Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

March 25, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Mindfulness based approaches has been found to be particularly effective in supporting diabetes management and the mental turmoil that is accompanied with a diagnosis of such as chronic physical illness. It can address the feelings of guilt, anger and aid self-acceptance to encourage the fulfilment of an unobstructed life. Mindfulness has also been found to have an enhanced clinical effect of glycemic control so not only aids psychological health but could potentially have a positive impact on the management of the physical condition.” – Diabetes UK

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.

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. The problems resulting from diabetes get magnified in the elderly. So, it is important to study the efficacy of ACT for Type 2 Diabetes in the elderly.

In today’s Research News article “Efficacy of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/), Maghsoudi and colleagues recruited patients with Type 2 Diabetes over 60 years of age. They all continued on routine care while half were randomly selected to receive Acceptance and Commitment Therapy (ACT) in groups once a week for 90 minutes for 8 weeks. They were measured before and after training and 2 months later for diabetes-related emotional distress including the dimensions of emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress.

They found that in comparison to baseline and the usual care group the patients who received Acceptance and Commitment Therapy (ACT) had significantly lower diabetes-related emotional distress. This lower diabetes-related emotional distress was maintained 2 months later. The study contained only a passive control condition, so caution must be exercised in interpreting the results. Nevertheless, ACT\ was a safe, effective, and lasting treatment to improve the emotions of elderly patients with Type 2 Diabetes.

So, improve emotional distress in the elderly with Type 2 Diabetes with mindfulness.

“Mindfulness training, including focused breathing and awareness training, helped U.S. veterans with diabetes significantly lower their diabetes-related distress and blood sugar levels and improve their self-management of the disease, researchers report.” – Science Daily

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Maghsoudi, Z., Razavi, Z., Razavi, M., & Javadi, M. (2019). Efficacy Of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 2137–2143. doi:10.2147/DMSO.S221245

Abstract

Introduction

Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes.

Materials and methods

In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis.

Results

The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02).

Conclusion

ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/

Improve Blood Fat Levels in Type 2 Diabetes with Yoga

March 19, 2020 psyjdc Leave a comment

Improve Blood Fat Levels in Type 2 Diabetes with Yoga

By John M. de Castro, Ph.D.

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation, leading many experts to recommend yoga for diabetes management.” – Healthline

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II 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 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 a common and increasingly prevalent illness that 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. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes.

In today’s Research News article “Efficacy of a Validated Yoga Protocol on Dyslipidemia in Diabetes Patients: NMB-2017 India Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963794/), Nagarathna and colleagues recruited a stratified sample of adult patients with Type 2 Diabetes and assigned them to receive yoga training that was specifically designed for the treatment of diabetes and consisted of 9 days of 2-hour training sessions followed by daily 1-hour practice at home guided by DVD. They were measured before training and 3 months later for body size and blood was drawn and assayed for fasting blood glucose, glycated hemoglobin (HbA1c), total cholesterol, triglycerides, LDL, VLDL, and HDL.

They found that in both male and female patients with Dyslipidemia (high blood fat levels) there was a significant decrease in the total blood fat levels produced by participation in the yoga program. This included significant decreases in triglycerides, LDL, and VLDL. These improvements were significantly greater in patients from rural areas than those from urban areas. Around two thirds of the patients with Dyslipidemia had their blood fat levels returned to normal levels after yoga practice.

These results are interesting but the lack of a comparison (control) conditions limits their significance. But prior controlled studies have shown the yoga practice produces significant improvements in the symptoms of Type 2 Diabetes. So, the present results likely also reflect the effects of yoga practice and not a confounding variable.

The results suggest that yoga practice can reduce Dyslipidemia in Type 2 Diabetes patients. It would be useful to follow up these patients to see if the treatment improves the patients’ overall health and reduces heart disease. The reduction in Dyslipidemia would predict such benefits.

So, improve blood fat levels in Type 2 Diabetes with yoga.

