Insulin

Improve Glycemic Control in Patients with Type 2 Diabetes with Tai Chi

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Improve Glycemic Control in Patients with Type 2 Diabetes with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi does not mean oriental wisdom or something exotic. It is the wisdom of your own senses, your own mind and body together as one process.” – Chungliang Al Huang

 

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 lifestyle. 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 that has been found to improve the symptoms of Type 2 Diabetes. The research is accumulating. So, it is reasonable to examine what has been learned

 

In today’s Research News article “Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814847/ ) Guo and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of Tai Chi practice in the treatment of Type 2 Diabetes. They identified 23 published randomized clinical trials.

 

They report that the published research found that in comparison to usual clinical care, patients who were given Tai Chi practice had significantly lower levels of body mass index, systolic and diastolic blood pressure, insulin levels, fasting blood glucose, blood glucose levels after meals, HbA1c, total cholesterol, and low density lipoproteins (LDL), and higher levels of high density lipoproteins (HDL). Tai Chi produced similar results in comparison to aerobic exercise with body mass index, fasting blood glucose levels, total cholesterol, triglycerides, and low-density lipoproteins (LDL). Tai Chi produced superior results to aerobic exercise in reducing HbA1c and increasing high density lipoproteins (HDL).

 

Hence, the research published to date indicates that Tai Chi practice is superior to usual clinical care in improving obesity, glycemic control, and plasma fats and is superior to  aerobic exercise in improving glycemic control and blood fats. This suggests that Tai Chi practice should be recommended for patients with Type 2 Diabetes.

 

“Tai Chi Chuan, the great ultimate, strengthens the weak, raises the sick, invigorates the debilitated, and encourages the timid.” – Cheng Man-ch’ing

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Guo S, Xu Y, Qin J, Chen Y, You Y, Tao J, Liu Z, Huang J. Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review. J Rehabil Med. 2021 Mar 22;53(3):jrm00165. doi: 10.2340/16501977-2799. PMID: 33594445; PMCID: PMC8814847.

 

Abstract

Objective

The aim of this systematic review was to evaluate the effects of tai chi on metabolic control and body composition indicators in patients with type 2 diabetes mellitus.

Design

Systematic review and meta-analysis of existing literature.

Methods

Electronic resource databases were searched to collect eligible studies. Two reviewers selected studies and independently evaluated methodological quality.

Results

Twenty-three studies were included in this meta-analysis. The pooled results showed that tai chi had significant effects in improving metabolic indices, such as fasting blood glucose (mean difference (MD) = –1.04; 95% confidence interval (95% CI) –1.42 to 0.66; p < 0.01) and total cholesterol (MD = –0.50; 95% CI –0.86 to –0.13; p < 0.01) compared with conventional clinical therapy. Most indices did not support the use of tai chi over aerobic exercise, except for glycated haemoglobin (HbA1c) (MD = –0.24; 95% CI –0.49 to 0.00; p < 0.01) and high-density lipoprotein (MD = 0.07; 95% CI 0.01 to 0.12; p < 0.01).

Conclusion

Tai chi had better effects on metabolic control and body composition indicators than clinical conventional therapy, but only on HbA1c and HDL were superior than that of aerobic exercise. The best time-window for tai chi intervention may differ with different metabolic indices.

LAY ABSTRACT

Exercise therapy is a possible alternative and effective strategy for blood glucose control in patients with type 2 diabetes, since drug therapy is associated with side-effects, long-term loss of efficacy, and poor adherence to lifelong treatment. A review of evidence was performed regarding the effects of tai chi on glycaemic control and other indicators in patients with type 2 diabetes mellitus. The results indicate that tai chi not only improves metabolic control, e.g. fasting blood glucose and total cholesterol, but also improves body composition indicators, e.g. body mass index. However, benefits of tai chi over aerobic exercise were seen in only a few outcome measures. The type and methodology of studies varied widely, with discrepancies in intensity, frequency, and duration of tai chi; therefore, further high-quality research is needed in order to draw specific and accurate conclusions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814847/

 

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

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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

 

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. 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

 

Decrease Stroke Risk with Tai Chi or Qigong

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Decrease Stroke Risk with Tai Chi or Qigong

 

By John M. de Castro, Ph.D.

