% CI = -20.06 to -4.68) and HbA1c by 0.35% (95% CI = -0.70 to -0.01). Compared to the walking group, the yoga group had a significant reduction in FBG by 12.07 mg/dL (95% CI = -24.34 to - 0.20), HbA1c by 0.20% (95% CI = -0.37 to -0.04), fasting insulin by 10.06 μIU/mL (95% CI = -23.84 to 3.71) and HOMA-IR by 5.97 (95% CI = -16.92 to 4.99). Conclusions Yoga or walking with OHA has positive effects on glycemic control. For the management of T2DM, yoga has relatively more significant effects on glycemic control than walking.Review registration number: PROSPERO registration number CRD42022310213.
Collapse
Affiliation(s)
- Biswajit Dhali
- Department of Physical Education, Jadavpur University, Kolkata, India
| | - Sridip Chatterjee
- Department of Physical Education, Jadavpur University, Kolkata, India
| | - Sudip Sundar Das
- Department of Physical Education, Jadavpur University, Kolkata, India
| | | |
Collapse
|
6
|
Promsrisuk T, Kongsui R, Sriraksa N, Boonla O, Srithawong A. Elastic band resistance combined with modified Thai yoga exercise to alleviate oxidative stress and airway inflammation in type 2 diabetes mellitus. J Exerc Rehabil 2023; 19:114-125. [PMID: 37163180 PMCID: PMC10164522 DOI: 10.12965/jer.2346040.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/26/2023] [Indexed: 05/11/2023] Open
Abstract
The objective of this study was to investigate the effects of the combination of elastic band resistance exercise (EBRE) with modified Thai yoga on the alleviation of blood glucose and oxidative stress in type 2 diabetes mellitus (T2DM). Forty-two patients with T2DM were enrolled and allocated to an exercise or control group (n=21/group). The exercise group participated in EBRE combination with modified Thai yoga for 40 min, 5 days/wk, for 12 consecutive weeks. Blood glucose, oxidative stress markers, antioxidants, pulmonary function, respiratory muscle strength, and airway inflammation were measured before and after the 12 weeks. The results showed that the exercise group had a significant reduction in fasting blood glucose and glycated hemoglobin. Moreover, T2DM patients in the exercise group showed a significant reduction in plasma malondialdehyde, while superoxide dismutase and catalase were significantly increased. The exercise group also observed a significant improvement in pulmonary function; forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow, and forced midexpiratory flow as well as respiratory muscle strength. Interestingly, the combination of EBRE with modified Thai yoga markedly improved airway inflammation through the reduction in fractional exhaled nitric oxide. In conclusion, these findings suggest that the combination of EBRE with modified Thai yoga improves blood glucose, oxidative stress, antioxidants, pulmonary function, respiratory muscle strength, and airway inflammation in T2DM patients. Hence, it could be considered as a possible exercise program for T2DM patients.
Collapse
Affiliation(s)
- Tichanon Promsrisuk
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao,
Thailand
- Unit of Excellence in the Pulmonary and Cardiovascular Health Care, University of Phayao, Phayao,
Thailand
| | - Ratchaniporn Kongsui
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao,
Thailand
| | - Napatr Sriraksa
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao,
Thailand
- Unit of Excellence in the Pulmonary and Cardiovascular Health Care, University of Phayao, Phayao,
Thailand
| | - Orachorn Boonla
- Faculty of Allied Health Sciences, Burapha University, Chonburi,
Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi,
Thailand
| | - Arunrat Srithawong
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao,
Thailand
- Corresponding author: Arunrat Srithawong, Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand,
| |
Collapse
|
7
|
Sanogo F, Xu K, Cortessis VK, Weigensberg MJ, Watanabe RM. Mind- and Body-Based Interventions Improve Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:69-79. [PMID: 36070591 DOI: 10.1089/jicm.2022.0586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims/Hypothesis: Only 51% of patients with type 2 diabetes achieve the hemoglobin A1c (HbA1c) <7% target. Mind and body practices have been increasingly used to improve glycemic control among patients with type 2 diabetes, but studies show inconsistent efficacy. The authors conducted a systematic review and meta-analysis to assess the association between mind and body practices, and mean change in HbA1c and fasting blood glucose (FBG) in patients with type 2 diabetes. Methods: The authors conducted a literature search of Ovid MEDLINE, Embase, and ClinicalTrials.gov seeking through June 10, 2022, published articles on mind and body practices and type 2 diabetes. Two reviewers independently appraised full text of articles. Only intervention studies were included. Reviewers extracted data for meta-analysis. Restricted maximum likelihood random-effects modeling was used to calculate the mean differences and summary effect sizes. The authors assessed heterogeneity using Cochran's Q and I2 statistics. Funnel plots were generated for each outcome to gauge publication bias. Weighted linear models were used to conduct study-level meta-regression analyses of practice frequency. Results: The authors identified 587 articles with 28 meeting the inclusion criteria. A statistically significant and clinically relevant mean reduction in HbA1c of -0.84% (95% confidence interval [CI]: -1.10% to -0.58%; p < 0.0001) was estimated. Reduction was observed in all intervention subgroups: mindfulness-based stress reduction: -0.48% (95% CI: -0.72% to -0.23%; p = 0.03), qigong: -0.66% (95% CI: -1.18% to -0.14%; p = 0.01), and yoga: -1.00% (95% CI: -1.38% to -0.63%; p < 0.0001). Meta-regression revealed that for every additional day of yoga practice per week, the raw mean HbA1c differed by -0.22% (95% CI: -0.44% to -0.003%; p = 0.046) over the study period. FBG significantly improved following mind and body practices, with overall mean difference of -22.81 mg/dL (95% CI: -33.07 to -12.55 mg/dL; p < 0.0001). However, no significant association was found between the frequency of weekly yoga practice and change in FBG over the study period. Conclusions/Interpretation: Mind and body practices are strongly associated with improvement in glycemic control in patients with type 2 diabetes. The overall mean reduction in HbA1c and FBG was clinically significant, suggesting that mind and body practices may be an effective, complementary nonpharmacological intervention for type 2 diabetes. Additional analyses revealed that the mean decrease in HbA1c was greater in studies requiring larger number of yoga practice sessions each week.
Collapse
Affiliation(s)
- Fatimata Sanogo
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Keren Xu
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Victoria K Cortessis
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Marc J Weigensberg
- USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Richard M Watanabe
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Physiology and Neuroscience, Keck School of Medicine of USC, Los Angeles, CA, USA
| |
Collapse
|
8
|
Chen S, Deng S, Liu Y, Yin T. Effects of Yoga on Blood Glucose and Lipid Profile of Type 2 Diabetes Patients Without Complications: A Systematic Review and Meta-Analysis. Front Sports Act Living 2022; 4:900815. [PMID: 35813055 PMCID: PMC9259958 DOI: 10.3389/fspor.2022.900815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Type II diabetes mellitus (T2DM) has become a worldwide public health problem. Although it has been empirically established that physical activity is a promising therapeutical approach to the prevention and management of T2DM, the effectiveness of yoga on T2DM has not yet reached an agreement across studies and also needs an updated synthetic examination. Purpose The purpose of this study was to examine the effect of yoga training on diabetes-related indicators compared with usual care. Methods The review protocol of this study has been registered in the PROSPERO with a registration number CRD42021267868. A systematic literature search through electronic databases was conducted to identify yoga-based intervention (i.e., randomized controlled trial [RCT]; e.g., yogic postures, movements, breathing, and meditation) studies reporting outcomes on glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), and body mass index (BMI). A number of two researchers manually reviewed and assessed each article using the Cochrane Risk of Bias Tool 2.0. The literature search identified 296 eligible entries, of which 13 were finalized after screening using predefined inclusion and exclusion criteria. The extracted data (group mean and standard deviation at posttest) were synthesized using random-effects meta-analyses. Finally, potential moderators were explored using subgroup analysis and sensitivity analysis. Results The standardized mean difference for the effects of yoga was significant on HbA1c (MD = −0.47; 95%CI: −0.77, −0.16; Z = 3.02, p = 0.003), FBG (SMD = −0.92; 95%CI: −1.55, −0.29; Z = 2.87, p = 0.004), PPBG (SMD = −0.53; 95%CI: −0.86, −0.21; Z = 3.20, p = 0.001), and TG (SMD = −0.32; 95%CI: −0.54, −0.10; Z = 2.86, p = 0.004). However, yoga effect was not observed on TC (SMD = −0.84; 95%CI: −1.71, 0.04; Z = 1.87, p = 0.06) and BMI (MD = −0.63; 95%CI: −1.42, 0.16; Z = 1.57, p = 0.12). Conclusion The findings suggest that yoga can improve the biochemical indices of blood glucose and the lipid profile of patients with T2DM. Therefore, yoga can be prescribed as an effective and active complementary treatment for T2DM. However, this study only tested yoga as a short-term treatment. In the future, rigorous RCTs with a larger sample size may be carried out to examine the long-term effect of yoga on T2DM. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=267868, identifier: CRD42021267868.