“findings suggest that yogic practices may promote significant improvements in several indices of importance in [Type 2 Diabetes] management, including glycemic control, lipid levels, and body composition.” – Kim Innes

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Nagarathna, R., Tyagi, R., Kaur, G., Vendan, V., Acharya, I. N., Anand, A., … Nagendra, H. R. (2019). Efficacy of a Validated Yoga Protocol on Dyslipidemia in Diabetes Patients: NMB-2017 India Trial. Medicines (Basel, Switzerland), 6(4), 100. doi:10.3390/medicines6040100

Abstract

Background: Dyslipidemia is considered a risk factor in Type 2 diabetes mellitus (T2DM) resulting in cardio-vascular complications. Yoga practices have shown promising results in alleviating Type 2 Diabetes pathology. Method: In this stratified trial on a Yoga based lifestyle program in cases with Type 2 diabetes, in the rural and urban population from all zones of India, a total of 17,012 adults (>20 years) of both genders were screened for lipid profile and sugar levels. Those who satisfied the selection criteria were taught the Diabetes Yoga Protocol (DYP) for three months and the data were analyzed. Results: Among those with Diabetes, 29.1% had elevated total cholesterol (TC > 200 mg/dL) levels that were higher in urban (69%) than rural (31%) Diabetes patients. There was a positive correlation (p = 0.048) between HbA1c and total cholesterol levels. DYP intervention helped in reducing TC from 232.34 ± 31.48 mg/dL to 189.38 ± 40.23 mg/dL with significant pre post difference (p < 0.001). Conversion rate from high TC (>200 mg/dL) to normal TC (<200 mg/dL) was observed in 60.3% of cases with Type 2 Diabetes Mellitus (T2DM); from high LDL (>130 mg/dL) to normal LDL (<130 mg/dL) in 73.7%; from high triglyceride (>200 mg/dL) to normal triglyceride level (<200 mg/dL) in 63%; from low HDL (<45 mg/dL) to normal HDL (>45 mg/dL) in 43.7% of T2DM patients after three months of DYP. Conclusions: A Yoga lifestyle program designed specifically to manage Diabetes helps in reducing the co-morbidity of dyslipidemia in cases of patients with T2DM.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963794/

Improve the Symptoms of Diabetic Neuropathy with Mindfulness

March 5, 2020 psyjdc Leave a comment

Improve the Symptoms of Diabetic Neuropathy with Mindfulness

By John M. de Castro, Ph.D.

“Daily mindfulness practice can be helpful for people living with chronic pain because sometimes there are negative or worrisome thoughts about the pain. These thoughts are normal, and can affect mood and increase pain. Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Mayo Clinic

Diabetes can lead to a very painful condition known as diabetic neuropathy. The high blood glucose levels associated with diabetes can damage nerves and result in a burning pain and numbness, particularly from the legs and feet. It affects the majority of long-term diabetes patients. This is not only painful but is also disruptive to the normal life functions of these patients. There are no cures, but diabetic neuropathy can be prevented by blood glucose control in the diabetic patient with a rigorous program of measured diet and exercise. Treatment for diabetic neuropathy usually involves pain management with drugs.

Mindfulness practices have been shown to help with pain management and with quality of life in diabetes patients. and has been shown to improve the symptoms of diabetic neuropathy. It is important, then, to continue studying the effectiveness of mindfulness practices for reducing pain and improving quality of life in patients with diabetic neuropathy.

In today’s Research News article “Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757487/), Hussain and Said recruited elderly females with diabetes. They were randomly assigned to one of three condition, Mindfulness-Based Cognitive Therapy (MBCT), progressive muscle relaxation training, or a control condition consisting of 15 minutes of discussion and 20 minutes of quiet sitting. Treatment occurred twice a week for 8 weeks. MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to their neuropathy. The participants were measured before and after training for pain, analgesia, impression of change in their condition, and patient satisfaction.

They found that in comparison to baseline and the control group both the Mindfulness-Based Cognitive Therapy (MBCT) and progressive muscle relaxation groups had significant reductions in daily pain intensity and significant enhanced impression of change in their condition. In addition, the MBCT group had significant improvement in their satisfaction with treatment.

These results suggest that both Mindfulness-Based Cognitive Therapy (MBCT) and progressive muscle relaxation improve the daily pain of elderly female diabetic neuropathy patients and their perception of improvement in their condition. MBCT would appear to be somewhat superior to progressive relaxation in improving the condition. This is important as these patients suffer greatly and the pain interferes with their ability to conduct their lives. The pain relief is most welcome.

So, improve the symptoms of diabetic neuropathy with mindfulness.

