Background: The purpose of this article is to clarify and define medical qigong and to identify an appropriate study design and methodology for a large-scale study looking at the effects of qigong in patients with type 2 diabetes mellitus (T2DM), specifically subject enrollment criteria, selection of the control group and study duration. Methods: A comprehensive literature review of English databases was used to locate articles from 1980–May 2017 involving qigong and T2DM. Control groups, subject criteria and the results of major diabetic markers were reviewed and compared within each study. Definitions of qigong and its differentiation from physical exercise were also considered. Results: After a thorough review, it was found that qigong shows positive effects on T2DM; however, there were inconsistencies in control groups, research subjects and diabetic markers analyzed. It was also discovered that there is a large variation in styles and definitions of qigong. Conclusions: Qigong exercise has shown promising results in clinical experience and in randomized, controlled pilot studies for affecting aspects of T2DM including blood glucose, triglycerides, total cholesterol, weight, BMI and insulin resistance. Due to the inconsistencies in study design and methods and the lack of large-scale studies, further well-designed randomized control trials (RCT) are needed to evaluate the ‘vital energy’ or qi aspect of internal medical qigong in people who have been diagnosed with T2DM.

Type 2 diabetes mellitus (T2MD) is a complex, chronic, metabolic disease with hyperglycemia arising from insulin resistance, progressive pancreatic beta cell failure, insufficient insulin secretion and increased hepatic glucose output. In the Chinese medicine theory, T2DM is often referred to as a form of Xiao Ke (消渴)or"wasting-thirst disorder." Genetic, dietary, lifestyle and environmental factors play a role in T2DM. People with a family history of diabetes or who are obese are at the highest risk of developing the disease. T2DM is often associated with hypertension, dyslipidemia and atherosclerosis and if not managed can lead to complications including cerebrovascular accident, peripheral vascular disease and nephropathy. T2DM can be well managed with biomedical and Chinese medicine treatment approaches. Lifestyle changes including appropriate diet and exercise are paramount in managing T2DM. Regular Qigong practice can be a beneficial part of one's exercise routine for T2DM self-care. Qigong exercise has shown promising results in clinical experience and in randomized, controlled pilot studies for affecting aspects of T2DM including positive associations between participation in Qigong and blood glucose, triglycerides, total cholesterol, weight, BMI and insulin resistance. This chapter looks at how traditional Chinese medicine (TCM) views diabetes as well as new understandings of how Qigong can support the management of T2DM.