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Table of Contents
CASE REPORT
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 135-139

Effect of long-term Yogic practices in type 2 diabetes mellitus: a single case study


Department of Swasthvritta and Yoga, Government Ayurved College, Nagpur, Maharashtra, India

Date of Submission01-Apr-2021
Date of Decision10-Jun-2021
Date of Acceptance18-May-2021
Date of Web Publication28-Jun-2021

Correspondence Address:
Dr. Ketaki H Patil
Department of Swasthvritta and Yoga, Government Ayurved College, Nagpur, Maharashtra.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jism.jism_30_21

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  Abstract 

Diabetes is a chronic noncommunicable disease for which there is not yet a cure. Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder resulting from a defect in insulin secretion, insulin action, or both, resulting in abnormally high blood glucose levels. Madhumeha (Diabetes) described in Ayurveda texts is often compared with T2DM. Yoga, an ancient practice, is now emerging as a complementary therapy in noncommunicable diseases such as hypertension, diabetes, etc. In the present case study, a 51-year-old female patient with a known case of T2DM for the past one year presented with complaints of increased frequency urination, stress, burning sensation at soles, excessive sweating, hunger, thirst, and fatigue. A properly designed one-year Yoga module was provided to her by a certified Yoga trainer. Appropriate modifications were made in diet and lifestyle. After one year, fasting blood sugar dropped from 187 to 117 mg/dL and postprandial blood sugar dropped from 311 to 194 mg/dL. Weight reduced from 61 to 52 kg. The subjective symptoms also reduced remarkably. The results concluded that consistent long-term practice of a Yogic lifestyle can not only maintain the blood sugar levels of patients with diabetes but also improve the quality of life.

Keywords: Diet, fasting blood sugar, lifestyle, postprandial blood sugar, type 2 diabetes mellitus, Yoga


How to cite this article:
Patil KH, Wasnik (Thatere) V, Patrikar VG. Effect of long-term Yogic practices in type 2 diabetes mellitus: a single case study. J Indian Sys Medicine 2021;9:135-9

How to cite this URL:
Patil KH, Wasnik (Thatere) V, Patrikar VG. Effect of long-term Yogic practices in type 2 diabetes mellitus: a single case study. J Indian Sys Medicine [serial online] 2021 [cited 2021 Jul 26];9:135-9. Available from: https://www.joinsysmed.com/text.asp?2021/9/2/135/319463




  Introduction Top


Diabetes is a major health problem and an important area of research due to its high prevalence. Type 1 diabetes mellitus (T1DM) and T2DM are the two broad categories of diabetes. T1DM is a chronic disease in which the pancreas is unable to produce insulin. T2DM encompasses individuals who have insulin resistance and usually relative (rather than absolute) insulin deficiency.[1] According to Ayurveda, Madhumeha is extensively correlated to T2DM. Epidemiological studies show that India has 62.4 million individuals with diabetes whereas the overall weighted prevalence of diabetes is 8.4% in Maharashtra.[2] Inappropriate dietary habits, sleep patterns, sedentary lifestyle, and stress lead to the development of noncommunicable diseases such as diabetes, hypertension, etc. Chronicity of hyperglycemia is associated with long-term damage and failure of various organ systems, mainly affecting the eyes, nerves, kidneys, and the heart.[1]Yoga, an ancient science, has become increasingly popular in these recent years due to its noninvasive and cost-effective techniques, which are now proven to show therapeutic effects in many lifestyle disorders such as diabetes, hypertension, etc. Yogic practices such as cleansing processes, Asanas, Pranayama, Bandha, and meditation are known to reduce the blood glucose levels associated with T2DM. Most of the research studies have conducted their intervention for a smaller period of time, such as one month, three months, six months, etc. So, to foresee the long-term effect of Yogic practices, we have conducted this one-year Yoga module.


  Case Report Top


A 51-year-old female housewife, residing in Sangli, Maharashtra with a known case of T2DM since past one year presented with the complaints of increased frequency of urination, burning sensation at soles, excessive sweating, hunger, thirst, and fatigue. She was under the treatment of oral hypoglycemic drugs (OHA). She was already a Yoga enthusiast, so she approached us on June 27, 2019. After getting her biochemical investigations like fasting and postprandial blood sugar levels, urinary sugar, weight and (BMI) body mass index done, we provided her with a planned Yoga module of one year. She was advised to continue her OHA. Patient had her regular follow-up at the interval of every 3 months. With the consistent practice of one year Yoga, notable changes were observed in both subjective and objective parameters.


  Chief Complaints Top


Increased frequency of urination

Burning sensation at soles

Excessive sweating

Excessive hunger and thirst

Fatigue

All the symptoms were present since one year.


