BackgroundThe pre-diabetic stage is important in terms of identification and timely management due to its reversible nature. Along with other factors, insulin resistance in skeletal muscle is often considered as primary defect before development of overt hyperglycemia and Diabetes Mellitus (DM). Physical exercises are beneficial in prevention of DM by improving skeletal muscle mediated glucose metabolism. Evidence suggests that Yoga interventions appear to be equal and/or superior to exercise in most outcome measures. As the Yogic postures are relatable to exercises, they are considered to improve skeletal muscle function and reverse the pre-diabetic stage. MethodsThis open-labelled, randomized clinical study is planned to evaluate effect of Yoga interventions on muscle mass, strength, endurance and flexibility which are direct/indirect indicators of fat deposition in skeletal muscles. Association between changes in muscle quality/ functionality and glycemic control will also be explored. With ethics committee permission, 120 pre-diabetic individuals of either sex between age group of 35–49 years with BMI range of 25–35 kg/m2 and family history of Type 2 Diabetes Mellitus (T2DM) will be recruited after obtaining written informed consent. They will be randomly allocated to either Yoga or exercise group by computer generated randomized method in a 1:1 ratio. One group will receive defined Yoga interventions, while other group will receive fixed program of physical exercises. Prior to initiating this 12-week study, both groups will undergo a training session for 4 weeks under supervision of a trained instructor. The outcome measures will be parameters related to muscle quality/functionality and glucose metabolism markers. DiscussionOur study aims to explore practicality of Yoga in pre-diabetic stage on skeletal muscle related glycemic control, which is novel. Additionally, the study will generate awareness about pre-diabetes and provide people with active coping skills for reversing it.