Yoga for Diabetics
Diabetes mellitus (DM2) has emerged as a major global health concern worldwide, affecting an estimated 537 million adults in 2021. This percentage has more than doubled in the previous three decades, paralleling the expanding obesity pandemic and the widespread influence of Western lifestyles. Global burden is likely to rise further in both developed and developing nations, reaching 643 million individuals by 2030. Diabetes is the main cause of morbidity and death, increasing the risk of both macrovascular consequences like atherosclerosis and microvascular problems like retinitis, diabetic neuropathy, and renal failure.
Diabetes is also significantly linked to an increased risk of other major chronic diseases, such as cardiovascular, obesity, depression, and dementia.  Heart-related diseases are the leading major cause of death in people with diabetes, accounting for approximately 65% of fatalities in the world. Furthermore, the economic and social impact of DM2 is large and quickly increasing. For instance, diabetes amounts to roughly 10% of all medical costs in the United States, ranking diabetes the priciest chronic condition. In the presence of insulin resistance, hyperglycemia leads to DM2. Other problems that lead to DM2 include hypertension, cholesterol, chronic inflammatory, hypercoagulation, and induction of oxidative stress.
Diabetes risk increases with age and is even higher in specific racial and ethnic groups, such as non-Hispanic blacks, Pacific Islanders, Asians, and Native Americans. While ethnicity, genetic factors, age, and other factors are crucial in the etiology of DM2, lifestyle factors, particularly lack of physical activity, obesity, are regarded to be the root drivers of the present global diabetes epidemic. Chronic stress, poor sleep, and smoking are also contributory lifestyle variables. In fact, lifestyle variables are strong predictors of DM2-related incidence and death and may account for up to 90% of incident diabetes cases. Hence, lifestyle management is a major component of DM2 therapy, since it is deemed key to the management of acute symptoms and the decrease of chance for long-term issues. 
The decrease of blood sugar levels, which has been demonstrated to lower the risk of microvascular and probably other problems, is a primary aim in DM2 therapy. While maintaining glycemic control is still a goal, the vital relevance of multivariate DM2 treatment has been stressed in current history, highlighting the complicated set of variables that underpins the progression of DM2 and its consequences. Eliminating CVD risk factors, in particular, is critical to effective DM treatment. Other objectives include minimizing DM-related stress, reducing depression, and improving emotional health and quality of life, all of which are major indicators of glycemic control, treatment adherence, complication rates, and other results.
Given the foregoing, it is evident that discovering good lifestyle therapies with the ability to alter several characteristics relevant to the treatment of this complicated condition is critical. Mind-body techniques like yoga, which leverage on the mind’s potential to promote health, appear to be highly well-suited for tackling multiple diseases. Yoga is an ancient mind-body system that originated in India over thousand years ago.
Yoga has become increasingly popular in both rich and developing countries around the world in recent decades, and the area of yoga treatment is expanding rapidly. The most generally practiced varieties of yoga include Raja yoga and the closely related Hatha yoga, also known as the yoga of activity. Hatha and Raja yoga emphasize specific postures (asanas), breath control (pranayama), concentration (dharana), and meditation (dhyana).  An increasing body of research suggests that yoga practice may decrease CVD risk and promote overall health and well-being in a variety of populations, perhaps including people with diabetes.
Effects of Yoga on Diabetes: The Research
Despite the fact that yoga has already been followed from the old period, it would still be a fairly young and rising trend in the healthcare area. An extensive study has been conducted to investigate the effects of yoga practice on biochemical, physiological, molecular, genetic, neurological, and radiological parameters.  This has enabled the practicability of yoga in a variety of ailments, and it is now widely recognized as a clinically effective treatment.
Yoga is a study of the healthcare system instead of a medicine for treating specific conditions. It is a mind-body process control with the objective of spiritual insight.  Yoga practice is a multifaceted approach that includes controlled breathing (pranayama), postures (asana), purification processes (kriya), meditation, mantra chanting, yogic food, relaxation, and philosophy.  Several yoga techniques have been proven to be useful in diabetes management; nevertheless, they should only be used judiciously after a detailed evaluation of a patient’s health, individual needs, risk factors associated, and contraindications. Yoga activities of lower or higher intensity may be advised by taking the person as a whole into account, particularly lack of physical activity and poor health habits. A study found that in patients with diabetes, yoga postures improved glucose usage and fat redistribution.  The periodic abdominal spasms and relaxation of the muscles included in yoga practice may renew pancreatic cells and boost pancreatic -cell sensitivity in diabetic individuals. Higher blood flow to the muscles boosts glucose absorption.
Chronic mental stress can increase the risk of diabetes, and heart diseases. Yoga generally reduces stress, depression, and anxiety which aids with diabetes management. It also improves physical, mental, and overall life quality; a sense of balance; and a fresh outlook on life. Yoga practice improves the results on a variety of psychological tests, particularly happiness effect and stress.  In addition to its impact on stress relief management, yoga improves daily fitness, behavioral changes, and dietary patterns.