  General Examination Top


BP: 120/80 mm Hg

P: 80 min

Weight: 61 kg

Height: 148 cm

BMI: 27.84

Systemic examination: Normal

K/C/O: T2DM for the past one year

F/H: Father: T2DM


  Personal History Top


Bowel habits: one time/day, satisfactory

Exercise: Never

Day sleeping: 1 h

Food: vegetarian

Water: After waking, two glasses of warm water

Coffee: twice daily

Junk food: two to three times/week


  Restrictions Advised Top


  1. Daytime sleep


  2. Sweets, dairy products such as curd, paneer, cheese, etc.


  3. Refrigerated, salty, spicy, and deep-fried oily food items and junk food.



  Intervention Top


Appropriate changes were made in the dietary habits of the patient [Table 1]. After obtaining written informed consent, she was put on a specially designed Yoga module [Table 2] for one year (July 1, 2019 to July 1, 2020). She practiced this module daily for 1h at 6 am and 6 pm under the supervision of a Yoga trainer.
Table 1: Dietary advice

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Table 2: Yogic intervention

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  Result Top


Significant improvement was observed in the subjective as well as objective parameters of the patient [Table 3].
Table 3: Results

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  Discussion Top


According to Ayurveda, Prameha is a Tridoshaja disorder (predominantly Kaphaj)[3] where Madhumeha is a subtype of Vataj Prameha.

Probable mode of action:

Shatkarma

Consistent practice of Shatkarma gradually decrease the Meda and Kapha by reducing the weight.[4] According to Yogic texts, Kapalbhati is Kaphadoshvishoshini, which absorbs the vitiated Kapha dosha in Prameha.[5]Kapalbhati is an abdomino-respiratory-autonomic exercise in which the forceful contraction of abdominal muscles places pressure on the abdominal organs, thus regulating the brain-pancreas-endocrine pathway and resulting in increased basal metabolic rate and fat metabolism. A research study shows that the regular practice of Kapalbhati leads to a significant reduction in the blood sugar levels of patients with borderline diabetes.[6]Agnisar destroys all the abdominal diseases and ignites Jatharagni.[7] As Madhumeha is the result of Dhatvagnimandya, it first improves the Jatharagni, ultimately improving the Dhatvagni. The conscious movement of abdominal muscles increases blood flow to the entire abdominal cavity, including the pancreas, due to which the autonomic nerves comprising the solar plexus are strengthened. Thus, Agnisar affects the optimal functioning of this region and reduces the body weight.[8]Laghu Shankha Prakshalan/Varisaar purifies the alimentary canal. The Asanas involved in Varisaar produce a churning effect on the water consumed and remove the toxins from the intestine, thus strengthening the abdominal organs. A study indicates that it reduces the bile acid pool, due to which cholesterol is reduced, resulting in reduced fat absorption for the next several days and thus it can help in reducing weight.[8] The regular practice of Vaman Dhauti relieves a person from diseases arising due to vitiated Kapha and Pitta as in Madhumeha. Recent research showed that Shatkarma practice (Dhauti, Neti, and Kapalbhati) led to a significant reduction in their serum glucose and cholesterol level.[9]

Suryanamaskar

Suryanamaskar exerts a massaging effect on all the abdominal organs, including the pancreas, and burns abdominal fat. According to a review, Suryanamaskar practice stimulates insulin production through brain signaling and decreases hip circumference, exerting beneficial effects on glycemic outcomes.[10]

Asanas

Asanas affect insulin kinetics, which help the release of stored insulin from the pancreas and increase the utilization and metabolism of glucose in the peripheral tissues and liver.[11]Asanas improve blood supply to the muscles, thus enhancing insulin receptor expression in the muscles and causing increased glucose uptake.[10] Thus, the progressive long-term practices of Asanas may lead to the increased sensitivity of B cells of the pancreas to the glucose signals.

Pranayama

Pranayama refers to breathing exercises that involve the regulation of breath in a controlled manner. Regular practice of Anulom Vilom leads to leanness of body, increases glow, and ignites the Jatharagni.[12] Suryabhedi destroys Vata disorders,[13] hence it is useful in Madhumeha. It stimulates the sympathetic nervous system and Pingala nadi, which increase metabolism.[14]Ujjayi destroys Dhatugat doshas,[15] which combats Madhumeha (Dhatudushtijanya disorder). It tackles autonomic nervous centers and subcortical centers by reducing the “arousal” of the reticular activating system, thus regulating endocrinal secretions.[16] The humming sound produced in Bhramari calms the mind and relieves stress. Bhastrika is said to be Tridoshnashak.[17] The rapid and rhythmic pumping of the diaphragm and lungs stimulates active blood circulation to the visceral organs. Bhastrika reduces the BMI and waist-hip ratio in obese patients, thus helping in weight reduction.[18] Both Seetkari and Sheetali control the sensation of thirst and hunger. This generates the feeling of satiety, which normalizes the increased appetite and thirst.