“in addition to improving pain, mindfulness also addresses the psychological consequences of chronic pain, including depression symptoms.” -0 Shanna Patterson

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Hussain, N., & Said, A. (2019). Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy. Journal of evidence-based integrative medicine, 24, 2515690X19876599. doi:10.1177/2515690X19876599

Abstract

Chronic pain, the most common complication of diabetes, is treated with medication often to no avail. Our study aimed to compare the use of mindfulness meditation and progressive relaxation to reduce chronic pain in older females with diabetes. Methods The 105 study participants were divided randomly into 3 groups: Group MM (mindfulness meditation), Group CM (control meditation), and Group PM (progressive relaxation meditation). Assessment of analgesic effectiveness required changes in average daily pain Brief Pain Inventory (BPI) modified for painful diabetic peripheral neuropathy and Patient Global Impression of Change using descriptive statistics, Student’s t test, and analysis of variance where applicable. Results Both Groups MM and PM experienced significant (P < .05) reduction in average daily pain in last 24 hours at study end compared to baseline (28.7% and 39.7%, respectively). Group MM had more significant (P < .01) reduction of pain compared to control, a score of 5.2 ± 1.2 dropped to 3.0 ± 1.1 by week 12 of treatment. Groups MM and PM showed significant improvement in patients’ impression at study end, 75 ± 5.1% (n = 36) and 61 ± 6.5% (n = 32), respectively. In Group MM, patient satisfaction scores increased significantly (P < .05) to 3.8 ± 1.9 by week 12. Conclusion Integrative therapies such as mindfulness meditation can be part of a comprehensive pain management plan. Benefits include reduction of pain-related medication consumption, better treatment outcomes, improvement in comorbid conditions such as anxiety and depression as well as no risk of addiction or abuse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757487/

Improve Type 2 Diabetes with Tai Chi Practice

January 18, 2020 psyjdc Leave a comment

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

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

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

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

Abstract

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.

Background

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513484/

Yoga Practice May Help Prevent the Development of Type II Diabetes

December 13, 2019 psyjdc Leave a comment

Yoga Practice May Help Prevent the Development of Type II Diabetes

By John M. de Castro, Ph.D.

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/), Ramamoorthi and colleagues reviewed, summarized, and performed a meta-analysis of the published controlled research studies of the effectiveness of yoga practice in improving prediabetic symptoms. The found 14 published studies with a total of 834 participants.

They report that the published research found that yoga practice significantly improved prediabetic symptoms. They included a significant reduction in fasting blood glucose levels and systolic blood pressure, and improved blood lipid profiles including low density lipoproteins, cholesterol, and triglycerides.

This meta-analysis suggests that yoga practice is a safe and effective practice that improves the metabolic signs predictive of future Type II diabetes. It appears to improve glycemic control, blood lipid profiles, and blood pressure. These are very encouraging results. It will be important to follow-up over the long-term to see if these improvements are lasting and if they reduce the transition from then prediabetic state to Type II diabetes.

So, yoga practice may help prevent the development of Type II Diabetes.

“yoga for diabetes provides unique benefits that can effectively restore the body to a state of natural health and proper function.” – Yoga U

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Ramamoorthi, R., Gahreman, D., Skinner, T., & Moss, S. (2019). The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: A systematic review and meta-analysis. PloS one, 14(10), e0221067. doi:10.1371/journal.pone.0221067

Abstract

A systematic review and meta-analysis was conducted to investigate the effects of yoga on glycemic control, lipid profiles, body composition and blood pressure in people in the pre-diabetic state. Studies on the effectiveness of yoga on population groups under high risk for diabetes, called prediabetic or suffering from metabolic syndromes were extracted from a thorough search of PubMed, Scopus, Cochrane Library, EBSCO and IndMED databases. Both Randomised Controlled Trial (RCT) and non-RCT studies were included in the systematic review and meta-analysis. Studies published between Jan 2002 and Dec 2018 were included. Studies were considered for evaluation if they investigated a yoga intervention to prevent T2DM, against a control group, while also reporting glycemic control and other health parameters of T2DM management. Summary effect sizes and 95% confidence intervals (CI) were calculated using the Comprehensive Meta-Analysis software in addition to publication bias. Of the 46,500 identified studies, 14 studies with 834 participants of whom were 50% women, were found to be eligible for inclusion in our systematic review. Our quantitative synthesis included 12 randomized control trials and 2 non-randomized control trials, with the follow-up period ranging from 4 to 52 weeks. Compared to controls, yoga intervention improved fasting blood glucose (FBG) [Standard Mean Difference (SMD -0.064 mg/dL (95% CI -0.201 to 0.074)]; low density lipoprotein (LDL) [SMD-0.090 mg/dL (95% CI -0.270 to 0.090)]; triglycerides [SMD -0.148 mg/dL (95% CI -0.285 to -0.012)]; total cholesterol [SMD -0.058 mg/dL (95% CI -0.220 to 0.104)] and systolic blood pressure [SMD -0.058 mm Hg (95% CI -0.168 to 0.053)]. This meta-analysis uncovered clinically improved effects of yoga intervention on glycemic control, lipid profiles and other parameters of T2DM management in prediabetic population. These results suggest that yoga intervention may be considered as a comprehensive and alternative approach to preventing T2DM. Further adequately powered, well designed RCTs are needed to support our findings and investigate the long-term effects of yoga in T2DM patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/

