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Part II: CLINICAL RESEARCH ON THE BENEFITS OF YOGA PRACTICE ON DIABETES

Many studies have reported the beneficial effect of the practice of yoga on diabetes. (10,11,12,13,14, 15,16, 17, 18, 19). Some studies have mentioned up to 65 percent beneficial effect of yogic therapy for diabetes. (11,13,15, 19) K.N. Udupa has even mentioned 5 cases of juvenile diabetes who were completely controlled by yogic treatment. (17) All of these studies have emphasized the possible mechanism of the yogic practices as:

1. Direct influence on pancreatic secretion by rejuvenation of the pancreatic cells, through alternate abdominal contractions and relaxation, during asanas (yogic postures which produce relaxation) and breathing exercises.

2. Reduction in blood sugar due to muscular exercise involved in the asanas.

S.A.A. Ramaiah's study conducted in Washington, D.C. compared the effects of walking, treadmill, static cycling, Amarantha Kokkuasana (Sitting crane), Nindra Kokkuasana (Standing crane) and Vil asana (Bow pose, rocking, especially side to side). The most effective were found to be the latter. it was concluded that the direct stimulation of the pancreas by the postures rejuvenated its capacity to produce insulin.

Several studies have focused upon why the practice of yoga has been more successful than other forms of exercise. M.V. Bhole (20) and K.N. Udupa (18) have measured the effects of yoga on mental stresses. Muhammad (13) has shown the differences between physical exercises and yoga. He has reported how doing the yogic practices without exertion has more benefits.

The mechanism of yogic practices and other exercises is very different. (21) Yogic practices are supposed to change one's attitude towards the situations of life, by developing mental relaxation and balance.

One study focused on the practice of the postures in a slow, smooth and non-exerting manner. (22) The postures were maintained comfortably and easily for a length of time and the patients were taught to focus on breathing or on some infinitely vast object like the sky or the ocean while doing the yoga posture. Two thirds of the patients were significantly benefited by this treatment. The others also showed improvement.

A number of institutions in India offer treatment programs for diabetes. (23,24,25,26) Participants generally stay for between two to five weeks, and follow a program of instruction and practice of yoga asanas for at least an hour in the morning and the evening, dietary control, meditation and breathing exercises. They generally become subjects in on going research projects.

RECOMMENDATIONS REGARDING THE PRACTICE OF YOGA BY DIABETICS

1. The patient must learn to control and his or her self of diabetes in a wholistic manner, at all levels of your being: physical, emotional, mental, intellectual and spiritual, recognizing the effects of stress, emotional imbalance, and dietary and living habits on the disease condition.

2. Before beginning a program, measure ones exercise toleration. Start with simple movements and positions before progressing gradually to complicated postures.

3. Throughout the program, monitor glucose levels and under the supervision of a physician, and take appropriate medicinal dosages as and when required. After several weeks one may be able to reduce such dosages.

4. Practice in the morning and the evening for 40 to 60 minutes the recommended series of postures according to ones capacity. Practice before meals, but after consuming glucid liquids.

5. Avoid exertion, that is heavy muscular activity. Perform the movements slowly and smoothly, stretching the limbs and joints, and gently compressing the abdomen, without straining. Maintain the postures for a comfortable length of time. The maintenance period of postures should be increased gradually from 5 seconds to one minute, or even longer depending upon the posture and capacity of the patient.

6. Focus on the breath during the maintenance period of the posture, with the eyes closed or focused on one point, as a means of learning to focus the mind and to manage stress and tension in the body.

7. Perform the Shavasana, or complete peace relax pose on the back, systematically relaxing all of the parts of the body, at the end of the session, or after completing several postures, if one begins to feel fatigued.

8. The following postures have been found to be effective in the control and cure of diabetes (Sanskrit names; the English and tamil names are in parentheses): Dhanurasana (Bow pose, Vilasana), Paschimottanasana (Sitting crane, Amarntha kokkuasana), Padangusthansana (Standing crane, Nindra kokkuasana), Bhujangasana (Serpent pose, Paambuasana), Sarvangasana (Shoulder stand), Ardha-matsyendrasana (Spinal twist), Halasana (Plough pose, Kalapoy asana), Yoga mudrasana (Yogic Symbol pose), Supta Vajrasana (Sitting pose of Firmness), Chakrasana (Wheel pose), Shalabhasana (Grasshopper pose, Vittelasana). (19,22)

9. The practice of Udiyana bandam, or the abdominal squeeze has also been found to be useful. (22)

10. Regulate the diet throughout the program. Avoid simple sugars such as white sugar, honey, glucose and sweets. and eat complex carbohydrates such as wheat, oatmeal, buckwheat, corn, brown rice and beans. Avoid processed food and eat foods with lots of fibre and nutrients.

11. Obese patients can start with different asanas, cleansing processes, bhastrika pranayama and relaxation. Lean and thin patients should start with relaxation and pranayama, and practice in a relaxed manner.(20)

12. Meditation practices have been shown to help the endocrine glands through relaxation of the sympathetic nervous system. (27)

CONCLUSION:

Western medical research has focused upon diabetes as only a physical disorder, requiring only physical modalities of intervention. It has been able to confirm that regular physical exercise does have some beneficial effects in diabetics of both types, and that in those who are geneticallyÔ predisposed to type 2, it could prevent its development. Western studies have recommended exercise of moderate intensity, as a means to adopt a regular diet and insulin dosage, or to control body weight and improve circulation.

