Improve Type 2 Diabetes with Tai Chi Practice
By John M. de Castro, Ph.D.
“Tai Chi exercises can improve blood glucose levels and improve the control of type 2 diabetes and immune system response.” – Medical News Today
Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.
Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Tai Chi is mindfulness practice and a gentle exercise. As such, it is reasonable to investigate its usefulness in preventing and treating Type 2 Diabetes.
In today’s Research News article “Tai Chi for type 2 diabetes mellitus.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513484/), Zhou and colleagues review and summarize the published research randomized controlled trials of the effectiveness of Tai Chi practice for the treatment of Type 2 Diabetes. They report on 8 published randomized controlled trials.
The published studies found that in general Tai Chi practice produces significant improvements in the metabolic profile of Type 2 Diabetes patients including a significant reduction in fasting blood glucose levels, plasma HbA1c, total cholesterol, triglycerides, and body mass index (BMI). For fasting blood glucose levels, plasma HbA1c these reductions were greatest when Tai Chi had been practiced for at least 3 months.
These results suggest that Tai Chi practiced for at least 3 months is effective in treating Type 2 diabetes. It is important to recognize that Tai Chi is a gentle and safe exercise that is appropriate for all ages including the elderly and for individuals with illnesses. Also, Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle exercise to treat Type 2 Diabetes.
So, improve type 2 diabetes with Tai Chi practice.
“Diet and exercise are the cornerstone of diabetes management. People with diabetes who exercise regularly have better control over their blood glucose levels and fewer complications such as heart disease and stroke. Many people, however, are unable to keep up with their regular exercise because they either don’t enjoy it, or have a problem finding time to exercise. Tai chi offers a major advantage: It’s enjoyable, and to many, it’s almost addictive.” – Paul Lam
CMCS – Center for Mindfulness and Contemplative Studies
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Zhou, J., Zhang, H., Shi, G., Zhang, L., Liu, H., Qin, Y., & Yang, J. (2018). Tai Chi for type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews, 2018(7), CD009717. doi:10.1002/14651858.CD009717.pub2
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
To assess the effects of Tai Chi for type 2 diabetes mellitus.
Description of the condition
Diabetes mellitus is a metabolic disorder resulting from a defect in insulin secretion, insulin action, or both. A consequence of this is chronic hyperglycaemia (that is elevated levels of plasma glucose) with disturbances of carbohydrate, fat and protein metabolism. Long‐term complications of diabetes mellitus include retinopathy, nephropathy and neuropathy. The risk of cardiovascular disease is also increased. For a detailed overview of diabetes mellitus, please see under ‘Additional information’ in the information on the Cochrane Metabolic and Endocrine Disorders Group in the Cochrane Library (see ‘About’, ‘Cochrane Review Groups (CRGs)’).
Description of the intervention
Exercise or physical activity is one of the principal therapies for type 2 diabetes (Kirk 2007). A systematic review found that exercise can significantly reduce glycosylated haemoglobin A1c (HbA1c) levels by 0.6% (Thomas 2006). The rate of aerobic and resistance exercise necessary to achieve metabolic benefits in clinical trials has sometimes resulted in poor compliance (Brandon 2003), because a large proportion of adults with type 2 diabetes mellitus do not follow recommended physical activity guidelines (Mokdad 2003). A low‐impact, low‐intensity exercise such as Tai Chi may reduce poor compliance in this population and provide a beneficial alternative.
Tai Chi is a traditional Chinese martial art that has been practised for many centuries. The three major components of Tai Chi are movement, meditation and deep breathing (Li 2001a). There are various perspectives on how Tai Chi works. Eastern philosophy holds that Tai Chi unblocks the flow of ‘Qi’. When Qi flows properly, the body, mind and spirit are in balance and health is maintained (Cohen 1997). Others believe that Tai Chi works in the same way as other mind‐body therapies, i.e. the connection between the mind and the body can relieve stress, combat disease and enhance physical well‐being (Li 2001a; Qiang 2010). Tai Chi combines deep diaphragmatic breathing and relaxation with movement, including many fundamental postural stances, and Qi is said to flow imperceptibly and smoothly from one to the other through slow and soft activity (Chinese Sport 1983). Physical responses to Tai Chi do not exceed 55% of maximum oxygen intake or 60% of the individual maximum heart rate (Li 2001b).
Adverse effects of the intervention
Exercise may lead to hypoglycaemia, falls, injuries, pain or fatigue.
How the intervention might work
A meta‐analysis showed that exercise significantly improves glycaemic control and reduces visceral adipose tissue and plasma triglycerides, but not plasma cholesterol, in people with type 2 diabetes, independently of weight loss (Thomas 2006). Tai Chi is a low‐impact, low‐intensity exercise, and people with diabetes who exercise regularly have better glycaemia control and cardiovascular outcomes than those who do not exercise (Kuramoto 2006; Li 2001b). Tai Chi also has an impact on muscle mass through slow and gentle movements (Orr 2006; Qin 2005).
An insulin receptor defect is an important risk factor in the pathology of type 2 diabetes (Youngren 2007). Tai Chi exercise may increase insulin sensitivity (Wang 2008). Furthermore, Tai Chi enhances type 1 T helper function along with an increase in blood interleukin (IL)‐12 levels in people with type 2 diabetes mellitus (Yeh 2009).
Why it is important to do this review
Exercise is one of the principal therapies for type 2 diabetes mellitus and has definite effects and few side effects. Exercise interventions significantly improve glycaemic control, as indicated by a decrease in HbA1c. Tai Chi may be especially useful for elderly type 2 diabetes patients. Although Tai Chi may improve insulin sensitivity and lead to better glucose control, the evidence of the effects of Tai Chi on type 2 diabetes are still limited and conflicting. A systematic review of the effects of Tai Chi on type 2 diabetes is warranted.