Mindfulness’ Reduction of Depression is not Related to Patient Engagement, Therapist Adherence or Interpersonal Skills

August 30, 2019 psyjdc Leave a comment

Mindfulness’ Reduction of Depression is not Related to Patient Engagement, Therapist Adherence or Interpersonal Skills

By John M. de Castro, Ph.D.

“Mindfulness training helps improve a patient’s engagement with their health, particularly in patients with chronic pain. It fosters a sense of bodily engagement and improves an individual’s ability to promote their health and well-being outside of the clinical setting.” – Caroline Meade

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance. The personality and characteristics of the therapist are essential ingredients in forming a therapeutic alliance. Research has shown that effective therapists are able to express themselves well. They are astute at sensing what other people are thinking and feeling. In relating to their clients, they show warmth and acceptance, empathy, and a focus on others, not themselves.

There are also other factors that may be important for successful therapy. The client’s engagement in the process may be as important as the therapists. In addition, the therapist’s adherence to the therapeutic program or interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There is little known, however, of the role of these characteristics in the effectiveness of treatment for mental health issues such as depression.

In today’s Research News article “Explaining variability in therapist adherence and patient depressive symptom improvement: The role of therapist interpersonal skills and patient engagement. Clinical psychology & psychotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585745/), Snippe and colleagues recruited adults with diabetes and comorbid depression and randomly assigned them to receive either Mindfulness-Based Cognitive Therapy (MBCT), Cognitive Behavioral Therapy, or to a wait-list. Treatments occurred in 8 weekly 45-60-minute sessions. MBCT was specifically developed to treat depression and involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms, particularly depression.

The patients were measured before and after treatment for depression. “Therapists received a structured treatment manual including specific instructions on exercises, inquiry, and homework assignments per session.” All treatment sessions were video recorded. The recordings were viewed and coded by 2 blinded evaluators who rated the sessions according to the therapists’ adherence to the manual, therapists’ interpersonal skills, and client engagement in the sessions.

They found that although depression levels were significantly reduced by both treatments, the degree of improvement was not related to either the therapists’ adherence to the manual, therapists’ interpersonal skills, or to the clients’ engagement in the sessions. They found that the clients’ engagement in the sessions was positively associated with the therapists’ adherence to the manual. They also found that non-adherence to the manual occurred with verbose clients, when no symptoms were present, and with the clients’ life events during the week.

The results are interesting and reveal, as has previously been reported, that Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) are both effective in reducing depression. It is interesting that the degree of effectiveness was not related to therapists’ adherence to the manual, therapists’ interpersonal skills, or to the clients’ engagement in the sessions. It remains for future research to identify the factors responsible for differing therapeutic outcomes.

So, mindfulness’ reduction of depression is not related to patient engagement, therapist adherence or interpersonal skills.

“When you are looking at primary care, this is the single most important thing. Can your intervention help enhance people’s capacity for self-management and health behavior change, especially among those who struggle most with self-regulation? Because at the heart of accountable care and patient-centered care is people being able to self-manage their own illness.” – Zev Schuman-Olivier

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Snippe, E., Schroevers, M. J., Tovote, K. A., Sanderman, R., Emmelkamp, P., & Fleer, J. (2019). Explaining variability in therapist adherence and patient depressive symptom improvement: The role of therapist interpersonal skills and patient engagement. Clinical psychology & psychotherapy, 26(1), 84–93. doi:10.1002/cpp.2332

