Selected Yoga Poses for Diabetes Patients A -Systematic Review

Abstract

The science of yoga is an ancient one. It is a rich heritage of our culture. Several older books make a mention of the usefulness of yoga in the treatment of certain diseases and preservation of health in normal individuals. The effect of yogic practices on the management of diabetes has not been investigated well. We carried out well designed studies in normal individuals and those with diabetes to assess the role of yogic practices on glycaemic control, insulin kinetics, body composition exercise tolerance and various co morbidities like hypertension and dyslipidemia. These studies were both short term and long term. Yoga therapists prescribe specific regimens of postures, breathing, exercise and relaxation techniques to suit individual needs. Medical research shows that yoga therapy is among effective complementary therapies for several common ailments. Hence it has been concluded that Yoga cannot "cure" diabetes, but there are several ways yoga can be beneficial in controlling diabetes. There was a decrease in free fatty acids. There was an increase in lean body mass and decrease in body fat percentage. The number of insulin receptors was also increased. There was an improvement in insulin sensitivity and decline in insulin resistance. All these suggest that yogic practices have a role even in the prevention of diabetes. Keyword: Yoga, Diabetes. INTRODUCTION There are different approaches to yoga including spiritual, therapeutic, and developmental However, the underlying premise of mind-body exercise modalities like yoga is that the physiological state of the body can affect emotions, thoughts, and attitudes, which in turn have a reciprocal effect on the body. Diabetes mellitus has reached epidemic proportions worldwide as we enter the new millennium. The World Health Organization (WHO) has commented there is 'an apparent epidemic of diabetes, which is strongly related to lifestyle and economic change'. Over the next decade the projected number will exceed 200 million. Most will have type-2 diabetes, and all are at risk for the development of complications The science of yoga is an ancient one. It is a rich heritage of our culture. Several older books make a mention of the usefulness of yoga in the treatment of certain diseases and preservation of health in normal individuals. It has now become the subject of modern scientific evaluation. Apart from its spiritual philosophy, yoga has been utilized as a therapeutic tool to achieve positive health and cure disease. This concept is promoted in Hatha yoga and Ghatastha yoga by the yoga preceptors. Interest has been evinced in this direction by many workers and studies on the effect of yoga on hypertension, diabetes, asthma, obesity and other common ailments have been carried out. Diabetes by the following mechanisms: exercise effect, changes in biochemical and hormonal profile, elimination of stress and instilling a sense of discipline. To assess these postulations normal individuals and diabetics were investigated with a carefully chalked out protocol for the effect of yogic practices on exercise tolerance, obesity, hypertension, and insulin kinetics and lipid metabolism. Diabetes represents a spectrum of metabolic disorders, which has become a major health challenge worldwide. The unprecedented economic development and rapid

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International Journal of Movement Education and Sports Sciences (IJMESS)
Annual Refereed & Peer Reviewed Journal Vol. VI No. 1 January-December 2018
Online ISSN 2321-7200 Print ISSN 2348-5604
A UGC Approved & Notified Journal
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Copyright 2013 Dabas Educational Welfare Society (DEWS)
Selected Yoga Poses for Diabetes Patients A –Systematic Review
Chandan Singh* Dr. T.O. Reddy**
*Research Scholar, Department of Physical Education, BHU., Varanasi, U.P. India.
