The following is a guest post by Dr. Gregory Dodell, MD, FACE, a board certified endocrinologist.
I am in the exam room listening to my 45 year-old patient with recently diagnosed type 2 diabetes explain the cumulative stress of a demanding job, an emotionally challenging marriage, and trying to figure out the best approach to taking care of his health. Unfortunately, his is not a unique story. The American Psychological Association’s 2016 Stress in America survey reported that 80% of Americans experienced at least one health symptom related to stress. A third of Americans reported specific symptoms such as headaches (34%), feeling overwhelmed (33%), feeling nervous or anxious (33%), or feeling depressed or sad (32%). Stress has a particularly detrimental effect on type 2 diabetes since cortisol, the hormone that our body releases during times of stress, raises our blood sugar and has been linked with insulin resistance, a hallmark of type 2 diabetes. I explain to my patient the impact of stress on diabetes control and tell him that I believe I have an answer (or at least something to try) that will address the multifactorial etiology for diabetes.
These days, one of the prescriptions that I’m “writing” isn’t for a drug. I have started to “prescribe” yoga to my patients, which research suggests should improve overall wellbeing as well as diabetes control.
A study by Satish et al in 2016 published in the International Journal of Yoga demonstrated that after 12 one-hour sessions of yoga over a 3-month period, 90 people with type 2 diabetes were 70% less worried about diabetes, were more confident in their ability to be physically active, and there was a significant reduction in the intensity of their depression. These are crucial findings because a large barrier to controlling diabetes may the psychological impact of having a chronic disease. The diagnosis of diabetes can be a stress in and of itself, which exacerbates symptoms and may be overlooked in standard medical practice. Addressing the underlying stress and building confidence that yoga movement is possible for everyone will pay long-term health dividends.
Madanmohan et al in 2012 from the International Journal of Yoga showed that 15 people with type 2 diabetes who completed a comprehensive yoga program (3x/week for 6-weeks) had improved metabolic markers (fasting blood glucose, postprandial glucose values, and cholesterol values) and 42% stated that their overall well-being was better than before.
A randomized control study in Diabetes Care by Hegde et al in 2011 concluded that 3-months of yoga decreased malondialdehyde (a reactive species, marker for oxidative stress) by 20%, and improved glutathione and vitamin C (antioxidants). Reactive species (free radicals) prevent our cells and tissues from functioning properly. Antioxidants are the body’s defense to oxidative stress. Many of the risk factors for diabetes (unhealthy eating, not enough physical activity and excessive stress) produce free radicals.
Yoga has become increasingly accessible. Community centers, gyms, yoga studios and the Internet offer yoga for all skill levels and abilities. Chair yoga is a wonderful option for people with mobility limitations or for those who want to integrate yoga into their workday. Today’s high stress environment has increased the risk factors for type 2 diabetes. Yoga may be the antidote we are looking for.
Gregory Dodell, MD, FACE is an Assistant Clinical Professor of Medicine, Endocrinology, Diabetes and Bone Disease at Icahn School of Medicine at Mount Sinai and is in private practice at Central Park Endocrinology. You can follow him on Twitter @dodellmd and Instagram @everything_endocrine
Alexis Conason is a clinical psychologist in private practice in New York City specializing in body image and overeating disorders. Want more mindful eating? Sign up for her newsletter at www.drconason.com, like her on Facebook, or follow her on Twitter.
Satish L & Lakshmi V S. Impact of individualized yoga therapy on perceived quality of life performance on cognitive tasks and depression among Type II diabetic patients. Int J Yoga 2016;9:130-6
Madanmohan, Bhavanani AB, Dayanidy G, Sanjay Z, Basavaraddi IV. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients. Int J Yoga 2012;5:10-5
Hegde SV, Adhikari P, Kotian S, et al. Effect of 3-month yoga on oxidative stress in type 2 diabetes with or without complications: a controlled clinical trial. Diabetes Care. 2011 Oct: 34 (10): 2208-2210.