Abstract

Understanding why therapists deviate from a treatment manual is crucial to interpret the mixed findings on the adherence–outcome association. The current study aims to examine whether therapists’ interpersonal behaviours and patients’ active engagement predict treatment outcome and therapist adherence in cognitive behaviour therapy (CBT) and mindfulness‐based cognitive therapy (MBCT) for depressive symptoms. In addition, the study explores rater’s explanations for therapist nonadherence at sessions in which therapist adherence was low. Study participants were 61 patients with diabetes and depressive symptoms who were randomized to either CBT or MBCT. Depressive symptoms were assessed by the Beck Depression Inventory‐II. Therapist adherence, therapist interpersonal skills (i.e., empathy, warmth, and involvement), patients’ active engagement, and reasons for nonadherence were assessed by two independent raters (based on digital video recordings). Therapist adherence, therapists’ interpersonal skills, and patients’ active engagement did not predict posttreatment depressive symptom reduction. Patients’ active engagement was positively associated with therapist adherence in CBT and in MBCT. This indicates that adherence may be hampered when patients are not actively engaged in treatment. Observed reasons for nonadherence mostly covered responses to patient’s in‐session behaviour. The variety of reasons for therapist nonadherence might explain why therapist adherence was not associated with outcomes of CBT and MBCT.

Key Practitioner Message

Therapist adherence was not associated with posttreatment depressive symptom improvement after CBT and MBCT
Patient engagement was positively associated with therapist adherence to CBT and MBCT
A broad variety of patient‐related reasons for therapist nonadherence were observed, of which some may not result in poorer treatment outcomes and may rather reflect therapist flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585745/

Improve the Physical and Mental Health of Older Patients with Hypertension and Type 2 Diabetes with Meditation

August 24, 2019 psyjdc Leave a comment

Improve the Physical and Mental Health of Older Patients with Hypertension and Type 2 Diabetes with Meditation

By John M. de Castro, Ph.D.

“Though diabetes is a heterogenous disorder, with multiple clinical manifestations, its chronic complications occur due to vascular (endothelial) dysfunction. Mindfulness Meditation helps by improving the autonomic and endocrine regulation of vascular tone, thus leading to better cardiovascular health.” – Sanjay Kalra

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, hypertension, 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.

High Blood Pressure (Hypertension) is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. It is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths per year have high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.

Type 2 diabetes and hypertension are common and increasingly prevalent illnesses, especially in older individual. But they are treatable with medications and largely preventable with lifestyle changes. Recently, mindfulness practices have been shown to be helpful in managing diabetes and also in reducing hypertension. This suggests that there is a need for further research on the effects of meditation training for the treatment of hypertension and Type II diabetes.

In today’s Research News article “Brain education-based meditation for patients with hypertension and/or type 2 diabetes: A pilot randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531095/), Lee and colleagues recruited older participants (57-87 years of age) with hypertension and/or Type 2 diabetes and were under medication. The participants were randomly assigned to receive either health education or meditation training twice a week for 8 weeks. Before and after training blood was drawn for biochemical, RNA, and c-DNA analysis and completed questionnaires on their mental and physical health.

They found that in comparison to baseline and health education control group, after meditation training there were significant reductions in blood low-density lipoprotein (LDL), inflammatory gene expression, and levels of fatigue, and significant increases in mental health, including significant increases in relaxation, focus, happiness, and confidence, and significant decreases in anger and loneliness. These results suggest that meditation training is effective in treating older patients with hypertension and/or Type 2 diabetes who are already being treated with medication. Hence meditation practice supplements the benefits of medications.

The reductions in LDL cholesterol have been previously reported with mindfulness training and are very important as LDL cholesterol is a significant marker for cardiovascular disease. The reduction in inflammatory gene expression has also been previously reported and is very important as inflammation is a marker for a variety of disease conditions. In addition, the improvements in mental health have been previously reported and are significant as the elderly have higher levels of mental health difficulties than younger people.

It appears from these results that meditation training as a supplement to medication can be very beneficial for the mental and physical health of older patients suffering from hypertension and/or Type 2 diabetes. It would appear reasonable to recommend meditation training for these patients in addition to their medications.

So, improve the physical and mental health of older patients with hypertension and type 2 diabetes with meditation.