Research in India has recognized it as a psychosomatic disorder with causative factors being sedentary habits, physical, emotional and mental stress. Many studies there have confirmed that the practice of the postures can rejuvenate the insulin producing cells in the pancreas of diabetics of both types, and that doing the postures in a relaxed manner, without exertion, yogic meditation and breathing help most patients to control the causes of diabetes.

References:

1. Siscovick, D.S., Laporte, R.E., Newman, J.M. "The disease-specific benefits and risks of physical activity and exercise", Public Health Report, March/April 1985, 100, 2: 180-188.

2. Shephard, R.S., "Physical activity and child health", Sports Medicine, May/June 1984, 1: 205-233.

3. Campaigne, B.N. et al., "The effect of physical training on blood lipid profiles in adolescents with insulin-dependent diabetes mellitus", The Physician and Sportsmedicine, Dec. 1985, 13,12: 83-89.

4. Laporte, R.E. et all, "Pittsburgh insulin-dependent diabetes mellitus morbidity and mortality study: physical activity and diabetic complications" Pediatrics, Dec. 1986, 78: 1027-1033.

5. Richter, E.A., Galbo, H., "Diabetes, insulin and exercise", Sports Medicine, July/august 1986, 3,4: 275-288

6. Zinman, B. Vranic, M. "Diabetes and exercise", Medical Clinics of North America, Jan. 1985, 69, 1: 145-157.

7. Richter, E.A., Schneider, S.H., "Diabetes and exercise", American Journal of Medicine", 1981, 70: 201-209

8. Nadeau, Andre "L'activite physicque chez le diabetique", Federation des medecins omnipraticens du Quebec, Congres "L'omnipraticien et le sport", Quebec, 15 et 16 mai 1986, 12p.

9. American College of Sports Medicine, "Guidelines for exercise testing and prescription, 3rd edition, Philadelphia, Lea and Febiger, 1986, 175 p.

10. Desai, B.P. "Influence of yogic treatment on serum lipase activity in diabetics". Yoga Mimamsa Vol. XXIII, No. 3 & 4, p. 1 to 8, Jan. 1985

11. Divekar, M.V. and Bhat "Effect of yoga therapy in diabetes and obesity", Clinical diabetes update 1981, Diab. Assoc. India.

12. Koshti et al. "Electrophoretic pattern of serum proteins in diabetes mellitus as influenced by physical exercises (Yogasanas), Journal of the Mysore Medical Assoc. 36; p. 64, July 1972

13. Mohammad U. et al. "glucose tolerance and insulin therapy after yoga in diabetes mellitus", Dept. of Medicine and Diabetology, Govt. Stanley Hospital, Madras (unpublished)

14. Patel C. H., "Yoga and Biofeedback in the management of hypertension", The Lancet Nov. 10, p. 1053-1055, 1973

15. Rugmini, P.S. and Sinha, R.N. "Effect of yoga therapy in Diabetes mellitus", Seminar on yoga, Science and man, C.C., R.I. M.Hl, p. 175-189, 1976

16. Sahay, B.K. et al. "The effect of yoga in Diabetes" in Bajay, J.S. "Diabetes mellitus in developing countries", New Delhi, Interprint 1984, 379-381

17. Tulpule, T.H. "Yogic exercises and diabetes Mellitus (Madhumeh), Journal of Diab. Assoc. India Vol. 17, April 1977.

18. Udupa, K.N. "Stress and its management by yoga", p. 305-320

19. Ramaiah, S.A.A., "Yoga Therapy for Diabetes: Washington, D.C. Study", International Conference on Traditional Medicine, 1986, Madras. Published by Siddha Medical Board, Govt. of Tamil Nadu, Madras, India

20. Bhole, M.V. "Therapeutic applications of yoga techniques", Yoga Mimamsa, Journal Kaivalyadhama, Vol. XXIII, No. 3 & 4, p. 29, Oct. 1984

21. Gore, M.M. "Anatomy and Physiology of Yogic practices", p. 74-96, Ed. 1985 by Kanchan Prakashan Kaivalyadhama, Lonavla.

22. Gore, M.M. "Yogic Treatment for Diabetes", Yoga Mimamsa Vol. XXVI, no. 3& 4 pp. 130 to 145 Oct. 1987, Jan. 1988.

23. Bihar School of Yoga, Munger, Bihar, India under the direction of Dr. Shankardevananda MBBS

24. Vivekananda Kendra Yogas, Eknath Bhavan, no. 19, Gavipuram Circle, Bangalore, 560019, India. Tel. 0091-80-6597347 or 660.8645; fax: 0091-80-66-8645 or 667.3446 or 661.0666 email: vkyogas@bir.vsnl.net.in

25. The Yoga Institute, Prabhat Colony, Santacruz, (East) Bombay 400055

26. Kaivalyadhama Institute, Lonalva, India 410403 27. Shankardevananda, Dr. Swami, MBBS, "Yogic Management of Asthma and Diabetes", Bihar School of Yoga", Munger, Bihar, India pg. 76, 163-167

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