Bandha

The suction of the abdomen in Uddiyan Bandha strengthens the solar plexus, which directly affects the processes of digestion, assimilation, and elimination, thus improving pancreatic functions.

Dhyan

According to research, Omkar chanting regulates the HPA axis and reduces cortisol secretion,[19] which has a positive effect in patients with diabetes. Yognidra is a meditative practice that improves emotional self-regulation with reduced levels of depression, stress, and anxiety. Research shows that Yognidra with a drug regimen had better control in their fluctuating blood glucose and symptoms associated with diabetes, compared with those who were on oral hypoglycemics alone.[20]


  Conclusion Top


From the case study just cited, it can be concluded that the long-term yogic practices not only control blood sugar levels but also improve the quality of life of patients with T2DM.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab 2016;20:546-51.  Back to cited text no. 1
    
2.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al; ICMR–INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian council of medical research-India diabetes (ICMR-INDIAB) study. Diabetologia 2011;54:3022-7.  Back to cited text no. 2
    
3.
Ambikadutta S. Sushruta Samhita of Sushruta. Part-I. Nidanasthana. Prameha Nidana, Chapter 6, Verse 7. Varanasi: Chaukhamba Sanskrit Sansthan; 2009. p. 326.  Back to cited text no. 3
    
4.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verse 21. Munger, Bihar: Yoga Publications Trust; 1998. p. 185.  Back to cited text no. 4
    
5.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verse 35. Munger, Bihar: Yoga Publications Trust; 1998. p. 220.  Back to cited text no. 5
    
6.
Bharathi R, Preetha S, Jothi P. Effect of Kapalbhati Pranayama in the blood sugar level in diabetic patients. Drug Intervention Today2018;11:2235-7.  Back to cited text no. 6
    
7.
Sharma S. Gherand Samhita. Shatkarma Sadhanam, Chapter 1, Verse 20. Varanasi: Chaukhamba Surbharti Prakashan; 2017. p. 7.  Back to cited text no. 7
    
8.
Tiwari SP, Roy D. A study on the effect of Shatkarma on body weight in the patients of diabetes mellitus. DAMA Int 2013;3:18-20.  Back to cited text no. 8
    
9.
Pokhariyal KP, Kumar K. Effect of Shatkarma practices on serum glucose and serum cholesterol level of the human subjects: An Observation. Int J Yoga Allied Sci 2013;1:10-13.  Back to cited text no. 9
    
10.
Raveendran AV, Deshpandae A, Joshi SR. Therapeutic role of yoga in type 2 diabetes. Endocrinol Metab (Seoul) 2018;33:307-17.  Back to cited text no. 10
    
11.
Malhotra V, Singh S, Tandon OP, Sharma SB. The beneficial effect of yoga in diabetes. Nepal Med Coll J 2005;7:145-7.  Back to cited text no. 11
    
12.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verses 19-20. Munger, Bihar: Yoga Publications Trust; 1998. p. 29.  Back to cited text no. 12
    
13.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verse 50. Munger, Bihar: Yoga Publications Trust; 1998. p. 39.  Back to cited text no. 13
    
14.
Kuppusamy M, Kamaldeen D, Pitani R, Amaldas J, Shanmugam P. Effects of Bhramari Pranayama on health—A systematic review. J Tradit Complement Med 2018;8:11-6.  Back to cited text no. 14
    
15.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verses 51-52. Munger, Bihar: Yoga Publications Trust; 1998. p. 39.  Back to cited text no. 15
    
16.
Gore MM. Anatomy and Physiology of Yogic Practices. 4th ed. New Delhi: New Age Books; 2008. p. 198.  Back to cited text no. 16
    
17.
Muktibodhananda S. Hatha Yoga Pradipika. 3rd ed. Shatkarma and Pranayama, Chapter 2, Verse 65. Munger, Bihar: Yoga Publications Trust; 1998. p. 42.  Back to cited text no. 17
    
18.
Varun V. Evaluation of the effect of Bhastrika and Kapalbhati Pranayama on blood glucose level in type 2 diabetes mellitus. Dissertation.Government Yoga and Naturopathy Medical College and Hospital, Chennai; February 2018. p. 84.  Back to cited text no. 18
    
19.
Arora J, Dubey N. Immediate benefits of Om chanting on blood pressure and pulse rate in uncomplicated moderate hypertensive subjects. Natl J Physiol Pharm Pharmacol 2018;8: 1162-5.  Back to cited text no. 19
    
20.
Amita S, Prabhakar S, Manoj I, Harminder S, Pavan T. Effect of yoga-nidra on blood glucose level in diabetic patients. Indian J Physiol Pharmacol 2009;53:97-101.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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  In this article
Abstract
Introduction
Case Report
Chief Complaints
General Examination
Personal History
Restrictions Advised
Intervention
Result
Discussion
Conclusion
References
Article Tables

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