Today, more than 30 million Americans have type two diabetes1 and blood sugar dysregulation is the seventh leading cause of death in the United States2. As a result, much research has gone into any and all ways to mitigate the severity and progression caused by unhealthy sugar metabolism. Dietary approaches, herbal and nutritional supplements such as Gymnema, and a host of pharmaceutical drugs all play their role in helping manage blood sugar and stem the growing epidemic of diseases caused by sugar dysregulation. Ultimately, the results of sugar dysregulation impact all aspects of health, in particular, our cardiovascular, nervous, and renal systems. Common consequences of blood sugar dysregulation include poorly healing wounds, loss of sensation in the limbs, erectile dysfunction, and mood disturbances.3 The current recommendations to help with this disease are primarily dietary and lifestyle changes to favor more vegetables, avoid excess carbohydrates, and move more. This cornerstone of blood sugar dysregulation treatment should not be ignored, as the benefits of diet and activity are superior to simply using metformin.4 As part of staying active, there should be a healthy mixture of activities from walking to weight training and so on. One excellent exercise is yoga. Yoga has been developed over thousands of years as a complete medicine unto itself and has been harnessed by Ayurvedic practitioners for virtually all known chronic illnesses.5 Research today is now looking directly at yoga as an important all-around adjunctive treatment for blood sugar dysregulation. Yoga appears to improve diabetes outcomes, lower inflammation, improve mood, and strengthen bones and joints, to name a few. While this comes as no surprise to the Ayurvedic practitioner, this news is becoming more mainstream here in the west.
YOGA AND BLOOD SUGAR: POTENTIAL MECHANISMS
The way that yoga directly affects the body’s insulin and blood sugar is not fully understood. Nevertheless, yoga has a myriad of ways that it appears to influence the effects of blood sugar dysregulation. For example, yoga has been shown to favorably modulate adipokines, which play a role in sugar and lipid metabolism, in adults with metabolic syndrome as well as decrease blood pressure.6 Additionally, reductions in inflammation biomarkers such as High sensitivity C-reactive protein (hsCRP) and improvements in cardiac function have been noted after just 12 weeks of regular yoga practice.7 Another study found that 1-hour daily yoga practices can be correlated with improvements in lipid profiles of type 2 diabetic individuals.8 The authors also credit yoga’s ability to reduce stress as a major contributor to its efficacy. Another study found improvements in nerve conduction in patients with type 2 diabetes9 The specific mechanisms of action are more challenging to pin down, however. Currently, it is thought that yoga reduces perceived stress and modulates the Hypothalamus-Pituitary-Adrenal Axis thereby improving overall metabolic and psychological profiles, increasing insulin sensitivity, and improving glucose tolerance and lipid metabolism.10 Moreover, yoga appears to have an impact on regaining autonomic balance, vagal modulation, regulation of hormones and thus attaining glycemic control.11
DOES YOGA INFLUENCE THE GENOME?
As Ayurvedic practitioners intended esoteric yoga to play a role in the maintenance of one’s spirit, and by extension, influence their ancestors and progeny: it is particularly interesting to note that there is some evidence that demonstrates yoga plays a role in our DNA expression. Researchers found that consistent yoga practice was associated with improvements in mitigating oxidative DNA damage and promoting DNA repair.12 Another study looked at the children of diabetics. It is noteworthy that the risk of development of diabetes in children of single diabetes parents is 3.5-fold higher and in those with two diabetes parents is 6-fold higher when compared with children whose parents do not have diabetes.13 In this study of 64 non-diabetic offspring of type 2 diabetic parents, the children randomized to the yoga treatment group saw improvement in cardiac function as well as insulin resistance and glucose tolerance.14 It would appear that the theories of the Ayurvedic practitioners may have more merit in their concepts of intergenerational medicine than first assumed. Perhaps other aspects of intergenerational medicine in Ayurveda should merit similar research.
