Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes

A Systematic Review and Meta-analysis

Authors

DOI:

https://doi.org/10.15605/jafes.038.02.20

Keywords:

Yoga, Walking, type 2 diabetes, glycemic control, insulin resistance

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

Downloads

Download data is not yet available.

Author Biographies

Biswajit Dhali, Jadavpur University, Kolkata, India

Department of Physical Education

Sridip Chatterjee, Jadavpur University, Kolkata, India

Assistant Professor, Department of Physical Education

Sudip Sundar Das, Jadavpur University, Kolkata, India

Professor, Department of Physical Education

References

Hurtado MD, Vella A. What is type 2 diabetes? Medicine. 2019;47(1):10-5. https://doi.org/10.1016/j.mpmed.2018.10.010.

Galicia-Garcia U, Benito-Vicente A, Jebari S, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21(17):6275. https://pubmed.ncbi.nlm.nih.gov/32872570. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503727. https://doi.org/10.3390/ijms21176275.

Gowri MM, Rajendran J, Srinivasan AR, Bhavanani AB, Meena R. Impact of an integrated yoga therapy protocol on insulin resistance and glycemic control in patients with type 2 diabetes mellitus. Rambam Maimonides Med J. 2022;13(1):e0005. https://pubmed.ncbi.nlm.nih.gov/35089124. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798588. https://doi.org/10.5041/RMMJ.10462.

Mooventhan A, Nivethitha L. Evidence based effects of yoga practice on various health related problems of elderly people: A review. J Bodyw Mov Ther. 2017;21(4):1028-1032. https://pubmed.ncbi.nlm.nih.gov/29037619. https://doi.org/10.1016/j.jbmt.2017.01.004.

Raveendran AV, Deshpandae A, Joshi SR. Therapeutic role of yoga in type 2 diabetes. Endocrinol Metab (Seoul). 2018;33(3):307-17. https://pubmed.ncbi.nlm.nih.gov/30112866. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145966. https://doi.org/10.3803/EnM.2018.33.3.307.

Yuniartika W, Sudaryanto A, Muhlisin A, Hudiyawati D, Pribadi DR. Effects of yoga therapy and walking therapy in reducing blood sugar levels on diabetes mellitus patients in the community. J Med Sci. 2021; 25;9(E):906-12. https://doi.org/10.3889/oamjms.2021.7104.

Hegde SV, Adhikari P, Kotian S, Pinto VJ, D'Souza S, D'Souza V. Effect of 3-month yoga on oxidative stress in type 2 diabetes with or without complications: A controlled clinical trial. Diabetes Care. 2011;34(10):2208-10. https://pubmed.ncbi.nlm.nih.gov/21836105. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177728. https://doi.org/10.2337/dc10-2430.

Koo BK, Han KA, Ahn HJ, Jung JY, Kim HC, Min KW. The effects of total energy expenditure from all levels of physical activity vs. physical activity energy expenditure from moderate-to-vigorous activity on visceral fat and insulin sensitivity in obese Type 2 diabetic women. Diabet Med. 2010;27(9):1088-92. https://pubmed.ncbi.nlm.nih.gov/20722686. https://doi.org/10.1111/j.1464-5491.2010.03045.x.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://pubmed.ncbi.nlm.nih.gov/33782057. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005924. https://doi.org/10.1136/bmj.n71.

Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14:579. https://pubmed.ncbi.nlm.nih.gov/receiving oral antidiabetic drugs: A randomized control trial. J Altern Complement Med. 2021;27(12):1105-15. https://pubmed.ncbi.nlm.nih.gov/34582701.https://doi:10.1089/acm.2020.0489.

Rafii F, Masroor D, Haghani H, Azimi H. The effects of tai chi and walking on fasting blood glucose among patients with type II diabetes mellitus. Nursing and Midwifery Studies. 2018;7(2):56. https://doi:10.4103/nms.nms_77_17.