Collapse
|
9
|
Staudt MD, Prabhala T, Sheldon BL, Quaranta N, Zakher M, Bhullar R, Pilitsis JG, Argoff CE. Current Strategies for the Management of Painful Diabetic Neuropathy. J Diabetes Sci Technol 2022; 16:341-352. [PMID: 32856490 PMCID: PMC8861791 DOI: 10.1177/1932296820951829] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The development of painful diabetic neuropathy (PDN) is a common complication of chronic diabetes that can be associated with significant disability and healthcare costs. Prompt symptom identification and aggressive glycemic control is essential in controlling the development of neuropathic complications; however, adequate pain relief remains challenging and there are considerable unmet needs in this patient population. Although guidelines have been established regarding the pharmacological management of PDN, pain control is inadequate or refractory in a high proportion of patients. Pharmacotherapy with anticonvulsants (pregabalin, gabapentin) and antidepressants (duloxetine) are common first-line agents. The use of oral opioids is associated with considerable morbidity and mortality and can also lead to opioid-induced hyperalgesia. Their use is therefore discouraged. There is an emerging role for neuromodulation treatment modalities including intrathecal drug delivery, spinal cord stimulation, and dorsal root ganglion stimulation. Furthermore, consideration of holistic alternative therapies such as yoga and acupuncture may augment a multidisciplinary treatment approach. This aim of this review is to focus on the current management strategies for the treatment of PDN, with a discussion of treatment rationale and practical considerations for their implementation.
Collapse
Affiliation(s)
- Michael D Staudt
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
| | - Tarun Prabhala
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Breanna L Sheldon
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Nicholas Quaranta
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Michael Zakher
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Ravneet Bhullar
- Department of Anesthesiology, Albany Medical College, Albany, New York, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany NY, USA
| | - Charles E Argoff
- Department of Neurology, Albany Medical College, Albany, New York, USA
| |
Collapse
|
10
|
Venugopal V, Geethanjali S, Poonguzhali S, Padmavathi R, Mahadevan S, Silambanan S, Maheshkumar K. Effect of Yoga on Oxidative Stress in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis. Curr Diabetes Rev 2022; 18:e050421192663. [PMID: 33820522 DOI: 10.2174/1573399817666210405104335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/05/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus has a significant impact on public health. Oxidative stress plays a major role in the pathophysiology of Type 2 Diabetes Mellitus (T2DM), leading to various complications of T2DM. Yoga is being widely used in the management of T2DM. The primary objective of this systematic review and meta-analysis is to understand the effects of yoga on oxidative stress parameters among adult patients diagnosed with T2DM. MATERIALS AND METHODS Electronic databases such as PubMed, Scopus, Cochrane Library and Science Direct from start of the study till March 2020 were searched to obtain eligible studies. Study designs of all nature were included (except case studies and reviews). The primary outcome was Malondialdehyde (MDA) and secondary outcomes included fasting plasma glucose, HbA1C and Superoxide Dismutase (SOD) levels. RESULTS A total of four trials with a total of 440 patients met the inclusion criteria. The results of meta-analysis indicated that yoga significantly reduced MDA (SMD: -1.4; 95% CI -2.66 to -0.13; P = 0.03; I2 = 97%), fasting plasma glucose levels (SMD: -1.87: 95% CI -3.83 to -0.09; P = 0.06; I2= 99%), and HbA1c (SMD: -1.92; 95% CI - 3.03 to -0.81; P = 0.0007; I2 = 92%) in patients with T2DM. No such effect was found for SOD (SMD: -1.01; 95% CI -4.41 to 2.38; P = 0.56; I2= 99%). CONCLUSION The available evidence suggests that yoga reduces MDA, fasting plasma glucose and HbA1C, and thus would be beneficial in the management of T2DM as a complementary therapy. However, considering the limited number of studies and its heterogeneity, further robust studies are necessary to strengthen our findings and investigate the long-term benefits of yoga.
Collapse
Affiliation(s)
- V Venugopal
- Department of Yoga, Government Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
| | - S Geethanjali
- Department of Nutrition & Psychology, Government Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
| | - S Poonguzhali
- Department of Community Medicine, Government Yoga & Naturopathy Medical College & Hospital, Chennai- 600106, India
| | - R Padmavathi
- Department of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - S Mahadevan
- Department of Endocrinology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - S Silambanan
- Department of Biochemistry, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER) Chennai, Tamil Nadu, India
| | - K Maheshkumar
- Department of Physiology & Biochemistry, Govt. Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
| |
Collapse
|
11
|
Kurian J, Mohanthy S, Nanjumdaiah RM. Mechanism of action of yoga on prevention and management of type 2 diabetes mellitus: Narrative review. J Bodyw Mov Ther 2022; 29:134-139. [DOI: 10.1016/j.jbmt.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/23/2021] [Accepted: 10/17/2021] [Indexed: 10/20/2022]
|
12
|
Kaur N, Majumdar V, Nagarathna R, Malik N, Anand A, Nagendra HR. Diabetic yoga protocol improves glycemic, anthropometric and lipid levels in high risk individuals for diabetes: a randomized controlled trial from Northern India. Diabetol Metab Syndr 2021; 13:149. [PMID: 34949227 PMCID: PMC8696241 DOI: 10.1186/s13098-021-00761-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To study the effectiveness of diabetic yoga protocol (DYP) against management of cardiovascular risk profile in a high-risk community for diabetes, from Chandigarh, India. METHODS The study was a randomized controlled trial, conducted as a sub study of the Pan India trial Niyantrita Madhumeha Bharath (NMB). The cohort was identified through the Indian Diabetes Risk Scoring (IDRS) (≥ 60) and a total of 184 individuals were randomized into intervention (n = 91) and control groups (n = 93). The DYP group underwent the specific DYP training whereas the control group followed their daily regimen. The study outcomes included changes in glycemic and lipid profile. Analysis was done under intent-to-treat principle. RESULTS The 3 months DYP practice showed diverse results showing glycemic and lipid profile of the high risk individuals. Three months of DYP intervention was found to significantly reduce the levels of post-prandial glucose levels (p = 0.035) and LDL-c levels (p = 0.014) and waist circumference (P = 0.001). CONCLUSION The findings indicate that the DYP intervention could improve the metabolic status of the high-diabetes-risk individuals with respect to their glucose tolerance and lipid levels, partially explained by the reduction in abdominal obesity. The study highlights the potential role of yoga intervention in real time improvement of cardiovascular profile in a high diabetes risk cohort. TRIAL REGISTRATION CTRI, CTRI/2018/03/012804. Registered 01 March 2018-Retrospectively registered, http://www.ctri.nic.in/ CTRI/2018/03/012804.
Collapse
Affiliation(s)
- Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh, 160014, India
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Vijaya Majumdar
- Division of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, Karnataka, 560106, India
| | - Raghuram Nagarathna
- Division of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, Karnataka, 560106, India.
| | - Neeru Malik
- Dev Samaj College of Education, Sector 36B, Chandigarh, 160036, India
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | | |
Collapse
|
13
|
Patil SS, Raghuram N, Singh A, Rajesh SK, Ahmed S, Hongasandra N. A Prospective Study on Type-2 Diabetic Complications and Efficacy of Integrated Yoga: A Pan India 2017. Ann Neurosci 2021; 28:21-28. [PMID: 34733051 PMCID: PMC8558979 DOI: 10.1177/09727531211016271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background Type 2 diabetes (T2DM) contributes to high mortality and morbidity because of its major complications related to kidney, heart, brain, and eyes. It also poses a high risk for mortality because of COVID-19. Studies suggest the possible implications of Yoga in delaying or attenuating such complications. Methodology This was a pan-India multi centered cluster-randomized (4 level) two-armed trial in the rural and urban population of all populous states of India. Data were obtained using mobile app in all adults in the household of the selected clusters. Results We report the diabetes related complications in 16623 adults (48% males, 52% females) from 65 districts (1 in 10 districts, 2011 census) of 29 (out of 35) states and Union Territories of India; mean age was 48.2 ± 12.46 years. Out of this 40% lived in rural and 62% in urban locations. In high risk diabetes individuals (scored ≥ 60 points on Indian diabetes risk score key), 18.0% had self-reported history of (peripheral neuropathy, 6.1% had h/o major strokes, 5.5% had minor strokes (transient ischemic episodes), 18.1% had lower limb claudication, 20.5% leg ulcers, 4.4% had h/o cardiac surgery, 4.8% angioplasty, and 15.1% had diabetes retinopathy. Complications were higher in rural than in urban areas, higher in people with extended duration of diabetes. Integrated yoga module for three months (one hour daily) showed significantly better reduction in symptoms related to complications as compared to control group (P < .001). Conclusion The alarming high prevalence of complications in diabetes population calls for urgent action, where yoga may show the benefits in reduction of symptoms of complications.