“Recent research showed meditation can also help people with diabetes control their blood sugar levels, lower blood pressure and reduce the risk of cardiovascular disease.” – Roberta Kleinman

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Lee, S. H., Hwang, S. M., Kang, D. H., & Yang, H. J. (). Brain education-based meditation for patients with hypertension and/or type 2 diabetes: A pilot randomized controlled trial. Medicine, 98(19), e15574. doi:10.1097/MD.0000000000015574

Abstract

Background:

Hypertension and type 2 diabetes are chronic diseases, which generally require lifetime care. Meditation and yoga can be complementary to pharmacological therapies according to the scientific evidences so far. Brain education-based meditation (BEM) is a technique, which has been known to change brain structure, psychology, and physiology of healthy adult participants. This randomized, nonblinded pilot trial aimed to examine whether BEM affects the conditions of patients with hypertension and/or type 2 diabetes compared with health education classes.

Methods:

We randomly allocated 48 patients with hypertension and/or type 2 diabetes to BEM (n = 24) or health education (n = 24) classes in the Ulsan Junggu Public Health Center in Korea, where the classes were run during the same period and explored the impact of 8-week practice on the serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, gamma glutamyl transpeptidase, creatinine, high-density lipoprotein cholesterol, and low-density lipoprotein (LDL) cholesterol. Total RNA was extracted to examine inflammatory gene expressions from the whole blood using PAXgene blood RNA System. In addition, self-reports on mental/physical health were evaluated. The Student’s t test, chi-squared test, and analysis of covariance were used for statistical analysis.

Results:

The number of people who participated until the completion of the study was 14 in the control and 21 in the BEM group. After 8 weeks, LDL cholesterol level was significantly decreased in the BEM group after the intervention (13.82 mg/dL reduction, P < .05), while it was not significantly altered in the control group. The expression of inflammatory genes was significantly reduced after 8 weeks of the BEM training (0.3-, 0.5-, and 0.2-fold change for NFKB2, RELA, and IL1B, respectively, all P < .05). In the item analysis of mental/physical health self-reports, a significant improvement was confirmed as follows: increases in focus, confidence, relaxation, and happiness; decreases in fatigue, anger, and loneliness (all P < .05). There were no important adverse events or side-effects by BEM intervention.

Conclusion:

Compared to health education, BEM helps lower LDL cholesterol level and the inflammatory gene expression in the patients with hypertension and/or type 2 diabetes. Moreover, BEM induces positive effects on the self-reported mental/physical states, warranting further study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531095/

Improve “Diabetic Lung” with Yoga Therapy

July 29, 2019April 10, 2021 psyjdc 1 Comment

Improve “Diabetic Lung” with Yoga Therapy

By John M. de Castro, Ph.D.

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation.” – Daniel Bubnis

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II 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 heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, circulatory problems leading to amputations and pulmonary issues known as “Diabetic Lung.” As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

In today’s Research News article “Effectiveness of Adjuvant Yoga Therapy in Diabetic Lung: A Randomized Control Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521747/), Balaji and colleagues recruited diabetic patients whose lung function was less than 70% of normal. They were randomly assigned to receive either medical care as usual or to receive usual medical care and additional yoga therapy 3 times per week for 4 months. The yoga therapy included poses, relaxation, breathing exercises, and special postures designed to improve lung function. The participants were measured before and after the 4-month intervention for body size, and pulmonary function.

They found that compared to baseline and medical care as usual, after yoga practice there was a significant reduction in body weight and Body Mass Index (BMI) and a significant improvement in lung function including improvements in forced expiratory volume, forced vital capacity, and their ratio. Hence yoga therapy appears to be a safe and effective therapy for patients with “Diabetic Lung.”

In the present study the control condition did not include an exercise condition. So, it cannot be determined whether the exercise associated with the yoga practice or the other components of the practice were responsible for the improvements. But it is clear from this randomized controlled trial that yoga practice designed to improve lung function is a safe and effective treatment for diabetic patients with “Diabetic Lung.”

So, improve “Diabetic Lung” with yoga therapy.

“Although regular exercise can help, yoga for diabetes provides unique benefits that can effectively restore the body to a state of natural health and proper function.” – Yoga U

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Balaji, R., Ramanathan, M., Bhavanani, A. B., Ranganadin, P., & Balachandran, K. (2019). Effectiveness of Adjuvant Yoga Therapy in Diabetic Lung: A Randomized Control Trial. International Journal of Yoga, 12(2), 96–102. doi:10.4103/ijoy.IJOY_20_18

Abstract

Context:

Recent studies provide ample evidence of the benefits of yoga in various chronic disorders. Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia and Sandler coined the term “Diabetic Lung” for the abnormal pulmonary function detected in diabetic patients due underlying pulmonary dysfunction. Yoga therapy may help in achieving better pulmonary function along with enhanced glycaemic control and overall health benefits.