**Supervisor, Associate Professor, Dept. of Physical Education, BHU., Varanasi, U.P. India.
(Received 1 February 2018-Accepted & Published 15 February 2018)
Abstract
The science of yoga is an ancient one. It is a rich heritage of our culture. Several older books
make a mention of the usefulness of yoga in the treatment of certain diseases and
preservation of health in normal individuals. The effect of yogic practices on the management
of diabetes has not been investigated well. We carried out well designed studies in normal
individuals and those with diabetes to assess the role of yogic practices on glycaemic control,
insulin kinetics, body composition exercise tolerance and various co morbidities like
hypertension and dyslipidemia. These studies were both short term and long term. Yoga
therapists prescribe specific regimens of postures, breathing, exercise and relaxation
techniques to suit individual needs. Medical research shows that yoga therapy is among
effective complementary therapies for several common ailments. Hence it has been
concluded that Yoga cannot “cure” diabetes, but there are several ways yoga can be
beneficial in controlling diabetes. There was a decrease in free fatty acids. There was an
increase in lean body mass and decrease in body fat percentage. The number of insulin
receptors was also increased. There was an improvement in insulin sensitivity and decline in
insulin resistance. All these suggest that yogic practices have a role even in the prevention of
diabetes.
Keyword: Yoga, Diabetes.
INTRODUCTION
There are different approaches to yoga including spiritual, therapeutic, and developmental
However, the underlying premise of mind–body exercise modalities like yoga is that the
physiological state of the body can affect emotions, thoughts, and attitudes, which in turn
have a reciprocal effect on the body. Diabetes mellitus has reached epidemic proportions
worldwide as we enter the new millennium. The World Health Organization (WHO) has
commented there is ‘an apparent epidemic of diabetes, which is strongly related to lifestyle
and economic change’. Over the next decade the projected number will exceed 200 million.
Most will have type-2 diabetes, and all are at risk for the development of complications The
science of yoga is an ancient one. It is a rich heritage of our culture. Several older books
make a mention of the usefulness of yoga in the treatment of certain diseases and
preservation of health in normal individuals. It has now become the subject of modern
scientific evaluation. Apart from its spiritual philosophy, yoga has been utilized as a
therapeutic tool to achieve positive health and cure disease. This concept is promoted in
Hatha yoga and Ghatastha yoga by the yoga preceptors. Interest has been evinced in this
direction by many workers and studies on the effect of yoga on hypertension, diabetes,
asthma, obesity and other common ailments have been carried out. Diabetes by the following
mechanisms: exercise effect, changes in biochemical and hormonal profile, elimination of
stress and instilling a sense of discipline. To assess these postulations normal individuals and
diabetics were investigated with a carefully chalked out protocol for the effect of yogic
practices on exercise tolerance, obesity, hypertension, and insulin kinetics and lipid
metabolism. Diabetes represents a spectrum of metabolic disorders, which has become a
major health challenge worldwide. The unprecedented economic development and rapid

International Journal of Movement Education and Sports Sciences (IJMESS)
Annual Refereed & Peer Reviewed Journal Vol. VI No. 1 January-December 2018
Online ISSN 2321-7200 Print ISSN 2348-5604
A UGC Approved & Notified Journal
15
Copyright 2013 Dabas Educational Welfare Society (DEWS)
urbanization in Asian countries, particularly in India has led to a shift in health problems
from communicable to non-communicable diseases. Of all the non-communicable diseases,
diabetes and cardiovascular diseases lead the list.
Medical research shows that yoga therapy is among effective complementary therapies for
several common ailments. Hence it has been concluded that Yoga cannot “cure” diabetes, but
there are several ways yoga can be beneficial in controlling diabetes. If medically prescribed
regimens are followed by diabetic patient, they can safely add yoga to their treatment. Due to
the potential impact on their glucose levels, and overall body function, great strides can be
made through regular committed yoga practice. Therefore, regular practice of yoga may
prevent and control the status of diabetes mellitus and produce optimum healthy population.
Diabetes Mellitus (DM)
Commonly referred to as diabetes, is a group of metabolic disorders in which there are high
blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent
urination, increased thirst, and increased hunger if left untreated, diabetes can cause many
complications. Acute complications can include diabetic and ketoacidosis, hyperosmolar
hyperglycemic state, or death. Serious long-term complications include cardiovascular
disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes. Diabetes is due
to either the pancreas not producing enough insulin or the cells of the body not responding
properly to the insulin produced.