Collapse
Affiliation(s)
- Suchitra S Patil
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Nagarathna Raghuram
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Amit Singh
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - S K Rajesh
- Department of Yoga and Physical Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Sabzar Ahmed
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Nagendra Hongasandra
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| |
Collapse
|
14
|
Danasegaran M, Pal GK, Sahoo J, Pal P, Nanda N, Renugasundari M. Effects of 12 Weeks Practice of Yoga on Heart Rate Variability in Males with Type 2 Diabetes Receiving Oral Antidiabetic Drugs: A Randomized Control Trial. J Altern Complement Med 2021; 27:1105-1115. [PMID: 34582701 DOI: 10.1089/acm.2020.0489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the effects of 12 weeks practice of a structured yoga module on heart rate variability (HRV) and cardiometabolic risks in patients with type 2 diabetes (T2D) receiving similar kind of oral antidiabetic drugs (OAD) with yoga therapy and without yoga therapy, matched for all the known confounders. Design: Parallel design interventional (randomized control trial) study. Subjects: Eighty treatment-naive males with T2D were randomized into control group (n = 40) and study group (n = 40). Intervention: Study group participants received a structured yoga therapy that included asana and pranayama practice for 12 weeks in addition to OAD, whereas control group participants received OAD alone. Outcome measures: Before and after intervention, BP parameters, rate pressure product (RPP) as the marker of myocardial stress, total power (TP) of HRV, low-frequency to high-frequency (LF-HF) ratio of HRV, homeostatic model of insulin resistance (HOMA-IR), lipid profile and lipid risk factors, malondialdehyde (MDA), and high-sensitive C-reactive protein (hsCRP) were measured. TP of HRV was defined as the primary outcome. Association of TP (the marker of HRV) and LF-HF ratio (the marker of sympathovagal balance) with cardiometabolic parameters was assessed by correlation and regression analyses. Results: After 12 weeks yoga therapy, there was significant reduction in cardiometabolic risks (TP of HRV, RPP, lipid risks factors, levels of MDA, and hsCRP) in study group subjects compared with control subjects that did not receive yoga therapy. All cardiometabolic risk factors were significantly correlated with TP in study group, having maximum significance with homeostatic model of insulin secretion (r = 0.502, p ≤ 0.001). Multiple regression analysis demonstrated the independent contribution of decrease in RPP, HOMA-IR, hsCRP, and MDA to increased TP and decreased LF-HF ratio in T2D patients after yoga therapy. Conclusion: From the results of this study, the authors conclude that 12 weeks practice of a structured yoga module improves TP of HRV, sympathovagal balance, and metabolic functions, and reduce cardiovascular (CV) risks in patients with diabetes who received routine antidiabetic medicines along with yoga therapy, compared with the patients with diabetes who received antidiabetic medicines alone. The reduction in cardiometabolic risks in these patients is linked to the improvement in TP of HRV. Future studies should also include a control group with rapid walking or a similar exercise program of equal time to the yoga intervention group to discern whether it is in fact yoga that is leading to these results and not simply increased CV activity. Clinical Trial Registry of India (No. CTRI/2021/06/034074).
Collapse
Affiliation(s)
| | | | | | - Pravati Pal
- Department of Physiology, JIPMER, Puducherry, India
| | | | | |
Collapse
|
15
|
Kurian J, Vijayakumar V, Mooventhan A, Mavathur R. Effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:649-651. [PMID: 33794078 DOI: 10.1515/jcim-2020-0215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/21/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The objective of the study is to evaluate the short-term effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus (T1DM). CASE PRESENTATION A 28-years old female was diagnosed with T1DM at the age of seven. She was under Human Mixtard insulin 30-70, thrice/day for 15-15-15 units. She had a history of poor glycemic control, diabetic ketoacidosis and hypoglycemic shock. At the age of 27, she got admitted with complaints of general weakness, joints stiffness and weight loss in our holistic health centre and underwent two weeks of yoga. Results showed a better reduction in the plasma glucose levels, lipid profile, blood pressure and insulin dose and an increase in hemoglobin levels with no episodes of hypoglycemia after yoga. CONCLUSIONS Yoga might be considered as a safer and effective adjuvant in the management of T1DM.
Collapse
Affiliation(s)
- Jintu Kurian
- Division of Yoga and Life Sciences, Department of Molecular Bioscience, S-VYASA Deemed to be University, Bengaluru, Karnataka, India
| | - Venugopal Vijayakumar
- Department of Yoga, Government Yoga and Naturopathy Medical College, Chennai, Tamilnadu, India
| | - A Mooventhan
- Department of Research, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, Tamilnadu, India
| | - Ramesh Mavathur
- Division of Yoga and Life Sciences, Department of Molecular Bioscience, S-VYASA Deemed to be University, Bengaluru, Karnataka, India
| |
Collapse
|
16
|
Viswanathan V, Sivakumar S, Sai Prathiba A, Devarajan A, George L, Kumpatla S. Effect of yoga intervention on biochemical, oxidative stress markers, inflammatory markers and sleep quality among subjects with type 2 diabetes in South India: Results from the SATYAM project. Diabetes Res Clin Pract 2021; 172:108644. [PMID: 33359750 DOI: 10.1016/j.diabres.2020.108644] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/12/2020] [Accepted: 12/21/2020] [Indexed: 11/27/2022]
Abstract
AIMS The aim of this study was to investigate the effect of yoga intervention on the biochemical, oxidative stress markers and inflammatory markers and sleep quality among subjects with type 2 diabetes. METHODS Subjects with type 2 diabetes attending a tertiary care centre for diabetes during Feb 2017 to Oct 2019 in Chennai, India were randomly assigned to two different groups. Group1(non-Yoga) (n = 150) was advised on simple physical exercises whereas group2(Yoga) (n = 150) was trained and advised to do yogasanas with static loosening exercises for 50 min for 5 days in a week. Both the groups were followed up for a period of 3 months. Anthropometric, biochemical, oxidative stress markers, inflammatory markers and sleep quality were assessed at baseline and after follow up. RESULTS There was a significant reduction in BMI, blood glucose levels, HbA1c, lipid levels, IL6, TNFα and TBARS in Yoga group as compared to non-Yoga group. There was marked improvement in the levels of Adiponectin, PTGIS and sleep quality among subjects practising yogasanas. CONCLUSION Regular practice of yogasanas improved glycaemic control, oxidative stress, inflammatory response and sleep quality among subjects with type 2 diabetes. Hence, Yogasanas can be used as an adjuvant therapy for managing type 2 diabetes.
Collapse
Affiliation(s)
- Vijay Viswanathan
- Department of Diabetology, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India.
| | - Sumathi Sivakumar
- Department of Yoga, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India
| | - A Sai Prathiba
- Department of Primary Prevention of Diabetes, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India
| | - Arutselvi Devarajan
- Department of Epidemiology, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India
| | - Leema George
- Department of Molecular Genetics, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India
| | - Satyavani Kumpatla
- Department of Biochemistry, M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India
| |
Collapse
|
17
|
Sawant RS, Zinjurke BD, Binorkar SV. Preventive aspect of ayurveda and yoga towards newly emerging disease COVID-19. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:667-678. [PMID: 33544526 DOI: 10.1515/jcim-2020-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022]
Abstract
The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.
Collapse
Affiliation(s)
- Ranjeet S Sawant
- Department of Rasashastra & BK, Smt. K. G. Mittal Punarvasu Ayurved College, Mumbai, India
| | - Bharat D Zinjurke
- Department of Swasthavritta & Yoga, Smt. K. G. Mittal Punarvasu Ayurved College, Mumbai, India
| | - Sandeep V Binorkar
- Department of Agadatantra, R. A. Podar Medical (Ayu.) College, Mumbai, India
| |
Collapse
|
18
|
Fakhari M, Fakhari M, BamBaeichi E. The effects of pilates and flavanol-rich dark chocolate consumption on the total antioxidant capacity, glycemic control and BMI in diabetic females with neuropathy complications. J Bodyw Mov Ther 2020; 26:294-299. [PMID: 33992261 DOI: 10.1016/j.jbmt.2020.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/20/2020] [Accepted: 11/13/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pilates is a type of exercise recommended to diabetic patients due to its health benefits. Dark chocolate is also well known for its antioxidant properties. The purpose of this study has been to compare the effects of regular Pilates and flavanol-rich dark chocolate consumption on the total antioxidant capacity (TAC), fasting blood glucose (FBG) and BMI in diabetic females with peripheral neuropathy complications. METHODS 36 diabetic patients enrolled in this single-blinded clinical trial. They were randomly allocated to the control (n = 12), Pilates and dark chocolate intake (n = 12), and Pilates and flavanol-free white chocolate (n = 12) groups. Two Pilates groups consumed 25 gr dark or white chocolate 10 min before each Pilates training session, three times per week, for 8 weeks. The control group consumed 25 gr of the same dark chocolate at a pre-determined time 3 times per week, without any regular exercise. Changes in TAC, BMI and FBG were then measured. RESULTS Paired t-test analysis showed significant increases in the TAC status, as compared to the baseline in all groups (P ≤ 0.05). However, BMI and FBG reduction were not significant. Covariance (ANCOVA) analysis also showed a significant difference between groups (p < 0.05). Post-hoc Bonferroni test revealed the group that consumed dark chocolate before training had statistically significant increase in the TAC status compared to other groups. CONCLUSION The findings indicated that regular flavanol-rich dark chocolate consumption and Pilates significantly increased the TAC status. While FBG was reduced, it was not statistically significant.
Collapse
Affiliation(s)
- Maryam Fakhari
- Sport Science Department, Isfahan University, Isfahan, Iran.
| | | | | |
Collapse
|
19
|
Khoshnaw DM, Ghadge AA. Yoga as a complementary therapy for metabolic syndrome: A narrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 19:6-12. [PMID: 32952098 DOI: 10.1016/j.joim.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/20/2020] [Indexed: 12/17/2022]
Abstract
Metabolic syndrome (MS) is associated with a sedentary and stressful lifestyle and affects underactive people disproportionately. Yoga is considered to be a low-impact mind-body stress-relieving exercise, and researchers are increasing their focus on the benefits of yoga for managing metabolic disorders. It is also important for physicians and health care professionals to understand the therapeutic efficacy of yoga intervention, in terms of its type, duration and frequency on various MS risk factors. The present review summarizes the current scientific understanding of the effects of yoga on MS risk factors such as glucose homeostasis markers, lipid profile, adipocytokines and cardiovascular risk factors, and discusses the possible mechanisms of action. MEDLINE, PubMed, Scopus and Cochrane Library were searched from their inception up to December 2019, using the keywords "metabolic syndrome," "diabetes," "cardiovascular diseases," "obesity" and "yoga." The literature summarized in this review have shown mixed effects of yoga on MS risk factors and do not provide robust evidence for its efficacy. More rigorous research and well-designed trials that have a higher standard of methodology and evaluate yoga's long-term impacts on MS are needed. Understanding yoga's biochemical and molecular mechanisms of action on various metabolic pathways is also needed.
