Abstract
This multicentre retrospective study examined the effects of adjunct yoga-treatment in achieving composite cardiovascular goals for type 2 diabetes (T2D), set forth by the American Diabetes Association (ADA) in rural Indian settings. Records were extracted for 146 T2D patients, aged ≥20–70 years, and treated under the “Apollo Total Health Programme” for rural diabetes management, for the period April 2016 to November 2016. The study cohort comprised of two treatment groups (n = 73 each); non-yoga group (standard of care) and yoga group (adjunct yoga-treatment). Propensity score matching was applied between the study groups to define the cohort. Composite cardiovascular scores were based on the combination of individual ADA goals; A1c < 7%, blood pressure (BP) < 140/90 mmHg, stringent BP (<130/80 mmHg) and lipid, LDL-C < 100 mg/dl [risk factor for atherosclerotic cardiovascular disease]. Logistic regression was used to compare between the two treatment groups. Compared to standard of care, adjunct yoga-treatment was found to significantly facilitate the attainment of ADA composite score by 8-fold; A1c, ~2-fold; LDL-C, ~2-fold; BP < 140/90 mmHg and <130/80 mmHg by ~8-and ~6-fold respectively. This study provides the first evidence for significant efficacy of adjunct yoga-treatment for the attainment of favourable treatment goals for T2D in rural Indian settings. Clinical Trial Registration Number: CTRI/2020/02/0232790
Highlights
Efficient diabetes care is a crucial aspect of the disease owing to its progressive nature[5,6,7]
The most effective approach towards reduced mortality and morbidity in type 2 diabetes (T2D) appears to be comprehensive risk factor reduction targeting glycemic control, management of blood pressure and dyslipidemia[9,10]. These factors underlie the guidelines for Standards of Medical Care issued towards efficient cardiovascular control in T2D by American Diabetes Association (ADA) which are updated annually in the month of January[7]
85.62% (n = 125) of the study cohort was found to be overweight/obese according to the Asian cut off for body mass index (BMI) (≥23 kg/m2)[20]
Summary
Efficient diabetes care is a crucial aspect of the disease owing to its progressive nature[5,6,7]. The most effective approach towards reduced mortality and morbidity in T2D appears to be comprehensive risk factor reduction targeting glycemic control, management of blood pressure and dyslipidemia[9,10] These factors underlie the guidelines for Standards of Medical Care issued towards efficient cardiovascular control in T2D by American Diabetes Association (ADA) which are updated annually in the month of January[7]. According to current ADA guidelines, lifestyle management, with medical nutrition therapy and physical activity, is a fundamental component of diabetes care[6] These guidelines recommend incorporation of yoga, the ancient skillset of Indian origin, into the regimen of physical activity based on individual preferences[5]. In view of the reported high receptivity of yoga on diabetes management in Asians Indians[3], we aimed to evaluate the effectiveness of this cost-effective lifestyle treatment in the marginalized rural clinical settings of Southern India
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