There are three main types of diabetes mellitus:
 Type 1 DM results from the pancreas's failure to produce enough insulin.[2] This form
was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile
diabetes" The cause is unknown.
 Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to
insulin properly. As the disease progresses a lack of insulin may also develop.[9] This
form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM)
or "adult-onset diabetes”. The most common cause is excessive body weight and
insufficient exercise.
 Gestational diabetes is the third main form, and occurs when pregnant women without a
previous history of diabetes develop high blood sugar levels.
Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a
normal body weight, and avoiding use of tobacco. Control of blood pressure and maintaining
proper foot care are important for people with the disease. Type1 DM must be managed with
insulin injections. Type 2 DM may be treated with medications with or without
insulin. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in
those with obesity is sometimes an effective measure in those with type 2 DM. Gestational
diabetes usually resolves after the birth of the baby.
Best Yoga Poses for Diabetics
You can perform the following sequence in the given order.
1. Pranayama
Breathing in deeply and breathing out helps oxygenate your blood, and improves
circulation. It also calms the mind and gives your rattled nerves some much needed
rest.

International Journal of Movement Education and Sports Sciences (IJMESS)
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Online ISSN 2321-7200 Print ISSN 2348-5604
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Procedure: Sit on a yoga mat on the floor. Fold your legs in either padmasana or sit
cross legged. Now straighten your back, keep your chin parallel to the floor, place
your hands on your knees with your palms facing upwards and close your eyes.
Breathe in deep and hold your breath for five counts. Exhale slowly. Repeat this
process at least ten times. Once you are done, rub your palms together till they are
warm, and place them on your eyes. Now slowly open them and smile
2. Setubandhasana
This pose not only helps keep one’s blood pressure in control it also helps to relax the
mind, improves digestion.
Procedure: Neck and head are flat on the mat and the rest of your body is in the air.
You can use your hands to push down for added support. If you are flexible you can
even clasp your fingers just below your raised back for that added stretch. The key
here is to not overexert or hurt you while doing this pose
Tips: Avoid doing this pose if you have a neck or back injury.
3. Balasana
Known quite aptly as the child’s pose this is a great stress buster. It gently stretches
the hips, thighs and ankles, calms the mind and helps relieve stress and fatigue. It is
also a great remedy for that lower back pain you might have from long hours of
sitting.
Procedure: Sit on the floor with your weight on your knees. Now flatten your feet
onto the floor and sit on your heels. Spread your thighs apart a little. Exhale and bend
forward from your waist. Let your stomach rest on your thighs and extend your back.
Now stretch out your arms in front of you to elongate the back. You can also rest your
forehead on the floor. This may require flexibility, so don’t push your body beyond its
limit. You will get better with time. This is a resting pose so you should ideally
breathe at a normal pace. You can stay in this pose for as long as three minutes or as
little as five counts.
Tips: If you are pregnant, have a knee injury or have diarrhea do not do this pose.
4. Vajrasana
This is a simple pose that is great to relax the mind, improve digestion and massages
the kanda. According to Ayurvedic principles, kanda is a spot about 12 inches above
the anus that is the point of convergence for over 72,000 nerves.
Procedure: All you need to do is place a yoga mat on the floor. Kneel on the mat,
and let the top surface of your feet touch the mat, such that your heels are pointing
upwards. Now gently place your buttocks on your heels. It is important to note that
your heels are on either side of your anus. Now place both your palms on your knees,
facing downwards. Close your eye and breathe in deeply at a steady rate.
5. Sarvangasana
This pose is essentially known for its ability to regulate the working of the thyroid
glands. These glands are responsible for the proper functioning of the entire body
including the digestive, nervous, reproductive system, regulating metabolism and
respiratory system.