Abdominal mobility during yoga activities is considered to result in pancreatic cell regeneration. The various postures used in yoga practice serve to increase the sensitivity of -cells to glucose, hence enhancing insulin secretion, as well as improving circulation to the muscle and muscular relaxation, all of which aid to improve glucose absorption. Advances in hormonal balance improve glycemic control in persons with diabetes. Immunomodulation occurs as a result of yoga practice by lowering pro-inflammatory responses and increasing immune system function.
Yoga asana also increases muscle activity, power, stamina, agility, and balance, which has a positive influence on body mass, obesity, high cholesterol, and insulin resistance. Yoga decreases oxidative stress, by lowering levels of interleukin 6, leptin, and serum malondialdehyde and enhancing the level of adiponectin. In diabetic individuals, yoga therapy improves insulin kinetics by decreasing fasting insulin levels.  It also lowers free fatty acid levels, which indicates reduced insulin resistance. Yoga can also help people who are at high risk of developing diabetes. It was discovered to improve symptom scores in diabetics. It also reduces postprandial blood sugar, fasting blood sugar, and anti-diabetic prescription requirements, implying better glycemic control.
Yoga treatment is useful for both wellness and sickness. The most recent studies indicate that yoga-based lifestyle changes may have a role in the management of diabetes.  It has been proposed that psychoneuroendocrine and immunological processes have a comprehensive effect on diabetes regulation. Parasympathetic activation and the related anti-stress mechanisms serve to improve’ metabolism and psychological profiles, enhance glucose tolerance, and cholesterol metabolism. Yoga practices have been shown to lower blood sugar levels and aid in the management of diabetes, with positive substantial health results.
Sarvottam, R.K. Yadav, Obesity-related inflammation & cardiovascular disease: Efficacy of a yoga-based lifestyle intervention, Indian J. Med. Res. 139 (2014) 822. https://pubmed.ncbi.nlm.nih.gov/25109716/ (accessed February 18, 2022).
Kumar, A. Jagannathan, M. Philip, A. Thulasi, P. Angadi, N. Raghuram, Role of yoga for patients with type II diabetes mellitus: A systematic review and meta-analysis, Complement. Ther. Med. 25 (2016) 104–112. https://www.sciencedirect.com/science/article/abs/pii/S0965229916300103?via%3Dihub.
D. Hunter, M. Dhindsa, E. Cunningham, T. Tarumi, M. Alkatan, H. Tanaka, Improvements in glucose tolerance with Bikram yoga in older obese adults: A pilot study, J. Bodyw. Mov. Ther. 17 (2013) 404–407. https://www.bodyworkmovementtherapies.com/article/S1360-8592(13)00005-3/fulltext.
E. Innes, T.K. Selfe, Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials, J. Diabetes Res. 2016 (2016). https://www.hindawi.com/journals/jdr/2016/6979370/.
K. Patel, A.H. Newstead, R.L. Ferrer, The effects of yoga on physical functioning and health related quality of life in older adults: A systematic review and meta-analysis, J. Altern. Complement. Med. 18 (2012) 902–917. https://www.liebertpub.com/doi/10.1089/acm.2011.0473.
Ivaki, S. Schulz, M. Jeitler, C.S. Kessler, A. Michalsen, F.I. Kandil, S.M. Nitzschke, W. Stritter, A. Voss, G. Seifert, Effects of yoga and mindfulness practices on the autonomous nervous system in primary school children: A non-randomised controlled study, Complement. Ther. Med. 61 (2021). https://www.sciencedirect.com/science/article/pii/S0965229921001126?via%3Dihub.
V. Raveendran, A. Deshpandae, S.R. Joshi, Therapeutic Role of Yoga in Type 2 Diabetes, Endocrinol. Metab. 33 (2018) 307. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145966/.
Chattopadhyay, P. Mishra, N.K. Manjunath, T. Harris, M. Hamer, S.M. Greenfield, H. Wang, K. Singh, S.A. Lewis, N. Tandon, S. Kinra, D. Prabhakaran, Development of a Yoga Program for Type-2 Diabetes Prevention (YOGA-DP) Among High-Risk People in India, Front. Public Heal. 8 (2020) 688. https://www.frontiersin.org/articles/10.3389/fpubh.2020.548674/full.
Ramamoorthi, D. Gahreman, S. Moss, T. Skinner, The effectiveness of yoga to prevent diabetes mellitus type 2: A protocol for systematic review and meta-analysis, Medicine (Baltimore). 98 (2019) e14019. https://journals.lww.com/md-journal/Fulltext/2019/01180/The_effectiveness_of_yoga_to_prevent_diabetes.22.aspx.
Ramamoorthi, D. Gahreman, T. Skinner, S. Moss, 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 (2019) e0221067. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221067.