Aim:

To study the effect of adjuvant yoga therapy in diabetic lung through spirometry.

Settings and Design:

Randomized control trial was made as interdisciplinary collaborative work between departments of Yoga Therapy, Pulmonary Medicine and Endocrinology, of MGMC & RI, Sri Balaji Vidyapeeth Puducherry.

Materials and Methods:

72 patients of diabetic lung as confirmed by spirometry (<70% of expected) were randomized into control group (n=36) who received only standard medical treatment and yoga group (n=36) who received yoga training thrice weekly for 4 months along with standard medical management. Yoga therapy protocol included yogic counseling, preparatory practices, Asanas or static postures, Pranayama or breathing techniques and relaxation techniques. Hathenas of the Gitananda Yoga tradition were the main practices used. Spirometry was done at the end of the study period. Data was analyzed by Student’s paired and unpaired ‘t’ test as it passed normality.

Results:

There was a statistically significant (P < 0.05) reduction in weight, and BMI along with a significant (P < 0.01) improvement in pulmonary function (FEV1, FVC) in yoga group as compared to control group where parameters worsened over study period.

Conclusion:

It is concluded from the present RCT that yoga has a definite role as an adjuvant therapy as it enhances standard medical care and hence is even more significant in routine clinical management of diabetes, improving physical condition and pulmonary function.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521747/

Produce Long-Term Improvements in Depression and Insulin Resistance in Adolescents with Mindfulness

June 26, 2019 psyjdc Leave a comment

Produce Long-Term Improvements in Depression and Insulin Resistance in Adolescents with Mindfulness

By John M. de Castro, Ph.D.

“So like with so many topics related to type 2 diabetes, insulin resistance can be avoided, and reversed, through living healthfully and mindfully.” – Defeat Diabetes Foundation

Type 2 diabetes is a common and increasingly prevalent illness that 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. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. This suggests that mindfulness training may be able to reduce insulin resistance in adolescents at risk for Type II diabetes.

In today’s Research News article “One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01040/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_990182_69_Psycho_20190516_arts_A), Shomaker and colleagues recruited overweight and obese adolescent girls (12-17 years of age) with a family history of Type II Diabetes. They were randomly assigned to receive a 6-week program of either a mindfulness-based intervention (MBI) or a cognitive behavioral therapy (CBT) depression prevention. They were measured before and after the interventions and 1-year later for mindfulness, insulin resistance, depression, body size, and body fat.

They found that 1 year after the interventions only the mindfulness group had significant improvement in insulin resistance. Although both groups had significant decreases in depression, the mindfulness group had significantly greater decreases than the CBT group. These findings are consistent with prior findings by this research group. But these results demonstrate that the effectiveness of mindfulness training is lasting. This suggests that mindfulness training should be recommended for adolescent girls who are overweight and obese and with a family history of Type II Diabetes. This may prevent the onset of type II diabetes in this at-risk group.

So, produce long-term improvements in depression and insulin resistance in adolescents with mindfulness.

“Research shows that meditation actually helps the body regulate blood sugar by using insulin more efficiently. The stress hormone cortisol is a major contributor to insulin resistance, and meditation leads to lower cortisol levels, which in turn allows insulin to do its job properly.” – Avi Craimer

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Shomaker LB, Pivarunas B, Annameier SK, Gulley L, Quaglia J, Brown KW, Broderick P and Bell C (2019) One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance. Front. Psychol. 10:1040. doi: 10.3389/fpsyg.2019.01040

Introduction: To explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D).

Methods: Participants were 12–17y girls with overweight/obesity, elevated depression symptoms, and T2D family history participating in a randomized, controlled pilot trial of a six-session MBI vs. cognitive-behavioral therapy (CBT) group. At baseline and 1-year, mindfulness, depression, insulin resistance (IR), and body composition were assessed with validated instruments.

Results: One-year retention was 71% (n = 12) in MBI; 81% (n = 13) in CBT. At 1-year, depression decreased (Cohen’s d = 0.68) and IR decreased (d = 0.73) in adolescents randomized to MBI compared to those in CBT. There were no significant between-condition differences in mindfulness, adiposity, or BMI.

