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Yoga and Diabetes

I was asked to give a lecture on Yoga and Diabetes so I thought I would share a condensed version here!

Approximately 25 million people in the United States are living with diabetes; researchers across the country and abroad are searching for feasible methods of control.  In 2011 3.4 million people died due to complications caused by high blood sugar levels. It’s time to take control! 

Medication, diet changes and careful meal planning…sometimes these things are not enough to keep complications at bay. But what else is there?

Recent research performed at universities, private organizations and medical labs around the world are looking at yoga.  Yoga in all its forms from general Hatha classes to therapeutic sessions in controlled settings.  The results are VERY promising!  While yoga is not a cure for diabetes; it can help alleviate, reduce and even prevent some of the many comorbid conditions.  Today I will focus on 2 key points: Physiological and Psychological

Depression and Stress

Big subjects!  More times than not a diagnosis of diabetes, or any chronic illness for that matter, leads to depression.  For most this is short lived as life changes are made and a new routine is settled into and blood sugar levels come under control.  For others, however, depression becomes the new routine.  This is dangerous because depression makes things harder.  All things!  Including sticking to that new regimen.  The regimen that controls glucose levels.  The regimen that allows may people to move out of depression.  Self-care is the most important part of taking control, of preventing comorbid conditions and keeping glucose levels in check.

A number of people believe that yoga is just physical overlooking the most beneficial aspect of the practice: acceptance.  Yoga teaches us to push limits, to explore our boundaries.  To dance along these lines and then to push past them.  Creating new boundaries that will once more be tested.  This push is constant and eternal.  Yoga shows that us that even brick walls can be torn down and converted into pathways.  Yoga as a way out of depression has been well documented; on its own and as a comorbid condition.  Those that practice find acceptance and ways of testing limitations creating strength of body and mind.  Studies have centered on this fact to find that yoga helps people stick to regimens that will subsequently improve glycemic status.

Everyone has experienced some form of stress and/or anxiety in their life.  The body and mind are well equipped to deal with short term stress such as that before an exam, a big presentation, an event etc… however when it comes to chronic stress the system falls short.  Stress triggers the release of the hormone cortisol.  In small amounts this is no big deal but on a daily basis we get into trouble.

For those that suffer from diabetes cortisol can increase gluconeogenesis and insulin resistance, thus diminishing the insulin response from the pancreas.  Once more we find that yoga practice is a pathway out.  Mental aspects of yoga teach us to embrace the source of stress so that we can look reasonably at it to find feasible solutions.  The physical side of yoga give the body a way to release tension also leading to an overall release of stress.  The act of deep diaphragmatic breathing calms the nervous system signalling the brain to stop cortisol production.  Uniting breath to movement brings peace to the body as the brain is soothed.  Hence stress is released, cortisol production slowed and glycemic status stabilizes.

Dr. Larry Payne (medical doctor and yoga therapist) has set out a basic preliminary sequence (in his book Yoga Rx) that he has shown to be effective in the fight against diabetes.  This sequence works to stretch and strengthen all areas of the body while also teaching breath regulation and providing an opportunity for meditation.

It is up to the teacher/therapist to use this sequence as basic building blocks.  A stepping stone if you will.  Once the practitioners become familiar with the basics more can be added, postures can be changed or substituted in order to target a specific issue and/or match a person’s ability level.  Yoga is so diverse it can accommodate people of all ages, shapes and sizes; even within the same class.

When considering yoga asana as therapy for diabetes regulation the key point is always on calming the body and mind to bring about a reduction in the production of cortisol and other stress related hormones.  Thus meditation and breath regulation became important aspects.  In personal practice I have found bringing a mindfulness perspective to the practice helps practitioners discover relief faster.  By bringing awareness to the body people come to better understand their system leading to improved overall sugar regulation.

Another bonus? Physical practice helps people stay active and burn calories which in turn helps to maintain a healthy weight!

While diabetes is often genetic it does not have to appear, research shows that it can be preventable; as we see a rise in obesity across North America we see this same rise in diabetes.  In countries that put emphasis on health and nutrition all the way through school diabetes is less prominent.  Through education, diet changes and exercise we can stabilize blood sugar levels around the world.

The Practice

Sample Yoga Class as illustrated in “Hatha Yoga Practice for Type II Diabetes Mellitus Patients: A Pilot Study” – Maricarmen Vizcaino, MS, RYT, NSCA-CPT University of Texas published in the International Journal of Yoga Therapy No. 23 (2013) adapted from Dr. Larry Payne’s Yoga Rx.

  1. Short Meditation

  2. Warm-up:Neck Roll, Shoulder Roll, Mirror Stretch, Open Wing Stretch

  3. Seated Asana: Spinal Twist, Head to Knee Forward Fold, Wide Angle Seated Forward Fold

  4. Standing Asana: Warrior II, Triangle, Warrior I, Intense Side Stretch, Tree, Dancer

  5. Restorative Asana: Puppy POse, Child’s Pose, Lying Arm Raise with Bent Leg, Savasana

  6. Closing Meditation

Please remember that while many studies report yoga to be of benefit to those afflicted with diabetes it is not a cure.  Yoga should only be performed under the guidance of a knowledgeable teacher under medical supervision.

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