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Table of Contents
BRIEF COMMUNICATION
Year : 2014  |  Volume : 18  |  Issue : 4  |  Page : 582-584

Completion report : Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial


1 Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
3 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
4 Department of Physiology, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication25-Jul-2014

Correspondence Address:
V P Jyotsna
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.137499

Clinical trial registration CTRI/2009/091/000226

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   Abstract 

Background: Yoga has been shown to be benefi cial in diabetes in many studies, though randomized control trials are few. The aim of this randomized control trial was to see the effect of Sudarshan Kriya and related practices (comprehensive yogic breathing program) on quality of life, glycemic control, and cardiac autonomic functions in diabetes. Diabetes mellitus is a risk factor for sudden cardiac death. Cardiac autonomic neuropathy has been implicated in the causation of sudden cardiac death. Therefore, a maneuver to prevent progression of cardiac autonomic neuropathy holds signifi cance. Materials and Methods: A total of 120 patients of diabetes on oral medication and diet and exercise advice were randomized into two groups: (1) Continued to receive standard treatment for diabetes. (2) Patients administered comprehensive yogic breathing program and monitored to regularly practice yoga in addition to standard treatment of diabetes. At 6 months, quality of life and postprandial plasma glucose signifi cantly improved in the group practicing yoga compared to baseline, but there was no significant improvement in the fasting plasma glucose and glycated hemoglobin. Results: On per protocol analysis, sympathetic cardiac autonomic functions signifi cantly improved from baseline in the group practicing comprehensive yogic breathing. Conclusion: This randomized control trial points towards the beneficial effect of yogic breathing program in preventing progression of cardiac neuropathy. This has important implications as cardiac autonomic neuropathy has been considered as one of the factors for sudden cardiac deaths.Keywords: comprehensive yogic breathing program, diabetes mellitus, cardiac autonomic function

Keywords: Comprehensive yogic breathing program, diabetes mellitus, cardiac autonomic function


How to cite this article:
Jyotsna V P, Dhawan A, Sreenivas V, Deepak K K, Singla R. Completion report : Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial. Indian J Endocr Metab 2014;18:582-4

How to cite this URL:
Jyotsna V P, Dhawan A, Sreenivas V, Deepak K K, Singla R. Completion report : Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial. Indian J Endocr Metab [serial online] 2014 [cited 2019 Nov 20];18:582-4. Available from: http://www.ijem.in/text.asp?2014/18/4/582/137499


   Background Top


Diabetes mellitus is a risk factor for sudden cardiac death. Cardiac autonomic neuropathy has been implicated in the causation of sudden cardiac death. Therefore a maneuver to prevent progression of cardiac autonomic neuropathy holds significance.


   Introduction Top


We earlier published interim analysis [1],[2] of a randomized control trial in diabetes showing improvement in quality of life, [1] post prandial plasma glucose and cardiac autonomic functions [2] with practice of comprehensive yogic breathing program. Here we describe the final findings on completion of the study.


   Materials and Methods Top


In this randomized controlled trial,120 patients of type 2 diabetes, controlled on stable dose of medication, glycemic control, quality of life and cardiac autonomic functions were assessed. Patients were then randomized into two: (1) receiving standard therapy (2) receiving comprehensive yogic breathing program with Sudarshan Kriya yoga plus standard therapy for diabetes.

Glycemic control, quality of life and cardiac autonomic function tests (CAFT) were repeated after 6 months of intervention and compared with those before randomisation.


   Materials and Methods Top


Analysis by Student's t-test, Wilcoxon-Mann-Whitney test, and exact test for two-way symmetry. Stata/IC 11.1 software was employed.


   Results Top


There was significant lowering of the postprandial but not the fasting plasma glucose and glycated hemoglobin in the SKY group compared to standard group [Table 1].
Table 1: Change in parameters of glycemic control at 12 months as compared to at six months


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Psychological (domain 1), environmental (domain 4), and total quality of life (WHO BREF QOL) improved significantly in the SKY compared to standard group [Table 2].
Table 2: WHO BREF QOL mean scores at baseline and 3 and 6 months post randomisation


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Total and parasympathetic cardiac autonomic functions did not show any significant difference in both groups.

On per protocol analysis, the sympathetic cardiac autonomic functions showed significant difference in the SKY to the standard group [Table 3].

This change in sympathetic CAFT is not seen in the standard group [Table 4]. Neither of the groups showed any significant change in intention to treat analysis.
Table 3: Change in sympathetic functions in SKY Group at 6 months as compared to at randomization (per protocol analysis)


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Table 4: Change in sympathetic functions in standard Group at 6 months as compared to at randomisation


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   Discussion Top


This study shows that practice of Comprehensive Yogic breathing program improves quality of life. In a chronic diseases like diabetes, quality of life is important as it effects the compliance.

It shows significant decrease in the post prandial plasma glucose and the decrease in progression of sympathetic CAFT in per protocol analysis. This means that if practiced regularly, comprehensive yogic positively effects CAFT.

Both derangement of post prandial plasma glucose [3] and cardiac autonomic neuropathy [4] have been implicated in sudden cardiac death in diabetes.

This study has follow up only for 6 months and shows significant effect on CAFT. Since the HbA 1 c did not change, this effect on CAFT is independent of the effect on glycemic control. It indicates that, if added to lifestyle, comprehensive yogic breathing program has potential of preventing sudden cardiac death.

Longer period follow up in larger number of patients is needed to assess effect on progress of CAFT and glycemic control. That such studies are feasible, has been shown earlier [5] and this area of research needs to be explored.


   Conclusions Top


There is significant improvement in QOL, post prandial plasma glucose and sympathetic CAFT in patients practicing SKY.


   Acknowledgment Top


We acknowledge funding from the Indian council of Medical Research.

 
   References Top

1.Jyotsna VP, Joshi A, Ambekar S, Kumar N, Dhawan A, Sreenivas V. Comprehensive yogic breathing program improves quality of life in patients with diabetes. Indian J Endocrinol Metab 2012;16:423-8.  Back to cited text no. 1
    
2.Jyotsna VP, Ambekar S, Singla R, Joshi A, Dhawan A, Kumar N, et al. Cardiac autonomic function in patients with diabetes improves with practice of comprehensive yogic breathing program. Indian J Endocrinol Metab 2013;17:480-5.  Back to cited text no. 2
    
3.Gerich JE. Clinical significance, pathogenesis, and management of postprandial hyperglycemia. Arch Intern Med 2003;163:1306-16.  Back to cited text no. 3
[PUBMED]    
4.Pop-Busui R. What do we know and we do not know about cardiovascular autonomic neuropathy in diabetes. J Cardiovasc Transl Res 2012;5:463-78.  Back to cited text no. 4
[PUBMED]    
5.Kjellgren A, Bood SA, Axelsson K, Norlander T, Saatcioglu F. Wellness through a comprehensive yogic breathing program-a controlled pilot trial. BMC Complement Altern Med 2007;7:43.  Back to cited text no. 5
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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