Discussion: One-year outcomes from this randomized, controlled pilot trial suggest that brief MBI may reduce depression and IR in at-risk adolescents. Replication and exploration of mechanisms within the context of a larger clinical trial are necessary.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01040/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_990182_69_Psycho_20190516_arts_A

Improve Glucose Control in Type 2 Diabetes with Tai Chi Practice

May 25, 2019 psyjdc Leave a comment

Improve Glucose Control in Type 2 Diabetes with Tai Chi Practice

By John M. de Castro, Ph.D.

“Gentle exercise has been shown by studies to prevent diabetes in 60 percent of cases. Therefore, since tai chi is a gentle exercise, we can assume that it’s effective in preventing and improving the control of diabetes.” – Paul Lam

Qigong and Tai Chi are gentle exercises that are potentially useful in treating Type 2 Diabetes. There are many forms of mindful movement and practice can occur with different frequencies and durations. It would be useful to know what types and durations of Tai Chi practice were best for the treatment of Type 2 Diabetes. In today’s Research News article “Different training durations and styles of tai chi for glucose control in patients with type 2 diabetes: a systematic review and meta-analysis of controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419417/), Xia and colleagues review, summarize, and perform a meta-analysis of the published controlled research literature on the effectiveness of different types and durations of Tai Chi practice for the treatment of Type 2 Diabetes.

They identified 17 research studies that included a comparison, control, group. They report that the research finds 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 differences were not significant for Yang style movements of Tai Chi, but were significant for other Tai Chi styles.

These results suggest that only certain styles of Tai Chi practiced for at least 3 months are effective in treating Type 2 diabetes. These are useful findings that further clarify what are the most effective parameters for Tai Chi practice for 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 glucose control in Type 2 Diabetes with Tai Chi practice.

“According to two small studies, Tai Chi exercises can improve blood glucose levels and improve the control of type 2 diabetes and immune system response.” – Anna Sophia McKenney

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Xia, T. W., Yang, Y., Li, W. H., Tang, Z. H., Li, Z. R., & Qiao, L. J. (2019). Different training durations and styles of tai chi for glucose control in patients with type 2 diabetes: a systematic review and meta-analysis of controlled trials. BMC complementary and alternative medicine, 19(1), 63. doi:10.1186/s12906-019-2475-y

Abstract

Background

Physical activity is an important part of the diabetes management plan. However, the effects caused by different training durations and styles of Tai Chi have not been evaluated. We conducted an updated systematic review of the effects of Tai Chi on patients with type 2 diabetes based on different training durations and styles.

Methods

We performed a search for Chinese and English studies in 8 databases. Two reviewers independently selected the eligible trials and conducted a critical appraisal of the methodological quality.

Results

Seventeen trials were included. Tai Chi was found to have reduced fasting blood glucose (FBG) [SMD = − 0.54, 95% CI (− 0.91, − 0.16), P = 0.005] and HbA1c [SMD = − 0.68, 95% CI (− 1.17, − 0.19), P = 0.006] overall, compared with a control group. Considering the subgroup analysis, the pooled results showed that 24 movements or Yang-style Tai Chi did not significantly reduce FBG after a duration of ≤3 months [SMD = − 0.46, 95% CI (− 1.42, 0.50), P = 0.35] or > 3 months [SMD = − 0.50, 95% CI (− 1.49, 0.49), P = 0.32], nor did it reduce HbA1c [SMD = − 1.22, 95% CI (− 2.90, 0.47), P = 0.16] after a duration > 3 months in all studies. However, other styles of Tai Chi significantly reduced FBG [SMD = − 0.90, 95% CI (− 1.28, − 0.52), P < 0.00001] and HbA1c [SMD = − 0.90, 95% CI (− 1.28, − 0.52), P < 0.00001] after a duration > 3 months, while no significant reduction in FBG [SMD = − 0.34, 95% CI (− 0.76, 0.08), P = 0.12] or HbA1c [SMD = − 0.34, 95% CI (− 0.76, 0.08), P = 0.12] was found after a duration ≤3 months.

Conclusions

Tai Chi seems to be effective in treating type 2 diabetes. Different training durations and styles result in variable effectiveness. The evidence was insufficient to support whether long-term Tai Chi training was more effective.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419417/