The developed and developing nations across the globe are constantly facing various health issues. Most of the health issues are lifestyle related and are generally, the non-communicable diseases such as Hypertension, Cancer, Diabetes, Cardio Vascular diseases, Bronchitis etc. The number of people being affected by these diseases seems to be increasing day by day and this trend is posing a threat to the exchequer of the nation. In this article, Dr. H R Nagendra, points out how yoga can help control and manage diabetes.
The World Health Organization has declared diabetes as a global epidemic and it has also established that during the last two decades, there is an exponential increase in numbers of persons suffering from diabetes. It is estimated that more than 230 millions suffer from diabetes today. By 2030, India is likely to be declared as the diabetic capital of the world.
The science of yoga is an ancient one. It is a rich heritage of our Indian culture. Ancient books on Indian culture mentions the importance of Yoga in the treatment of diseases and preservation of health in normal individuals. Today, it has also become the subject of modern scientific evaluation. Apart from its spiritual philosophy, Yoga has been utilised as a therapeutic tool to achieve positive health and cure diseases. Interest has been evinced in this direction by many workers and studies on the effect of Yoga on hypertension, diabetes, asthma, obesity and other common ailments have been carried out. Studies have been carried out to evaluate the effect of Yoga on diabetes, by practicing Suryanamaskara, Pranayama, Meditation with individually customised asanas.
The diagnosis of diabetes has been established. A detailed clinical examination has been carried out and recorded. Patients with complications like retinopathy, nephropathies were not included in the study. Extended advice on diet, those on treatment were advised to continue on the same drugs. New patients were not prescribed any drugs. Clinical evaluation was done at periodic intervals and the tests were repeated regularly as per the protocol. Minor modifications by way of additional investigations and changes in frequency of investigations were done. Studies in normal healthy subjects were carried out to assess the effect of yogic practices on biochemical and hormonal parameters, exercise tolerance and on the performance of athletes. Studies were also carried out in the obese and diabetics with hypertension. In diabetics, the effect of individual Yogic practices was assessed and useful asanas (Yoga protocol for Diabetes) were identified. The whole Yoga session was designed to be completed in a 45 minute session. The majority of those who practiced the Yoga asana developed a sense of well being within 7 to 10 days and showed a significant fall in fasting and post-pardinal blood glucose values.
The ancient Indian physicians had a sound knowledge of diabetes. They described the clinical features and complications of diabetes vividly. Both Sushrutha and Charaka emphasised the importance of diet and exercise in the management of diabetes. They categorised diabetes into 2 groups the obese and the lean and prescribed strenuous exercises for the obese diabetics.
Diabetes Mellitus is a metabolic disorder of variation in sugar levels due to varied secretion of insulin. Type-I and Type-II are the two types of diabetes.Type-I is insulin dependent and Type-II are non insulin dependent. Type-II diabetes account for 75-80% of the diabetes. Insulin assays were done in type 2 diabetic patients. There was normalisation of the /IG ratios, as selected asanas which could be performed by subjects of all age groups, for assessing their effectiveness. In order to assess the effect of individual asanas, patients were randomly allotted to different groups and they performed yogic practices of that group for 45 minutes each day followed by relaxation practices i.e. Shavasana and Makrasana and their effects on blood sugar both fasting and postprandial. Effect of Yogic Practices on Body Composition In normal, healthy volunteers the skin fold thickness was significantly reduced with an increase in the lean body mass, without any significant change in the weight of the individuals. A small group of patients with Type 2 diabetes were studied for a period of 6 months. All these patients developed a sense of well being and showed a significant fall in the fasting and post-prandial blood sugar values with smooth control of blood sugar and significant fall in the glycosylated hemoglobin and the drug requirements.
The mechanism involved could be either correction of insulin resistance alone or additional improvement in beta cell function. Further, studies are required to unravel this. Effect of Yogic Practices on Elderly Type 2 Diabetics Study in elderly diabetics aged more than 60 years with a mean age of 66 years were followed up for few years. They achieved good glycaemic control. No long term complications of diabetes were encountered in them. Studies on Lean Diabetics A subset of lean diabetics with a BMI of less than 18 were studied. There was improvement in their glycaemic control with reduction in body fat content and improvement in lean body mass. There was a reduction in their cholesterol triglyceride, LDL and free fatty acid levels and an increase in the HDL levels.
We carried out well designed studies in normal individuals and those with diabetes to assess the role of yogic practices on glycaemic control, insulin kinetics, body composition exercise tolerance and various comorbidities like hypertension and dyslipidemia. These studies were both short term and long term. These studies have confirmed the useful role of yoga in the control of diabetes mellitus. Fasting and postprandial blood glucose levels came down significantly. Good glycaemic status can be maintained for long periods of time. There was a lowering of drug requirement and the incidence of acute complications like infection and ketosis was significantly reduced. There were significant changes in the insulin kinetics and those of counter-regulatory hormones like cortisol. There was a decrease in free fatty acids. There was an increase in lean body mass and decrease in body fat percentage. The number of insulin receptors was also increased. There was an improvement in insulin sensitivity and decline in insulin resistance. All these suggest that yoga practice have a role in prevention of diabetes and many other non communicable diseases.
Dr H R Nagendra
President-VYASA & Senior VP-IYA