Yoga as a Complementary Therapy for Type 2 Diabetes: An Initial Investigation

瑜伽作为 2 型糖尿病的补充疗法：初步调查

• 批准号: 8947179
• 负责人: Beth C Bock
• 金额: $ 23.25万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8947179
• 关键词: Accounting; Adult; Aerobic Exercise; Affect; American; Anxiety; Attention; Behavior; Behavior Therapy; Behavioral; Belief; Biological Markers; Blood Glucose; Body Composition; Body mass index; Breathing; Chronic Disease; Clinical Trials; Complementary therapies; Complications of Diabetes Mellitus; Country; Data; Diabetes Mellitus; Diagnosis; Diet; Elderly; Exercise; Eye; Fasting; Feasibility Studies; Focus Groups; Future; Glucose; Glycosylated hemoglobin A; Goals; Health; Health behavior; Healthcare Systems; Home environment; Hydrocortisone; Intervention; Investigation; Jogging; Kidney; Lead; Measures; Mediator of activation protein; Meditation; Methodology; Modeling; Nerve; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Perception; Pharmaceutical Preparations; Physical Fitness; Physical activity; Plasma; Population; Protocols documentation; Psychological Stress; Randomized; Randomized Controlled Trials; Relaxation; Role; Salivary; Self Care; Self Efficacy; Stress; Stroke; Testing; Time; Training; Walking; Yoga; base; cardiovascular disorder risk; design; diabetes management; diabetic; diet and exercise; exercise adherence; glycemic control; heart disease risk; improved; mindfulness; prevent; programs; psychologic; randomized trial; satisfaction; secondary outcome; sedentary; stress management; stress resilience; waist circumference

 DESCRIPTION (provided by applicant): Diabetes affects nearly 29 million Americans and another 86 million adults in the U.S. are prediabetic. Type 2 diabetes (T2DM) accounts for 90-95% of all diabetes cases in adults. Uncontrolled diabetes, over time, can cause serious damage to kidneys, eyes, and nerves and increases the risk of heart disease and stroke. Controlling blood glucose level is crucial to avoid these serious complications. Traditional aerobic exercise (e.g., walking, jogging, cycling) is known to improve blood glucose levels in patients with T2DM. Yoga, an ancient eastern practice, shares many of the same benefits as exercise. Like aerobic exercise, yoga practice can elicit improvements in health related aspects of physical fitness. Yoga is also a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, and therefore may have special relevance to people with T2DM. Yoga by increasing mindfulness and parasympathetic activity can alleviate stress. Randomized trials with healthy and diseased participants have shown the benefit of yoga on stress reduction. By inducing stress resilience, yoga may prevent stress-induced rise in cortisol, thus controlling rise in blood glucose levels. Moreover, by reducing stress, and increasing mindfulness, yoga may also lead to improved self-care behaviors including improved diet and physical activity. The role of yoga as a complementary therapy for diabetics within the socio-cultural context of the U.S. needs additional examination. The purpose of the current proposal is to test a yoga intervention for adults with T2DM and to gather data on the feasibility and acceptability of yoga compared to a contact control for glycemic control. We will conduct a pilot randomized controlled study with participants randomly assigned to 1) Yoga intervention, or 2) Group Walking program (control). Focus groups will be conducted with participants at the end of the intervention to identify facilitators and barriers to yoga practice and to examine their perceptions and beliefs about yoga and its relationship to stress and diabetes management. We will explore the effect of yoga on stress (biomarker = salivary cortisol) that may act as a mechanism of action underlying the efficacy of yoga for improved glycemic control. We will also measure HbA1c levels, fasting and postprandial plasma glucose at baseline, end of treatment (12-weeks), 6- and 9- month follow-ups. Study feasibility and acceptability will be assessed using participant recruitment, attendance and retention rates, and compliance with study protocols and general satisfaction with the program. Results from this study will provide scientific basis for a future larger clinical trial. Yoga, if found to offer advantages for glycemic control, can have potential for high impact on current practices of diabetes management.

 描述(申请人提供)：近2900万美国人患有糖尿病，另有8600万美国成年人患有糖尿病前期。2型糖尿病(T2 DM)占成人糖尿病病例的90%-95%。随着时间的推移，不加控制的糖尿病会对肾脏、眼睛和神经造成严重损害，并增加心脏病和中风的风险。控制血糖水平是避免这些严重并发症的关键。众所周知，传统的有氧运动(如散步、慢跑、骑自行车)可以改善2型糖尿病患者的血糖水平。瑜伽，一种古老的东方练习，与锻炼有许多相同的好处。像有氧运动一样，瑜伽练习可以在与健康相关的身体健康方面有所改善。瑜伽也是一种正念练习，强调放松、冥想和深呼吸，因此可能与T2 DM患者特别相关。瑜伽通过增加正念和副交感神经活动来缓解压力。对健康和患病参与者进行的随机试验表明，瑜伽在缓解压力方面有好处。通过诱导压力恢复能力，瑜伽可以防止压力引起的皮质醇水平上升，从而控制血糖水平的上升。此外，通过减少压力和提高正念，瑜伽还可能改善自我照顾行为，包括改善饮食和体力活动。在美国的社会文化背景下，瑜伽作为糖尿病患者的补充疗法的作用需要进一步研究。当前提案的目的是测试针对成人2型糖尿病患者的瑜伽干预，并收集关于瑜伽与接触控制血糖控制的可行性和可接受性的数据。我们将进行一项试验性的随机对照研究，参与者随机分配到1)瑜伽干预，或2)集体步行计划(对照)。在干预结束时，将与参与者进行重点小组讨论，以确定瑜伽练习的促进者和障碍，并检查他们对瑜伽及其与压力和糖尿病管理的关系的看法和信念。我们将探索瑜伽对压力(生物标记物=唾液皮质醇)的影响，这可能是瑜伽改善血糖控制效果的作用机制。我们还将在基线、治疗结束(12周)、6个月和9个月随访时测量HbA1c水平、空腹和餐后血糖。研究的可行性和可接受性将通过参与者招募、出勤率和保留率、对研究方案的遵守情况和对计划的总体满意度进行评估。本研究结果将为今后更大规模的临床试验提供科学依据。瑜伽如果被发现在控制血糖方面具有优势，可能会对当前的糖尿病管理实践产生重大影响。