BEYOND SUGAR: THE BENEFITS OF YOGA
While yoga’s ability to support those with blood sugar dysregulation is well established, it is also important to acknowledge the vast number of other benefits that yoga provides its practitioners, regardless of metabolic status. Research has shown yoga to be beneficial in decreasing fall risk in elderly patients as well as providing relief for those who experience chronic pain.15
Furthermore, studies have repeatedly linked yoga to improvements in cardiovascular disease.16
As is well known, yoga’s effects on the mind are robust. Multiple trials demonstrate yoga’s ability to decrease anxiety, depression, feelings of burnout, and improve memory and neuroplasticity.17 The combination of physical movements with breathwork and meditation is likely what makes yoga such a unique medicine that is particularly useful in treating the mind and spirit of individuals while also promoting the health of the body. Outside of the mental, the physical body is also improved, with trials supporting yoga’s utility in banishing chronic low back pain18 as well as chronic pelvic pain in individuals with endometriosis.19 Another stress-adjacent way that yoga improves health outcomes is through its influence on the immune system. Yoga has been linked to improvements in immune function in individuals with autoimmune conditions such as rheumatoid arthritis.20 Another trial found improvements in salivary immune function in middle-aged and older adults.21 Moreover, improvements in allergic rhinitis have been seen22 as well as improvements in COPD outcomes, suggesting yoga also provides respiratory benefits23 As is evident, the list of well-researched ways that yoga improves all aspects of human health is robust and diverse, to say the least.
Given what we know about yoga and its effects on stress; coupled with the myriad of ways that stress negatively impacts human health, it is no wonder that yoga also provides a significant benefit to individuals with blood sugar dysregulation. Yoga appears to prevent symptoms from worsening and may even play a role in the reversal of symptoms and disease progression. Studies have researched yoga and its effects on blood sugar dysregulation from many important key angles and most, if not all of them, found evidence to support its mechanisms. Yoga has been practiced to improve the overall health of diabetics and those with metabolic syndrome, as it can play a role in the prevention of acquiring a metabolic disease. Practicing yoga has also been shown to improve nerve conduction and lower inflammatory markers. In short, it appears that the regular practice of yoga leads to balance in all aspects of life, and that’s not stretching the truth
- CDC Type 2 Diabetes.
- Thind, H., Fava, J. L., Guthrie, K. M., Stroud, L., Gopalakrishnan, G., Sillice, M., Gidron, N., & Bock, B. C. (2018). Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and in Control (HA1C) Study. International journal of yoga therapy, 28(1), 123–132.
- Brunton S. (2016). Pathophysiology of Type 2 Diabetes: The Evolution of Our Understanding. The Journal of family practice, 65(4 Suppl), supp_az_0416.
- Diabetes Prevention Program Research Group (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The lancet. Diabetes & endocrinology, 3(11), 866–875.
- Rajagopalan K. (1982). Yoga and ayurveda. Ancient science of life, 2(1), I.
- Supriya, R., Yu, A. P., Lee, P. H., Lai, C. W., Cheng, K. K., Yau, S. Y., Chan, L. W., Yung, B. Y., & Siu, P. M. (2018). Yoga training modulates adipokines in adults with high-normal blood pressure and metabolic syndrome. Scandinavian journal of medicine & science in sports, 28(3), 1130–1138.
- Danasegaran, M., Pal, G. K., Sahoo, J., Pal, P., Nanda, N., & Renugasundari, M. (2021). Effects of 12 Weeks Practice of Yoga on Heart Rate Variability in Males with Type 2 Diabetes Receiving Oral Antidiabetic Drugs: A Randomized Control Trial. Journal of alternative and complementary medicine (New York, N.Y.), 27(12), 1105–1115.
- Shantakumari, N., Sequeira, S., & El deeb, R. (2013). Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia. Indian heart journal, 65(2), 127–131.
- Malhotra, V., Singh, S., Tandon, O. P., Madhu, S. V., Prasad, A., & Sharma, S. B. (2002). Effect of Yoga asanas on nerve conduction in type 2 diabetes. Indian journal of physiology and pharmacology, 46(3), 298–306.