Procedure: Lie on a yoga mat with your legs extending outwards. Now slowly raise
your legs either by first folding them at the knees or by lifting them straight. Place
your palms along your back and hips to support it, and raise your body while pointing

International Journal of Movement Education and Sports Sciences (IJMESS)
Annual Refereed & Peer Reviewed Journal Vol. VI No. 1 January-December 2018
Online ISSN 2321-7200 Print ISSN 2348-5604
A UGC Approved & Notified Journal
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Copyright 2013 Dabas Educational Welfare Society (DEWS)
your toes to the ceiling. All your weight should be on your shoulders. Make sure you
breathe slowly and lock your chin into your chest. Your elbows should be touching
the floor and your back should be supported. Hold this pose for as long as you are
comfortable. To return to the lying position, slowly lower your body. Do not fall back
to the lying position.
Tips: do not do this pose if you suffer from any neck or spinal injuries. If you do have
high blood pressure, perform this exercise only under supervision.
6. Hal asana
This pose is great for those who sit for long hours and tend to have bad posture. It
stimulates the thyroid glands, parathyroid glands, lungs and abdominal organs,
therefore helping the blood rush to your head and face, improves digestion and keeps
the hormonal levels in check.
Procedure: Lie flat on the floor with your feet flat stretched out. Place your arms by
your side and bend your knees so that your feet are flat on the floor. Now, slowly
raise your legs from the hips. Place your hands on your hips as you raise them and use
your hands as support. Now slowly bend your legs at the hips and try to touch the
floor behind your head with your toes and straighten your hands so they are flat on the
floor. Breathe out while going up. To return to the lying position gently rolls your
back onto the floor; breathe in while you come down. Do not drop down suddenly.
Tips: If you suffer from liver or spleen disorders, hypertension, have diarrhea, are
menstruating or have suffered a neck injury, avoid doing this pose.
7. Dhanurasana
This pose is great to strengthen your back and spine, stimulate the reproductive
organs.
Procedure: Lie on your stomach with your feet hip-width apart and your arms by
the side of your body. Fold your knees and hold your ankles. Breathing in, lift your
chest off the ground and pull your legs up and back. Look straight ahead with a smile
on your face. Keep the pose stable while paying attention to your breath. Continue to
take long deep breaths as you relax in this pose. But don’t get carried away! Do not
overdo the stretch. After 15 -20 seconds, as you exhale, gently bring your legs and
chest to the ground. Release the ankles and relax.
Tips: Do not practice this pose if you have high or low blood pressure, hernia, and
neck injury, pain in the lower back, headache, migraine or a recent abdominal surgery
or if you are pregnant
8. Paschimotasana
This is a forward bending pose that helps the blood to flow to the face. Apart from
that, it helps the stomach function better, strengthens the thigh muscles and relaxes
the back and arms.
Procedure: Sit with your legs stretched out on the floor. Next hold the big toe of
your feet with your index finger and thumb. Now, exhale and slowly bend forward
and try to touch your forehead to your knees. The key is that your elbows should
touch the floor. Do not breathe in. Stay in this position for five counts and inhale as
you rise back to the sitting position.
Tips: If you have any type of back pain or complaints with your spine, do not do this
pose. Moreover, be easy on yourself, you might not be able to touch your knees with

International Journal of Movement Education and Sports Sciences (IJMESS)
Annual Refereed & Peer Reviewed Journal Vol. VI No. 1 January-December 2018
Online ISSN 2321-7200 Print ISSN 2348-5604
A UGC Approved & Notified Journal
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Copyright 2013 Dabas Educational Welfare Society (DEWS)
your forehead. Know that if you keep at it you will regain your flexibility and be able
to do the pose properly.