Collapse
Affiliation(s)
- Dastan M Khoshnaw
- Department of Botany, Fergusson College, Savitribai Phule Pune University, Pune, Maharashtra 411004, India
| | - Abhijit A Ghadge
- Diabetes Laboratory, Interactive Research School for Health Affairs, Bharati Vidyapeeth, Pune, Maharashtra 411043, India.
| |
Collapse
|
20
|
Yadav R, Yadav RK, Khadgawat R, Pandey RM. Comparative efficacy of a 12 week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: a randomized controlled trial. Transl Behav Med 2020; 9:594-604. [PMID: 30020512 DOI: 10.1093/tbm/iby060] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The present randomized controlled trial (RCT) evaluated the comparative efficacy of 12 week yoga-based lifestyle intervention (YBLI) and dietary intervention (DI) alone on adipokines, inflammation, and oxidative stress in Indian adults with metabolic syndrome (Met S). A parallel, two arm, RCT was conducted in Integral Health Clinic (IHC), All India Institute of Medical Sciences, India from 2012 to 2014. IHC is an outpatient facility conducting YBLI programs for prevention and management of chronic diseases. Two hundred sixty men and women (20-45 years) visiting the outpatient department of a tertiary care hospital were diagnosed with Met S and randomized 1:1 to receive 12 week YBLI (n = 130) or DI (n = 130). Primary outcomes were change in plasma levels of adipokines (leptin, adiponectin, and leptin:adiponectin ratio), markers of inflammation (tumor necrosis factor [TNF]-α, interleukin [IL]-6), markers of oxidative stress (thiobarbituric acid reactive substances [TBARS], 8-hydroxy-2'-deoxyguanosine [8-OHdG], and superoxide dismutase [SOD]) measured at baseline, 2 weeks, and 12 weeks. YBLI group showed a significant decrease in leptin, leptin:adiponectin ratio, IL-6, 8-OHdG, and TBARS levels, whereas there was a significant increase in adiponectin and SOD levels. No significant changes were noticed in DI alone group. YBLI showed significantly greater reduction in TBARS levels than in DI group, suggestive of reduced oxidative stress in adults with Met S. A 12 week YBLI had a positive impact on oxidative stress versus DI alone in adults with Met S.
Collapse
Affiliation(s)
- Rashmi Yadav
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Khadgawat
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
21
|
Tobore TO. Towards a comprehensive theory of obesity and a healthy diet: The causal role of oxidative stress in food addiction and obesity. Behav Brain Res 2020; 384:112560. [DOI: 10.1016/j.bbr.2020.112560] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023]
|
22
|
Xia T, Yang Y, Li W, Tang Z, Huang Q, Li Z, Guo Y. Meditative Movements for Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:5745013. [PMID: 32089725 PMCID: PMC7016481 DOI: 10.1155/2020/5745013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/28/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Physical activity plays a specific role in the fundamental aspect of diabetes care. It is necessary to develop exercise programs for these patients. The aim of this systematic review is to summarize current evidence regarding the effectiveness of meditative movement in patients with type 2 diabetes. METHODS The following databases were searched: PubMed, CENTRAL, Web of Science, Ovid LWW, and EMBASE. Two independent investigators searched and screened the studies by finding duplications, excluding irrelevant titles and abstracts, and then selecting eligible studies by reviewing full texts. 21 studies fulfilled the inclusion criteria. Meta-analyses were performed on glycated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI). RESULTS Meta-analyses showed that meditative movements significantly improved FBG, HbA1c, PPBG, TC, LDL-C, and HDL-C. No improvement was found in BMI. CONCLUSIONS The results demonstrated a favorable effect or tendency of meditative movements to improve blood glucose and blood lipid levels in patients with type 2 diabetes mellitus. The special effects of meditative movements in type 2 diabetes mellitus patients need further research.
Collapse
Affiliation(s)
- Tingwei Xia
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Yue Yang
- Department of TCM, Qingyang District People's Hospital, Chengdu, Sichuan Province, China
| | - Weihong Li
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Zhaohui- Tang
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Qingsong Huang
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Zongrun Li
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Yongsong Guo
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| |
Collapse
|
23
|
Karrasch S, Hitzler M, Gumpp A, Karabatsiakis A, Kolassa IT. Molekulartoxische Folgen von chronischem und traumatischem Stress und deren Reversibilität durch entspannungs- und achtsamkeitsbasierte Interventionen. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000505380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
24
|
Ughreja RA, Ughreja RA. Type 2 diabetes mellitus, physical activity, yoga and telomere length: A literature review. JOURNAL OF INSULIN RESISTANCE 2019. [DOI: 10.4102/jir.v4i1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Type 2 diabetes mellitus (DM), a chronic metabolic disease prevalent in adults, is also prevalent amongst children, adolescents and young adults. On understanding the molecular basis of diabetes, a significant association is found between telomere length (TL) and type 2 DM.Aim: The aim of the study was to review the available evidence on effect of physical activity and yoga on DM including their effect on TL.Setting: The study was conducted in Bangalore.Method: A number of databases such as Google Scholar, PubMed and Cochrane Review were searched for relevant articles using keywords such as ’diabetes’, ‘type 2 DM’, ‘physical activity’, ‘yoga’, ‘TL’ and ‘telomerase activity’. All types of articles were included for the study, such as randomised controlled trial, systematic reviews, literature review and pilot study. Non-English articles were excluded from the study.Results: Studies have demonstrated the effectiveness of yoga and physical exercise in type 2 DM in various ways, such as reducing fasting blood glucose and glycosylated haemoglobin; improving lipid profile, blood pressure and waist-to-hip ratio; reducing inflammatory, oxidative and psychological stress markers; and improving the quality of life of patients. However, limited information is available on the effect of these interventions on TL in type 2 DM and mechanisms involved.Conclusion: Recent studies have shown positive effects of yoga and physical activity on TL. However, there is a dearth of good-quality studies evaluating the effects of yoga on TL in type 2 DM. Future studies need to be conducted with standard treatment protocols, long-term follow-up, appropriate control groups and large sample size.
Collapse
|
25
|
Baute V, Zelnik D, Curtis J, Sadeghifar F. Complementary and Alternative Medicine for Painful Peripheral Neuropathy. Curr Treat Options Neurol 2019; 21:44. [DOI: 10.1007/s11940-019-0584-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
26
|
Shiju R, Thomas D, Al Arouj M, Sharma P, Tuomilehto J, Bennakhi A. Effect of Sudarshan Kriya Yoga on anxiety, depression, and quality of life in people with type 2 diabetes: A pilot study in Kuwait. Diabetes Metab Syndr 2019; 13:1995-1999. [PMID: 31235126 DOI: 10.1016/j.dsx.2019.04.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 11/25/2022]
Abstract
AIM This pilot study in Kuwait was aimed to assess the effect of Sudarshan kriya yoga (SKY) on anxiety, depression and total quality of life in people with type 2 diabetes mellitus (T2DM). METHODS 26 T2DM patients aged greater than 30, male and female visiting the outpatient clinic of Dasman Diabetes Institute were enrolled for the study. Pre and post 5 day SKY intervention responses of participants on psychosocial problems were evaluated using four questionnaires (Hamilton anxiety, patient health questionnaire (PHQ-9), Hospital anxiety depression and WHO total quality of life (QOL). Biochemical parameters; such as lipid profile, glycated hemoglobin (HbA1c) were measured at baseline and after 15 weeks of SKY practice. RESULTS The mean age of the participants was 56.7 (±11.4 SD) years, and mean duration of diabetes 15.0 (±9.3 SD) years. Comparison of responses before and after intervention indicated a significant improvement in the QOL, depression, anxiety and insomnia. But no significant improvement in glycemic control. CONCLUSION Results indicate that SKY can be potentially beneficial for treating anxiety, insomnia, and depression associated in people with T2DM and in improving the quality of life in people with T2DM.