- Singh, V. P., Khandelwal, B., & Sherpa, N. T. (2015). Psycho-neuro-endocrine-immune mechanisms of action of yoga in type II diabetes. Ancient science of life, 35(1), 12–17.
- Kurian, J., Mohanthy, S., & Nanjumdaiah, R. M. (2022). Mechanism of action of yoga on prevention and management of type 2 diabetes mellitus: Narrative review. Journal of bodywork and movement therapies, 29, 134–139.
- Nair, R. G., Vasudev, M. M., & Mavathur, R. (2022). Role of Yoga and Its Plausible Mechanism in the Mitigation of DNA Damage in Type-2 Diabetes: A Randomized Clinical Trial. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 56(3), 235–244.
- J B Meigs, L A Cupples, P W Wilson; Parental transmission of type 2 diabetes: the Framingham Offspring Study.. Diabetes 1 December 2000; 49 (12): 2201–2207.
- Patil, S. G., Aithala, M. R., Naregal, G. V., Shanmukhe, A. G., & Chopade, S. S. (2019). Effect of yoga on cardiac autonomic dysfunction and insulin resistance in non-diabetic offspring of type-2-diabetes parents: A randomized controlled study. Complementary therapies in clinical practice, 34, 288–293.
- Schmid, A. A., Atler, K. E., Malcolm, M. P., Grimm, L. A., Klinedinst, T. C., Marchant, D. R., Marchant, T. P., & Portz, J. D. (2018). Yoga improves quality of life and fall risk-factors in a sample of people with chronic pain and Type 2 Diabetes. Complementary therapies in clinical practice, 31, 369–373.
- Sharma, K., Basu-Ray, I., Sayal, N., Vora, A., Bammidi, S., Tyagi, R., Modgil, S., Bali, P., Kaur, P., Goyal, A. K., Pal, D. K., Arvind, H., Jindal, K., Garg, V., Matyal, B., Thakur, N., Chhikara, A., Kaur, N., Maanju, P., Bhatia, K. S., … Anand, A. (2022). Yoga as a Preventive Intervention for Cardiovascular Diseases and Associated Comorbidities: Open-Label Single Arm Study. Frontiers in public health, 10, 843134.
- Simon, N. M., Hofmann, S. G., Rosenfield, D., Hoeppner, S. S., Hoge, E. A., Bui, E., & Khalsa, S. (2021). Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA psychiatry, 78(1), 13–20.
- Tilbrook, H. E., Cox, H., Hewitt, C. E., Kang'ombe, A. R., Chuang, L. H., Jayakody, S., Aplin, J. D., Semlyen, A., Trewhela, A., Watt, I., & Torgerson, D. J. (2011). Yoga for chronic low back pain: a randomized trial. Annals of internal medicine, 155(9), 569–578.
- Gonçalves, A. V., Barros, N. F., & Bahamondes, L. (2017). The Practice of Hatha Yoga for the Treatment of Pain Associated with Endometriosis. Journal of alternative and complementary medicine (New York, N.Y.), 23(1), 45–52.
- Gautam, S., Kumar, U., Kumar, M., Rana, D., & Dada, R. (2021). Yoga improves mitochondrial health and reduces severity of autoimmune inflammatory arthritis: A randomized controlled trial. Mitochondrion, 58, 147–159.
- Eda, N., Ito, H., Shimizu, K., Suzuki, S., Lee, E., & Akama, T. (2018). Yoga stretching for improving salivary immune function and mental stress in middle-aged and older adults. Journal of women & aging, 30(3), 227–241.
- Chanta, A., Klaewsongkram, J., Mickleborough, T. D., & Tongtako, W. (2022). Effect of Hatha yoga training on rhinitis symptoms and cytokines in allergic rhinitis patients. Asian Pacific journal of allergy and immunology, 40(2), 126–133.
- Özer, Z., Bahçecioğlu Turan, G., & Aksoy, M. (2021). The effects of yoga on dyspnea, sleep and fatigue in chronic respiratory diseases. Complementary therapies in