Akbarinia A, Kargarfard M, Naderi M. Aerobic training improves platelet function in type 2 diabetic patients: Role of microRNA-130a and GPIIb. Acta Diabetol. 2018;55(9):893-9. https://pubmed.ncbi.nlm.nih.gov/ 29855803. https://doi.org/10.1007/s00592-018-1167-2.

Gupta U, Gupta Y, Jose D, et al. Effectiveness of yoga-based exercise program compared to usual care, in improving HbA1c in individuals with type 2 diabetes: A randomized control trial. Int J Yoga. 2020;13(3):233-8. https://pubmed.ncbi.nlm.nih.gov/33343154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735507. https://doi.org/10.4103/ijoy.IJOY_33_20.

McDermott KA, Rao MR, Nagarathna R, et al. A yoga intervention for type 2 diabetes risk reduction: A pilot randomized controlled trial. BMC Complement Altern Med. 2014;14:212. https://pubmed.ncbi.nlm.nih.gov/24980650. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096416. https;//doi.org/10.1186/1472-6882-14-212.

Singh VP, Khandelwal B. Effect of yoga and exercise on glycemic control and psychosocial parameters in type 2 diabetes mellitus: A randomized controlled study. Int J Yoga. 2020;13(2):144-51. https://pubmed.ncbi.nlm.nih.gov/32669769. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336951. https://doi.org/10.4103/ijoy.IJOY_45_19.

Clifton L, Birks J, Clifton DA. Comparing different ways of calculating sample size for two independent means: A worked example. Contemp Clin Trials Commun. 2018 ;13:100309. https://pubmed.ncbi.nlm.nih.gov/30582068. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297128. https://doi.org/10.1016/j.conctc.2018.100309.

Yagiz G, Akaras E, Kubis HP, Owen JA. The effects of resistance training on architecture and volume of the upper extremity muscles: A systematic review of randomised controlled trials and meta-analyses. Applied Sciences. 2022;12(3):1593. https://doi.org/10.3390/app12031593.

Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014;14:135. https://pubmed.ncbi.nlm.nih.gov/25524443. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383202. https://doi.org/10.1186/1471-2288-14-135.

Chatterjee S, Bhattacharya P. Cardiometabolic syndrome and effects of yoga. The Principles and Practice of Yoga in Cardiovascular Medicine. Singapore: Springer Nature Singapore; 2022.

Mondal S. Science of exercise: Ancient Indian origin. J Assoc Physicians India. 2013;61(8):560-2. https://pubmed.ncbi.nlm.nih.gov/24818341.

Kuvalayananda S, Vinekar SL. Yogic therapy basic principles and methods. Twari OP, Kaivalyadhama, Lonavla, India; 2019 (reprinted).

Nagarathna R, Nagendra HR. Yoga for hypertension and heart diseases. Bangalore, India: Vivekananda Yoga Research Foundation, Swami Vivekananda Yoga Prakashana; 2002 (reprinted).

Bhavanani AB. Yoga: The original mind body medicine. 2012. https://www.researchgate.net/publication/237077700.

Taittiriyopanisad SS. Ch. 2: 1-6. Chennai: Shree Ramakrishna Publication; 2008.

Gainey A, Himathongkam T, Tanaka H, Suksom D. Effects of Buddhist walking meditation on glycemic control and vascular function in patients with type 2 diabetes. Complement Ther Med. 2016;26:92-7. https://pubmed.ncbi.nlm.nih.gov/27261988. https://doi.org/10.1016/j.ctim.2016.03.009.

Downloads

Published

2023-10-03

How to Cite

Dhali, B., Chatterjee, S., Das, S. S., & D Cruz, M. (2023). Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes : A Systematic Review and Meta-analysis. Journal of the ASEAN Federation of Endocrine Societies, 38(2), 113–122. https://doi.org/10.15605/jafes.038.02.20

Issue

Section

*Review Articles