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



 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.