 

“One of the main issues that a stroke survivor experiences is a problem with balance. . .This is where tai chi can make a huge difference. With a complete focus on slow, controlled, and repetitive movements, tai chi is effective in improving one’s balance through dynamic motion and coordination”. Saebo

 

Every year, more than 795,000 people in the United States have a stroke and it is the third leading cause of death, killing around 140,000 Americans each year. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Strokes come in two varieties. The most common (87%) is ischemic stroke resulting from a blocked artery. But strokes can also occur due to leaking or rupture of a blood vessel in the brain, known as hemorrhagic stroke.

 

There are a number of risk factors for stroke that are unchangeable, such as family history, age, and genes. But there are a very large number of factors that are under our control including high blood pressure, smoking, high cholesterol, poor diet, sedentariness, and obesity. Given this list it is clear that basic physical fitness and exercise would be excellent for stroke prevention. The ancient mindful movement technique Tai Chi is a very safe form of gentle exercise that appears to be beneficial for stroke victims.

 

In today’s Research News article “Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690748/ ),

Lauche and colleagues review, summarize, and perform a meta-analysis of the effects of Tai Chi or Qigong practice on risk factors for Stroke. They did not find any trials that reported actual incidence of stroke, but found 21 research controlled trials that reported on risk factors for stroke, including hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome.

 

They found that the published research reported that Tai Chi or Qigong practice produced significant improvement in hypertension including reductions in both systolic and diastolic blood pressure. The studies also reported significant improvements in hyperlipidaemia, including lower levels of triglycerides, and LDL cholesterol, and higher levels of HDL cholesterol and in diabetes including fasting blood glucose levels and insulin sensitivity. Tai Chi or Qigong practice was also found to improve the body weight index in overweight and obese individuals. No adverse events were reported in any of the trials.

 

These results are remarkable in the breadth and extent of the effects of Tai Chi or Qigong practice on risk factors for stroke. Although there were no direct measures of stroke incidence the reductions in risk factors would predict a reduction, over the long-term of the likelihood and incidence of stroke. Lauche and colleagues, however, caution that the trials tended to be of low quality with considerable risk of bias. Hence, conclusions need to be tempered and the results needs to be confirmed with more highly controlled trials.

 

The review found evidence that Tai Chi or Qigong practices are safe, with no negative effects or adverse reactions. In addition, they can be implemented to large numbers of individuals at relatively low cost, can be conveniently practiced at home or in a clinic, and can be practiced alone or in groups. Also, since the practice is gentle and safe it can be used with frail, sickly or elderly individuals. Hence, Tai Chi or Qigong practice appears to be an excellent treatment for the reduction of the risk for stroke in vulnerable individuals.

 

So, decrease stroke risk with Tai Chi or Qigong.

 

“The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance. Psycho-social benefits include less depression, anxiety and stress, and better quality of life.” – Ruth E. Taylor-Piliae

 

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

 

Lauche, R., Peng, W., Ferguson, C., Cramer, H., Frawley, J., Adams, J., & Sibbritt, D. (2017). Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis. Medicine, 96(45), e8517. http://doi.org/10.1097/MD.0000000000008517

 

Abstract

Background:

This review aims to summarize the evidence of Tai Chi and qigong interventions for the primary prevention of stroke, including the effects on populations with major stroke risk factors.

Methods:

A systematic literature search was conducted on January 16, 2017 using the PubMed, Scopus, Cochrane Library, and CINAHL databases. Randomized controlled trials examining the efficacy of Tai Chi or qigong for stroke prevention and stroke risk factors were included. Risk of bias was assessed using the Cochrane Risk of Bias tool.

Results:

Twenty-one trials with n = 1604 patients with hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome were included. No trials were found that examined the effects of Tai Chi/qigong on stroke incidence. Meta-analyses revealed significant, but not robust, benefits of Tai Chi/qigong over no interventions for hypertension (systolic blood pressure: −15.55 mm Hg (95% CI: −21.16; −9.95); diastolic blood pressure: −10.66 mm Hg (95% CI: −14.90, −6.43); the homeostatic model assessment (HOMA) index (−2.86%; 95% CI: −5.35, −0.38) and fasting blood glucose (−9.6 mg/dL; 95% CI: −17.28, −1.91), and for the body mass index compared with exercise controls (−1.65 kg/m2; 95% CI: −3.11, −0.20). Risk of bias was unclear or high for the majority of trials and domains, and heterogeneity between trials was high. Only 6 trials adequately reported safety. No recommendation for the use of Tai Chi/qigong for the prevention of stroke can be given.

Conclusion:

Although Tai Chi and qigong show some potential more robust studies are required to provide conclusive evidence on the efficacy and safety of Tai Chi and qigong for reducing major stroke risk factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690748/