Yoga can complement aerobic exercise in diabetes management, but not replace it

• “New systematic review and meta-analysis establishes that yoga can complement aerobic exercise in diabetes management, but not replace it
• Systematic joint review of eight international studies by researchers in India, Sri Lanka and Australia”

New Delhi/NCR, July 21, 2018:

A systematic review and meta-analysis published in Diabetes and Metabolic Syndrome: Clinical Research and Review has found that although yoga is beneficial for Type 2 Diabetic patients, it cannot replace aerobic exercise, only complement it. This has been illustrated through a systematic review of eight international studies among 842 patients between the ages of 30 and 78 years. The study further says that more well-controlled randomized trials are required to come to any definite conclusions about the superior benefits of yoga in the management of Type 2 Diabetes.

In the eight studies, the selected patients were assigned to two groups – a yoga intervention and a control group with aerobic exercise intervention. These participants were chosen after a careful screening process, which involved clinical assessments and bio-chemical testing. Methodology adopted to collect data was a search process using important key words from medical databases of PubMed, Web of Science and Scopus. The final analysis revealed that a notable reduction was found in the levels of fasting blood sugar (FBG), post prandial blood glucose (PPBG), mean sugar levels of last three months (HbA1C) and BMI in the yoga group compared to the exercise group. But no significant difference was observed between the two groups in lipid parameters, body composition measures (WC and WHR) and blood pressure. This means that while yoga brought about short-term improvement in diabetic patients, in the long term it had inconclusive effects on vital indications such as glycaemic control, HbA1c readings and other complications.

Key observations:

• Overall, a significant reduction in fasting blood glucose by about 15.16 mg/dl and post prandial blood glucose of PPBG 29 mg/dl was seen with yoga as compared to physical activity, however there were some studies which did not favour yoga. HbA1c (mean of last three months sugar control) decreased by 0.39% with yoga.
• There was some decrease in weight and BMI (0.71 kg/m2), however waist circumference did not show any decrease.
• There was no difference between the two groups in cholesterol and other lipids and blood pressure between two groups
• In conclusion, although results favour Yoga since it has beneficial effects on glycaemic control in comparison to physical exercise in Type 2 Diabetes, there are substantial differences in different studies making it difficult to arrive at a firm conclusions.

Since a limited number of people in India get an opportunity to exercise at the recommended duration, pace, intensity or play a sport due to infrastructural and economic constraints, this study was undertaken by researchers in India, Sri Lanka and Australia to see if yoga can replace exercise.

Dr Anoop Misra, Chairman, Fortis C-DOC Centre for Diabetes, Metabolic Diseases and Endocrinology, who was also the study author from India shared, “Yoga has immense benefits and it is increasingly being used as an additional therapy area for many noncommunicable diseases, including diabetes. But it is still early to say that yoga can replace physical exercise as this aspect needs further and properly controlled studies for firm conclusions. For example, there are different kinds of yoga – some recommend specific diets and lifestyle, others involve aerobic exercises too. A proper and uniform protocol for yoga must be made and then compared with physical aerobic activities keeping diet and other lifestyle factors absolutely constant for about a year. Only then can we see definite results.”

Diabetes is India’s fastest growing disease – India currently represents 49 percent of the world’s diabetes burden, with an estimated 72 million cases in 2017. This is expected to almost double to 134 million by 2025 as per a recent PHFI-ICMR Report released in November 2017.  Currently, one in every four people under 25 in India has adult-onset diabetes. Around 47.3% of India’s 70 million diabetics are undiagnosed and do not know they have high blood glucose levels that, if left untreated, can cause blindness, kidney failure, heart disease, stroke and foot amputation. General management of a diabetic patient in India involves prescription medications or insulin injections with lifestyle changes, involving a high-fibre balanced diet, healthy weight maintenance and a sustainable exercise regime of at least 30 minutes five times a week.