Collapse
Affiliation(s)
| | | | | | | | - Jaakko Tuomilehto
- National Institute of Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Finland
| | | |
Collapse
|
27
|
Tobore TO. On the Neurobiological Role of Oxidative Stress in Alcohol-Induced Impulsive, Aggressive and Suicidal Behavior. Subst Use Misuse 2019; 54:2290-2303. [PMID: 31369300 DOI: 10.1080/10826084.2019.1645179] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives: Alcohol abuse is known to result in behavioral impairments (such as increased impulsivity, aggressive, and suicidal behavior), but the neurobiological basis for these behavioral impairments remains unknown. The objective of this review is to propose a neurobiological basis for alcohol-induced aggression, impulsivity, and suicidal behavior. Methods: Search was done by accessing PubMed/Medline, EBSCO, and PsycINFO databases. The search string used was "(Alcohol OR Alcoholism* OR Alcohol Abuse) AND (Behavior* OR Behavioral Impairment or Disorder) AND (Oxidative Stress OR Reactive Oxygen Species)." The electronic databases were searched for titles or abstracts containing these terms in all published articles between January 1, 1960, and May 31, 2019. The search was limited to studies published in English and other languages involving both animal and human subjects. Articles selected included randomized clinical trials (RCTs), observational studies, meta-analyses, and both systemic and narrative reviews, providing both quantitative and qualitative information with a measure of alcohol abuse or alcoholism as an outcome. Exclusion criteria were unpublished data of any form, including conference proceedings and dissertation. New key terms were identified (new term included: "Antioxidants, Neurotransmitters, Dopamine, Serotonin, GABA, Glutamate. Aggression, Impulsivity, Suicidal Behavior, hippocampus, prefrontal cortex, limbic system, psychiatric disorders, PTSD, Anxiety, Depression. These new terms were searched with Alcohol or Alcoholism or Alcohol Abuse and Oxidative Stress separately resulting in the identification of over 3000 articles. 196 were included in this article. Results: Multiple lines of evidence indicate that oxidative stress (OS) plays a critical underlying role in alcohol toxicity and behavioral impairments. Conclusions/Importance: People diagnosed with PTSD, anxiety disorder, depression, and those with a personality high in psychoticism as measured by the P Scale of the Eysenck Personality Questionnaire, with comorbid alcohol abuse or alcohol use disorder (AUD), may display increased impulsivity, aggression, and suicidal behavior because of the potentiating effect of alcohol-induced OS on their elevated brain oxidative status. Antioxidant therapy should be an integral part of acute alcohol intoxication and AUD treatment. Further research is necessary to fully understand the relationship between OS and alcohol-induced behavioral impairments.
Collapse
|
28
|
Cheung C, Bhimani R, Wyman JF, Konczak J, Zhang L, Mishra U, Terluk M, Kartha RV, Tuite P. Effects of yoga on oxidative stress, motor function, and non-motor symptoms in Parkinson's disease: a pilot randomized controlled trial. Pilot Feasibility Stud 2018; 4:162. [PMID: 30377537 PMCID: PMC6198358 DOI: 10.1186/s40814-018-0355-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 10/15/2018] [Indexed: 01/04/2023] Open
Abstract
Objective To examine the feasibility, acceptability, and preliminary effects of Hatha yoga on oxidative stress, motor function, and non-motor symptoms among individuals with Parkinson's disease (PD). Methods The study has a pilot randomized controlled trial design with two arms: an immediate treatment group and a wait-list control group. The yoga-for-PD program was implemented via twice weekly 60-min group-based classes for 12 weeks. Participants were assessed at baseline, 12 weeks, and 6 months post-intervention. Outcome measures included oxidative stress, motor function, physical activity, cognitive function, sleep quality, and quality of life. Data on program acceptability and yoga adherence were collected during the intervention and at 6 months post-intervention. Results Participants (n = 20) had a mean age of 63 years (SD 8, range 49-75) and disease duration 4.8 years (SD 2.9, range 1-13). All participants had mild-moderate disease severity; 18 (90%) were on dopaminergic medications. Seventeen participants (85%) attended at least 75% of the classes and 4 (20%) attended all classes. Most participants (n = 17) reported they "definitely enjoyed" the intervention program. No adverse events were reported. At 12 weeks, there were no major differences in blood oxidative stress markers between the two groups. Motor function based on the Unified Parkinson's Disease Rating Scale was better in the treatment group, but their scores on sleep and outlook in Parkinson's Disease Quality of Life (PDQUALIF) Scale and the physical activity levels based on the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire were worse than those of the control group. In within-group comparisons, motor function, cognitive function, and catalase improved but three PDQUALIF domains (social and role function, sleep, and outlook) and physical activity level worsened by the end of the yoga intervention program compared to baseline. The response rate for the 6-month follow-up survey was 74% (n = 14) with six participants (43%) who signed up for a yoga class and four (29%) who practiced it independently. Health problems were the main barrier to yoga practice. Conclusion Yoga is feasible and acceptable and may serve as a complementary method for improving motor function in PD. Further research using a larger sample size is needed to determine its impact on oxidative stress and non-motor symptoms. Trial registration ClinicalTrials.gov Registration Number: NCT02509610031.
Collapse
Affiliation(s)
- Corjena Cheung
- 1School of Nursing, University of Minnesota, Minneapolis, MN 55455 USA
| | - Rozina Bhimani
- 1School of Nursing, University of Minnesota, Minneapolis, MN 55455 USA
| | - Jean F Wyman
- 1School of Nursing, University of Minnesota, Minneapolis, MN 55455 USA
| | - Jürgen Konczak
- 2School of Kinesiology, University of Minnesota, Minneapolis, MN 55455 USA
| | - Lei Zhang
- 3Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55455 USA
| | - Usha Mishra
- 4Center for Orphan Drug Research, Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455 USA
| | - Marcia Terluk
- 4Center for Orphan Drug Research, Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455 USA
| | - Reena V Kartha
- 4Center for Orphan Drug Research, Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455 USA
| | - Paul Tuite
- 5Department of Neurology, University of Minnesota, Minneapolis, MN 55455 USA
| |
Collapse
|
29
|
Raveendran AV, Deshpandae A, Joshi SR. Therapeutic Role of Yoga in Type 2 Diabetes. Endocrinol Metab (Seoul) 2018; 33:307-317. [PMID: 30112866 PMCID: PMC6145966 DOI: 10.3803/enm.2018.33.3.307] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/11/2018] [Accepted: 05/09/2018] [Indexed: 11/11/2022] Open
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.
Collapse
Affiliation(s)
- Arkiath Veettil Raveendran
- Department of General Medicine, Government Medical College, Kozhikode, India
- Department of Internal Medicine, Badr Al Samaa Hospital, Barka, Oman.
| | - Anjali Deshpandae
- Padma Yog Sadhana, A Unit of Terna Public Charitable Trust, Navi Mumbai, India
| | - Shashank R Joshi
- Joshi Clinic, Lilavati Hospital and Bhatia Hospital, Mumbai, India
| |
Collapse
|
30
|
Jayawardena R, Ranasinghe P, Chathuranga T, Atapattu PM, Misra A. The benefits of yoga practice compared to physical exercise in the management of type 2 Diabetes Mellitus: A systematic review and meta-analysis. Diabetes Metab Syndr 2018; 12:795-805. [PMID: 29685823 DOI: 10.1016/j.dsx.2018.04.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 04/09/2018] [Indexed: 12/26/2022]
Abstract
Yoga is increasingly used as an adjunctive therapy in the management of Type-2 Diabetes Mellitus (T2DM). The present study aims to systematically evaluate the literature and perform a meta-analysis on the effects of yoga practice compared to physical exercise in the management of T2DM. Data were obtained using a stepwise search process using keywords in the following online medical databases; PubMed, Web of Science and Scopus. All controlled clinical trials involving patients with T2DM, comparing yoga as an intervention with physical exercise and evaluating glycaemic control and other outcomes between the intervention and control groups were included in the analysis. Eight studies were eligible to be included in the systematic review. In total, 842 participants were assigned to a Yoga intervention or a control group with an Exercise intervention and the age range of participants was 30-78 years. A significant reduction in FBG (15.16 mg/dl), PPBG (28.66 mg/dl), HbA1c (0.39%) and BMI (0.71 kg/m2) was noted in the intervention group ('Yoga') compared to the control group ('Physical Exercise') in the pooled analysis. We did not observe any significant difference between the two groups for lipid parameters, other body composition measures (WC and WHR) and Blood Pressure. In conclusion, our results show that Yoga has beneficial effects on glycaemic control in comparison to physical exercise in T2DM However, individual studies showed considerable heterogeneity. Hence, further well-controlled randomized trials are required prior to drawing conclusions about the benefits of yoga in comparison to physical exercise.
Collapse
Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Tharindu Chathuranga
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, India
| |
Collapse
|
31
|
Thind H, Fava JL, Guthrie KM, Stroud L, Gopalakrishnan G, Sillice M, Gidron N, Bock BC. Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and in Control (HA1C) Study. Int J Yoga Therap 2018; 28:123-132. [PMID: 30130144 DOI: 10.17761/2018-00026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management.