9. Ardha Matsyendrasana
This asana is specifically designed to increase the capacity of your lungs so it can
inhale and hold more oxygen. It also loosens up the spine and relieves backaches and
discomfort in the back
Procedure: Sit up with your legs stretched out straight in front of you, keeping your
feet together and your spine erect. Bend your left leg and place heal of your left foot
beside your right hip (optionally, you can keep your left leg straight). Now, Take the
right leg over your left knee and place your left hand on your right knee and your
right hand behind you. Twist at the waist, shoulders and neck in this sequence to the
right and look over the right shoulder. Hold and continue with gentle long breaths in
and out. To come back to the starting position, continue breathing out, release the
right hand first (the hand behind you), release the waist, then chest, lastly the neck and
sit up relaxed yet straight. Repeat to the other side. Breathing out, come back to the
front and relax.
Tips: If you have a back injury does this pose only in the presence of a certified
trainer
10. Shalabhasana
It strengthens the whole body, particularly the lungs, abdominal organs, sciatic
nerves, prostate glands and the kidneys. It also provides relief in cases of diabetes,
constipation, dyspepsia, bronchitis, etc.
Procedure: Lie on your stomach with legs stretched, and feet together, chin resting
on the ground. Keep both your hands under the thighs. While inhaling, slowly lift
both your legs upwards and stretch as far as possible without bending the knees and
toes. Retain this position for some time and then, while exhaling, lower your legs
slowly and bring back to the original position. Repeat this three to four times.
Tips: Persons suffering from hernia, cardiac complaints and ulcer should avoid this
asana.
CONCLUSION
Based on the results of studies we had postulated that yogic practices help in controlling
diabetes by the following mechanisms: exercise effect, changes in biochemical and hormonal
profile, elimination of stress and instilling a sense of discipline. To assess these postulations
normal individuals and diabetics were investigated with a carefully chalked out protocol for
the effect of yogic practices on exercise tolerance, obesity, hypertension, and insulin kinetics
and lipid metabolism. Along with well balanced diet and nature cure treatment, Yoga should
be done for good control of blood sugar level. Asana, specifically useful to improve functions
of the liver, digestive system and pancreas are beneficial in treating diabetes.
References
1. Birch BB, Power Yoga. Fireside, New York. 1995.
2. Desai BP. "Influence of yogic treatment on serum lipase activity in diabetics". Yoga
Mimamsa Vol. XXIII, 1985; 3(4):1-8

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3. Divekar MV, Bhat. Effect of yoga therapy in diabetes and obesity, Clinical diabetes
update, Diab. Assoc. India. 1981.
4. Udupa KN. Stress and its management by yoga, 305-320 25.
5. Yardi, Nandan. Yoga for control of epilepsy. Seizure, 2001; 10:7–12.
http://www.idealibrary.com
6. Melkote GS. Science of Yoga versus modern medicine in Seminars on Yoga. (CURI
MHE) New Delhi. 1975:190-202.
7. Divakar MV, Bhatt, Mulla A. Effect of yoga therapy in diabetes and obesity. J
Diabetic Assoc Ind 1978;18:75-8.
8. Shambekar AG, Kate SK. Yogic exercise in management of diabetes mellitus. J
Diabetic Assoc Ind 1980;20:167-70.
9. "Diabetes Fact sheet N°312". WHO. October 2013. Archived from the original on 26
August 2013. Retrieved 25 March 2014.
10. Kitabchi, AE; Umpierrez, GE; Miles, JM; Fisher, JN (July 2009). "Hyperglycemic
crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–
43. doi:10.2337/dc09-9032. PMC 2699725 . PMID 19564476.
11. Cash, Jill (2014). Family Practice Guidelines (3rd ed.). Springer.
p. 396. ISBN 9780826168757. Archived from the original on 31 October 2015.
Website
1. Diabetes.co.uk, (2010). http://www.diabetes.co.uk/.
2. Bhatt, Manjaree. http://www.healthandyoga.com/. What Is Yoga Therapy? Copyright 2006
3. Yoga and Diabetes- An Alternate Therapy
.http://www.medindia.net/yogalifestyle/view_com. ment.asp.© All Rights Reserved 1997 –
2009.
4. http://en.wikipedia.org/wiki/Diabetes_mellitus, last modified on 6 May 2010