Collapse
Affiliation(s)
- Herpreet Thind
- 1. Assistant Professor, Department of Public Health, University of Massachusetts, Lowell, Mass
| | - Joseph L Fava
- 2. Research Associate, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Kate M Guthrie
- 3. Associate Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Laura Stroud
- 3. Associate Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Geetha Gopalakrishnan
- 4. Associate Professor of Medicine, The Warren Alpert Medical School of Brown University, Lifespan Center for Diabetes and Endocrinology, East Providence, R.I
| | - Marie Sillice
- 5. Postdoctoral Fellow, The Warren Alpert Medical School of Brown University, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Naama Gidron
- 6. Certified Iyengar Yoga Instructor, and Director, Motion Center Yoga Collective, Pawtucket, R.I
| | - Beth C Bock
- 7. Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, The Miriam Hospital, Providence, R.I
| |
Collapse
|
32
|
The effects of yoga exercise on lipid peroxidation and antioxidant status in pregnant women. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2018. [DOI: 10.1016/j.injms.2018.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
33
|
Ghezzi P, Floridi L, Boraschi D, Cuadrado A, Manda G, Levic S, D'Acquisto F, Hamilton A, Athersuch TJ, Selley L. Oxidative Stress and Inflammation Induced by Environmental and Psychological Stressors: A Biomarker Perspective. Antioxid Redox Signal 2018; 28:852-872. [PMID: 28494612 DOI: 10.1089/ars.2017.7147] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
SIGNIFICANCE The environment can elicit biological responses such as oxidative stress (OS) and inflammation as a consequence of chemical, physical, or psychological changes. As population studies are essential for establishing these environment-organism interactions, biomarkers of OS or inflammation are critical in formulating mechanistic hypotheses. Recent Advances: By using examples of stress induced by various mechanisms, we focus on the biomarkers that have been used to assess OS and inflammation in these conditions. We discuss the difference between biomarkers that are the result of a chemical reaction (such as lipid peroxides or oxidized proteins that are a result of the reaction of molecules with reactive oxygen species) and those that represent the biological response to stress, such as the transcription factor NRF2 or inflammation and inflammatory cytokines. CRITICAL ISSUES The high-throughput and holistic approaches to biomarker discovery used extensively in large-scale molecular epidemiological exposome are also discussed in the context of human exposure to environmental stressors. FUTURE DIRECTIONS We propose to consider the role of biomarkers as signs and to distinguish between signs that are just indicators of biological processes and proxies that one can interact with and modify the disease process. Antioxid. Redox Signal. 28, 852-872.
Collapse
Affiliation(s)
- Pietro Ghezzi
- 1 Brighton & Sussex Medical School , Brighton, United Kingdom
| | - Luciano Floridi
- 2 Oxford Internet Institute, University of Oxford , Oxford, United Kingdom .,3 Alan Turing Institute , London, United Kingdom
| | - Diana Boraschi
- 4 Institute of Protein Biochemistry , National Research Council, Napoli, Italy
| | - Antonio Cuadrado
- 5 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Investigación Sanitaria La Paz (IdiPaz), Instituto de Investigaciones Biomédicas Alberto Sols UAM-CSIC , Madrid, Spain .,6 Department of Biochemistry, Faculty of Medicine, Autonomous University of Madrid , Madrid, Spain
| | - Gina Manda
- 7 "Victor Babes" National Institute of Pathology , Bucharest, Romania
| | - Snezana Levic
- 1 Brighton & Sussex Medical School , Brighton, United Kingdom
| | - Fulvio D'Acquisto
- 8 William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London , London, United Kingdom
| | - Alice Hamilton
- 8 William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London , London, United Kingdom
| | - Toby J Athersuch
- 9 Department of Surgery and Cancer, Faculty of Medicine, and MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , London, United Kingdom
| | - Liza Selley
- 9 Department of Surgery and Cancer, Faculty of Medicine, and MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , London, United Kingdom
| |
Collapse
|
34
|
|
35
|
Sinha SS, Jain AK, Tyagi S, Gupta SK, Mahajan AS. Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease. Int J Yoga 2018; 11:122-128. [PMID: 29755221 PMCID: PMC5934947 DOI: 10.4103/ijoy.ijoy_30_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background and Objectives: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. It has been recognized that stress, diabetes, and hypertension are important in etiology and progression of CAD. This study is to evaluate the role of meditation in improving biochemical parameters such as blood glucose, glycosylated hemoglobin, and serum insulin levels in known CAD patients. Material and Methods: Sixty CAD patients are divided into two groups of which one group did meditation and other did not. Blood glucose, glycosylated hemoglobin, and fasting serum insulin levels were measured before and at the end of 6 months of study in both the groups. Results: At the end of the study, significant decrease was seen in patients who practiced meditation as compared to other group. Conclusion: Meditation may modulate the physiological response to stress through neurohumoral activation, which may be a novel therapeutic target for the treatment of CAD.
Collapse
Affiliation(s)
| | - Ajay Kumar Jain
- Department of Physiology, Maulana Azad Medical College, New Delhi, India
| | - Sanjay Tyagi
- Department of Cardiology, G. B. Pant Hospital, New Delhi, India
| | - S K Gupta
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
| | - Aarti Sood Mahajan
- Department of Physiology, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
36
|
Manna I. Effects of Yoga Training on Body Composition and Oxidant-Antioxidant Status among Healthy Male. Int J Yoga 2018; 11:105-110. [PMID: 29755218 PMCID: PMC5934944 DOI: 10.4103/ijoy.ijoy_31_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The stressful condition may cause oxidative stress, which is responsible for various diseases. Aims The present study was designed to find out whether yoga has impact on the reduction of oxidative stress. Methods For the present study, 95 (n = 95) healthy male volunteers within the age group of 18-24 years were included, 35 (n = 35) volunteers were excluded. The remaining 60 (n = 60) volunteers were randomly divided into two groups: (a) Yoga Group (n = 30) and (b) Control Group (n = 30). Yoga training was given for 60 min per day, 6 days per week for 12 weeks in the yoga group, with no yoga training in control group. Assessment of body composition and oxidant-antioxidant status were performed in both the groups at baseline, before yoga training (0 week) and after (12 weeks) of the training. Results Significant reduction (P < 0.001) in the percentage of body fat and malondialdehyde; significant elevation (P < 0.001) in superoxide dismutase, catalase, reduced glutathione and ascorbic acid levels were noted in the yoga group after 12 weeks when compared to baseline data (0 week). However, there was no significant difference in height, weight, body mass index, body surface area and lean body mass among the yoga group after 12 weeks when compared to baseline data. These changes might be due to yoga training. Conclusions Regular yoga practice reduces body fat and oxidative stress. Yoga training may be helpful to reduce the chance of occurrence of various diseases and helps to maintain normal healthy lifestyle.
Collapse
Affiliation(s)
- Indranil Manna
- Department of Physiology, Midnapore College (Autonomous), Midnapore, West Bengal, India
| |
Collapse
|
37
|
Thind H, Lantini R, Balletto BL, Donahue ML, Salmoirago-Blotcher E, Bock BC, Scott-Sheldon LAJ. The effects of yoga among adults with type 2 diabetes: A systematic review and meta-analysis. Prev Med 2017; 105:116-126. [PMID: 28882745 PMCID: PMC5653446 DOI: 10.1016/j.ypmed.2017.08.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 12/31/2022]
Abstract
The purpose of this meta-analysis was to examine the effects of yoga for glycemic control among adults with type 2 diabetes (T2DM). Comprehensive electronic databases searches located 2559 unique studies with relevant key terms. Studies were included if they (1) evaluated a yoga intervention to promote T2DM management, (2) used a comparison group, (3) reported an objective measure of glycemic control at post-intervention, and (4) had follow-up length or post-test of at least 8weeks from baseline. Independent raters coded participant, design and methodological characteristics and intervention content. Summary effect sizes and 95% confidence intervals (CI) were calculated. Twenty-three studies with 2473 participants (mean age=53years; 43% women) met eligibility criteria. Compared with controls, yoga participants were successful in improving their HbA1c (d+=0.36, 95% CI=0.16, 0.56; k=16), FBG (d+=0.58, 95% CI=0.40, 0.76; k=20), and PPBG (d+=0.40, 95% CI=0.23, 0.56; k=14). Yoga was also associated with significant improvements in lipid profile, blood pressure, body mass index, waist/hip ratio and cortisol levels. Overall, studies satisfied an average of 41% of the methodological quality (MQ) criteria; MQ score was not associated with any outcome (Ps >0.05). Yoga improved glycemic outcomes and other risk factors for complications in adults with T2DM relative to a control condition. Additional studies with longer follow-ups are needed to determine the long-term efficacy of yoga for adults with T2DM.
Collapse
Affiliation(s)
- Herpreet Thind
- Department of Public Health, University of Massachusetts Lowell, One University Avenue, Southwick 326 A, Lowell, MA 01854, United States.
| | - Ryan Lantini
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Brittany L Balletto
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Marissa L Donahue
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Medicine, Alpert School of Medicine, Brown University, 593 Eddy Street, Providence, RI 02903, United States
| | - Beth C Bock
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, 700 Butler Dr., Providence, RI 02906, United States; Department of Behavioral and Social Science, Alpert School of Medicine, Brown University, 121 South Main Street, Providence, RI 02903, United States
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, 700 Butler Dr., Providence, RI 02906, United States; Department of Behavioral and Social Science, Alpert School of Medicine, Brown University, 121 South Main Street, Providence, RI 02903, United States
| |
Collapse
|
38
|
Mooventhan A. A narrative review on role of Yoga as an adjuvant in the management of risk factor, disease progression and the complications of type 2 diabetes mellitus. Diabetes Metab Syndr 2017; 11 Suppl 1:S343-S346. [PMID: 28283397 DOI: 10.1016/j.dsx.2017.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/03/2017] [Indexed: 12/19/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is one of the major health problems in the world as well as in India that greatly affects the health care sector and economy. Use of drugs has its own drawbacks and in recent days the use of non-medical measures were reported not only to manage T2DM, but also to prevent its complications. Through there are various review articles that are dealing with the effect of Yoga on risk profiles, management along with the mechanisms of action of yoga in T2DM separately, there is a lack of comprehensive review on the effect of Yoga in combination with all the above mentioned including the effect of Yoga in the management of T2DM complications. Hence, we performed a narrative review in Medline/PubMed using keyword "Yoga and diabetes". All the relevant articles published till 08th November 2016 were included. Based on the available literature, it could be concluded that Yoga plays a vital role as an adjuvant in the management of risk factors, disease progression and the complications of the T2DM. Further studies are warranted using standard research designs and variables to find out the various mechanisms of effects of Yoga in detail.
Collapse
Affiliation(s)
- A Mooventhan
- Department of Research and Development, S-VYASA University, Bengaluru, Karnataka, India.
| |
Collapse
|
39
|
Pal R, Gupta N. Yogic practices on oxidative stress and of antioxidant level: a systematic review of randomized controlled trials. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2017; 16:/j/jcim.ahead-of-print/jcim-2017-0079/jcim-2017-0079.xml. [PMID: 29068790 DOI: 10.1515/jcim-2017-0079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/08/2017] [Indexed: 02/03/2023]
Abstract
Background Many clinical trials have evaluated the oxidative stress reduction and enhancement of antioxidant status following yogic practices, but a review has not been reported earlier. Present study is designed to systematically review the effect of yogic practices on oxidative stress and antioxidant status. Content Using the MEDLINE, EMBASE SCOPEMED, and Indian database electronic searches were performed through August 2016 using the keywords yoga AND oxidative stress OR antioxidant which yielded 97 studies. Selections were made to include only experimental studies written in English, published in peer-reviewed journals and investigating the effects of regular yogic practices on oxidative stress and antioxidant status in these studies. Summary and outlook Search yielded a total of 97 trials, 11 met rigorous criteria for final systematic review. Healthy population showed overall enhancement of antioxidant status and reduced oxidative stress following yogic practices. Diabetic patients showed increased glutathione, vitamin C content and superoxide dismutase activity and decreased malondialdehyde content following yogic practices. Prediabetic and hypertensive patients showed reduced malondialdehyde content following yogic practices. Renal disease patients showed decreased protein oxidation, and increased superoxide dismutase activity following yogic practices. Regular yogic practices can improve antioxidants and reduce oxidative stress in healthy, diabetic, prediabetic, hypertensive and renal disease patients. Studies on other disease population have rarely been reported and studies are very few to conclude strongly.
Collapse
Affiliation(s)
- Rameswar Pal
- Physiology Department, Bhojia Dental College and Hospital, Bhud, Baddi, India
| | - Navin Gupta
- Physiology Department, PDM Dental College and Research Institute, Bahadurgarh, India
| |
Collapse
|
40
|
Parasoglou P, Rao S, Slade JM. Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy. Clin Ther 2017; 39:1085-1103. [PMID: 28571613 PMCID: PMC5503477 DOI: 10.1016/j.clinthera.2017.05.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The present review highlights current concepts regarding the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. It discusses the lack of effective pharmacologic treatments and the role of physical exercise intervention in limb protection and symptom reversal. It also highlights the importance of magnetic resonance imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. METHODS This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of patients with diabetes. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. FINDINGS Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This finding is an important concern for patients with DPN because their falls are likely to be injurious and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate-intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and partially reverse some of the symptoms of DPN. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. IMPLICATIONS Noninvasive exercise intervention is particularly valuable in DPN because of its safety, low cost, and potential to augment pharmacologic interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed.
Collapse
Affiliation(s)
- Prodromos Parasoglou
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, New York.
| | - Smita Rao
- Department of Physical Therapy, New York University, New York, New York
| | - Jill M Slade
- Department of Radiology, Michigan State University, East Lansing, Michigan; Biomedical Imaging Research Center, Michigan State University, East Lansing, Michigan
| |
Collapse
|
41
|
Munster-Segev M, Fuerst O, Kaplan SA, Cahn A. Incorporation of a Stress Reducing Mobile App in the Care of Patients With Type 2 Diabetes: A Prospective Study. JMIR Mhealth Uhealth 2017; 5:e75. [PMID: 28554881 PMCID: PMC5468539 DOI: 10.2196/mhealth.7408] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/23/2017] [Accepted: 04/09/2017] [Indexed: 11/13/2022] Open
Abstract
Background Severe and sustained emotional stress creates a physiological burden through increased sympathetic activity and higher energy demand. This may lead to increased oxidative stress and development of the metabolic syndrome. Emotional stress has been shown to contribute to the onset, progression, and control of type 2 diabetes (T2D). Stress management and biofeedback assisted relaxation have been shown to improve glycemic control. Use of a mobile app for stress management may enhance the scalability of such an approach. Objective The aim of this study was to assess the effect of using a mobile app of biofeedback-assisted relaxation on weight, blood pressure (BP), and glycemic measures of patients with T2D. Methods Adult patients with T2D and inadequate glycemic control (hemoglobin A1c [HbA1c]>7.5%) were recruited from the outpatient diabetes clinic. Baseline weight, BP, HbA1c, fasting plasma glucose (FPG), triglycerides (TG), and 7-point self-monitoring of blood glucose were measured. Patients were provided with a stress reducing biofeedback mobile app and instructed to use it 3 times a day. The mobile app—Serenita—is an interactive relaxation app based on acquiring a photoplethysmography signal from the mobile phone’s camera lens, where the user places his finger. The app collects information regarding the user’s blood flow, heart rate, and heart rate variability and provides real-time feedback and individualized breathing instructions in order to modulate the stress level. All clinical and biochemical measures were repeated at 8 and 16 weeks of the study. The primary outcome was changes in measures at 8 weeks. Results Seven patients completed 8 weeks of the study and 4 completed 16 weeks. At week 8, weight dropped by an average of 4.0 Kg (SD 4.3), systolic BP by 8.6 mmHg (SD 18.6), HbA1c by 1.3% (SD 1.6), FPG by 4.3 mmol/l (4.2), and serum TG were unchanged. Conclusions Stress reduction using a mobile app based on biofeedback may improve glycemic control, weight, and BP.
Collapse
Affiliation(s)
- Maya Munster-Segev
- Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | | - Steven A Kaplan
- Icahn School of Medicine and Director of the Men's Wellness Program Mount Sinai, New York, NY, United States
| | - Avivit Cahn
- Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel.,Endocrinology and Metabolism Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| |
Collapse
|
42
|
Lew JKS, Pearson JT, Schwenke DO, Katare R. Exercise mediated protection of diabetic heart through modulation of microRNA mediated molecular pathways. Cardiovasc Diabetol 2017; 16:10. [PMID: 28086863 PMCID: PMC5237289 DOI: 10.1186/s12933-016-0484-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/17/2016] [Indexed: 12/18/2022] Open
Abstract
Hyperglycaemia, hypertension, dyslipidemia and insulin resistance collectively impact on the myocardium of people with diabetes, triggering molecular, structural and myocardial abnormalities. These have been suggested to aggravate oxidative stress, systemic inflammation, myocardial lipotoxicity and impaired myocardial substrate utilization. As a consequence, this leads to the development of a spectrum of cardiovascular diseases, which may include but not limited to coronary endothelial dysfunction, and left ventricular remodelling and dysfunction. Diabetic heart disease (DHD) is the term used to describe the presence of heart disease specifically in diabetic patients. Despite significant advances in medical research and long clinical history of anti-diabetic medications, the risk of heart failure in people with diabetes never declines. Interestingly, sustainable and long-term exercise regimen has emerged as an effective synergistic therapy to combat the cardiovascular complications in people with diabetes, although the precise molecular mechanism(s) underlying this protection remain unclear. This review provides an overview of the underlying mechanisms of hyperglycaemia- and insulin resistance-mediated DHD with a detailed discussion on the role of different intensities of exercise in mitigating these molecular alterations in diabetic heart. In particular, we provide the possible role of exercise on microRNAs, the key molecular regulators of several pathophysiological processes.
Collapse
Affiliation(s)
- Jason Kar Sheng Lew
- Department of Physiology, HeartOtago, University of Otago, 270, Great King Street, Dunedin, 9010, New Zealand
| | - James T Pearson
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.,Biomedicine Discovery Institute and Department of Physiology, Monash University, Clayton, Australia
| | - Daryl O Schwenke
- Department of Physiology, HeartOtago, University of Otago, 270, Great King Street, Dunedin, 9010, New Zealand.
| | - Rajesh Katare
- Department of Physiology, HeartOtago, University of Otago, 270, Great King Street, Dunedin, 9010, New Zealand.
| |
Collapse
|
43
|
Abstract
Autonomic dysfunction is a frequent and relevant complication of diabetes mellitus, as it is associated with increased morbidity and mortality. In addition, it is today considered as predictive of the most severe diabetic complications, like nephropathy and retinopathy. The classical methods of screening are the cardiovascular reflex tests and were originally interpreted as evidence of nerve damage. A more modern approach, based on the integrated control of cardiovascular and respiratory function, reveals that these abnormalities are to a great extent functional, at least in the early stage of the disease, thus suggesting new potential interventions. Therefore, this review aims to go further investigating how the imbalance of the autonomic nervous system is altered and can be influenced in many chronic pathologies through a global view of cardio-respiratory and metabolic interactions and how the same mechanisms are applicable to diabetes.
Collapse
Affiliation(s)
- Luciano Bernardi
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, University of Helsinki, Helsinki, Finland.
- Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
- , Villaggio dei Pioppi 2, 27020, Torre d'Isola, Italy.
| | - Lucio Bianchi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, Paris-Nord University, Bondy, France
| |
Collapse
|
44
|
Lauche R, Langhorst J, Lee MS, Dobos G, Cramer H. A systematic review and meta-analysis on the effects of yoga on weight-related outcomes. Prev Med 2016; 87:213-232. [PMID: 27058944 DOI: 10.1016/j.ypmed.2016.03.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/26/2016] [Accepted: 03/17/2016] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Overweight and obesity are among the most important modifiable risk factors for chronic diseases and premature death. The aim of this review was to systematically assess and analyze the effects of yoga on weight-related outcomes. METHODS Medline/PubMed, Scopus, and the Cochrane Library were screened through March 2015 for randomized controlled trials on yoga for weight-related outcomes in the general population or overweight/obese individuals. Risk of bias was assessed using the Cochrane risk of bias tool on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias. RESULTS Out of 445 records identified during literature search, 30 trials with a total of 2173 participants were included. No effects on weight, body mass index, body fat percentage or waist circumference were found. In studies with healthy adult participants an effect of yoga compared to usual care was found regarding waist/hip ratio (SMD=--1.00; 95% CI=--1.44, -0.55; p<0.001). In studies with overweight/obese participants only, effects relative to usual care were found for body mass index (SMD=-0.99; 95% CI=-1.67, -0.31; p=0.004). Effects however were not robust against selection bias; and publication bias could not be ruled out. No intervention-related adverse events were reported. CONCLUSIONS Despite methodological drawbacks, yoga can be preliminarily considered a safe and effective intervention to reduce body mass index in overweight or obese individuals.
Collapse
Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Myeong Soo Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
| |
Collapse
|
45
|
Pai LW, Li TC, Hwu YJ, Chang SC, Chen LL, Chang PY. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2016; 113:77-85. [PMID: 26822261 DOI: 10.1016/j.diabres.2016.01.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/30/2015] [Accepted: 01/07/2016] [Indexed: 11/19/2022]
Abstract
The objective of this study was to systematically review the effectiveness of different types of regular leisure-time physical activities and pooled the effect sizes of those activities on long-term glycemic control in people with type 2 diabetes compared with routine care. This review included randomized controlled trials from 1960 to May 2014. A total of 10 Chinese and English databases were searched, following selection and critical appraisal, 18 randomized controlled trials with 915 participants were included. The standardized mean difference was reported as the summary statistic for the overall effect size in a random effects model. The results indicated yoga was the most effective in lowering glycated haemoglobin A1c (HbA1c) levels. Meta-analysis also revealed that the decrease in HbA1c levels of the subjects who took part in regular leisure-time physical activities was 0.60% more than that of control group participants. A higher frequency of regular leisure-time physical activities was found to be more effective in reducing HbA1c levels. The results of this review provide evidence of the benefits associated with regular leisure-time physical activities compared with routine care for lowering HbA1c levels in people with type 2 diabetes.
Collapse
Affiliation(s)
- Lee-Wen Pai
- Department of Public Health, China Medical University, Taichung, Taiwan; Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan No. 666, Buzih Road, Beitun District, Taichung City 40601, Taiwan.
| | - Tsai-Chung Li
- Department of Public Health, China Medical University, Taichung, Taiwan.
| | - Yueh-Juen Hwu
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan No. 666, Buzih Road, Beitun District, Taichung City 40601, Taiwan.
| | - Shu-Chuan Chang
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan No. 666, Buzih Road, Beitun District, Taichung City 40601, Taiwan.
| | - Li-Li Chen
- School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
| | - Pi-Ying Chang
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan No. 666, Buzih Road, Beitun District, Taichung City 40601, Taiwan.
| |
Collapse
|
46
|
Kumar V, Jagannathan A, Philip M, Thulasi A, Angadi P, Raghuram N. Role of yoga for patients with type II diabetes mellitus: A systematic review and meta-analysis. Complement Ther Med 2016; 25:104-12. [PMID: 27062957 DOI: 10.1016/j.ctim.2016.02.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022] Open
Abstract
To understand the role and efficacy of yoga in the management of type 2 diabetes mellitus, this meta-analysis was conducted. Electronic data bases searched were PubMed/Medline, ProQuest, PsycINFO, IndMED, CENTRAL, Cochrane library, CamQuest and CamBase till December 17, 2014. Eligible outcomes were fasting blood sugar (FBS), post prandial blood sugar (PPBS) and glycosylated haemoglobin (HBA1C). Randomized controlled trials and controlled trials were eligible. Studies focussing only on relaxation or meditation or multimodal intervention were not included. A total of 17 RCTs were included for review. Data from research articles on patients, methods, interventions- control and results were extracted. Mean and standard deviations were utilized for calculating standardized mean difference with 95% confidence interval. Heterogeneity was assessed with the help of I(2) statistics. χ(2) was used to rule out the effects of heterogeneity due to chance alone. Beneficial effects of yoga as an add-on intervention to standard treatment in comparison to standard treatment were observed for FBS [Standardized Mean Difference (SMD) -1.40, 95%CI -1.90 to -0.90, p˂0.00001]; PPBS [SMD -0.91, 95%CI -1.34 to -0.48, p˂0.0001] as well as HBA1C [SMD -0.64, 95%CI -0.97 to -0.30, p˂0.0002]. But risk of bias was overall high for included studies. With this available evidence, yoga can be considered as add-on intervention for management of diabetes.
Collapse
Affiliation(s)
- Vinod Kumar
- Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA), Bengaluru, India.
| | - Aarti Jagannathan
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Mariamma Philip
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Arun Thulasi
- Samatvam Healthcare Pvt. Limited, Bengaluru, India.
| | - Praveen Angadi
- Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA), Bengaluru, India.
| | | |
Collapse
|
47
|
Abstract
OBJECTIVE We sought to prospectively evaluate the impact of a 10 minute seated yoga program added to standard comprehensive diabetes care on glucose control and cardiovascular health in the severely ill, medically complex diabetic population. METHOD A total of 10 patients with type 2 diabetes, ages 49-77, with duration of diabetes >10 years and haemoglobin A1C >9% (75 mmol/mol) were included in the study. Patients randomized to a yoga intervention were taught a 10 minute seated yoga practice, were given an explanatory DVD and a fold-out pocket guide to encourage adherence at home, and were instructed to incorporate the practice as often as they could. The patients in the control arm were provided information and hand outs on the available yoga classes on campus. RESULTS At 3 month clinical follow up, the mean decrease in fasting capillary blood glucose (CBG) was 45% among yoga participants (-5.2 ± 4.1 mmol/L). Heart rate (HR) dropped by 18% and Diastolic blood pressure (BP) dropped by 29% in the intervention arm, (-12.4 ± 6.69 and -26 ± 12.05 mmHg, respectively). There were no statistically significant changes in the haemoglobin A1C, systolic blood pressure, weight, or body mass index in either group. CONCLUSION Our small pilot study reinforces the current medical evidence supporting the use of yoga, combined with standard care, to improve health outcomes in diabetes.
Collapse
Affiliation(s)
- Rashmi S Mullur
- VA Greater Los Angeles Health Care System, Associate Chief of Integrative Medicine, Los Angeles, USA; Department of Internal Medicine, Division of Endocrinology, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Donna Ames
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, USA; Psychosocial Rehabilitation and Recovery Center, VA Greater Los Angeles Health Care System, Los Angeles, USA
| |
Collapse
|
48
|
Innes KE, Selfe TK. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res 2015; 2016:6979370. [PMID: 26788520 PMCID: PMC4691612 DOI: 10.1155/2016/6979370] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/19/2015] [Accepted: 08/26/2015] [Indexed: 12/29/2022] Open
Abstract
A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2). In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized) met our inclusion criteria (N = 2170 participants). Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2.
Collapse
Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
| | - Terry Kit Selfe
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
| |
Collapse
|
49
|
Pearson T. Stopping the tsunami of stress in primary care. Nurse Pract 2015; 40:1-6. [PMID: 26566130 DOI: 10.1097/01.npr.0000473070.88755.ef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article provides an overview of the psychoneuroimmunologic impact of stress on illness along with a review of mind/body therapies to counteract the effects of stress. Primary care providers are encouraged to promote stress reduction and translate evidence into practice by recommending mind/body therapies.
Collapse
Affiliation(s)
- Tamera Pearson
- Tamera Pearson is an associate professor and director of the Family Nurse Practitioner Program at Western Carolina University School of Nursing, Cullowhee, N.C
| |
Collapse
|
50
|
Sirsasana (headstand) technique alters head/neck loading: Considerations for safety. J Bodyw Mov Ther 2015; 19:434-41. [PMID: 26118514 DOI: 10.1016/j.jbmt.2014.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 10/02/2014] [Accepted: 10/17/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study examined the weight-bearing responsibility of the head and neck at moments of peak force during three headstand techniques. METHODS Three matched groups of 15 each (18-60 years old) were formed based upon lower limb entry/exit technique: symmetrical extended, symmetrical flexed, and asymmetrical flexed. All 45 practitioners performed 3 headstands. Kinematics and kinetics were analyzed to locate peak forces acting on the head, loading rate, center of pressure (COP) and cervical alignment. FINDINGS During entry, symmetrical extended leg position trended towards the lowest loads as compared to asymmetrical or symmetrical flexed legs (Cohen's d = 0.53 and 0.39 respectively). Also, symmetrical extended condition produced slower loading rates and more neutral cervical conditions during loading. INTERPRETATION Subjects loaded the head with maximums of 40-48% of total body weight. The data support the conclusion that entering the posture with straight legs together may reduce the load and the rate of change of that load.
Collapse
|