A Randomized controlled trial of the effect of yoga and peer support on glycaemic outcomes in women with type 2 diabetes mellitus: a feasibility study

Abstract

BackgroundType two diabetes is a complex and demanding chronic disease and its impact in a state (Kerala) which leads India in terms of the number of people with Diabetes is profound. Though the male to female ratio among the people with diabetes is roughly equal, women are uniquely and more severely affected. Management of type two Diabetes requires considerable dexterity on the part of the patient to manage drugs, diet and exercise. Therefore, in a low middle-income country like India it is necessary to look at low cost interventions that can empower the patient and build on available resources to help manage diabetes. Hence, we studied the feasibility and effect of two low cost interventions; yoga and peer support on glycaemic and other outcomes among women with type two diabetes.MethodsAn open label parallel three armed randomized control trial was conducted among 124 recruited women with Diabetes for three months. Block randomization with a block length of six was carried out with each group having at least 41 women. In the Yoga arm, sessions by an instructor, consisting of a group of postures coordinated with breathing were conducted for an hour, two days a week. In the peer support arm each peer mentor after training visited 13–14 women with diabetes every week followed by a phone call. The meeting was about applying disease management or prevention plans in daily life.ResultsThere was a trend in decline of fasting plasma glucose in the peer and yoga group and of glycosylated haemoglobin (HbA1c) in the yoga group only, though not significant. A significant decrease was observed in diastolic blood pressure and hip circumference in the yoga group. The process indicated that most (80%) of the women in the yoga group attended classes regularly and 90% of the women in the peer group reported that peer mentoring was useful.ConclusionThe effect of yoga and peer support on glycaemic outcomes was incremental. Longer term studies are necessary to ascertain the benefits shown by this feasibility study.Trial registration CTRI/2011/12/002227 dated 14/12/2011.

Lifestyle interventions for improving health and health behaviours in women with type 2 diabetes: A systematic review of the literature 2011–2017

“…With the exception of this study [40] all studies had a low risk of bias of selective outcome reporting. Overall, eight studies were found to have a low risk of bias [25,30,31,34,36,38,39,41]. A proportion of the trials examined in this review had an unclear risk of bias.…”

“…to determine eligibility for inclusion (see previous section) in the review. Both reviewers agreed that an additional 91 papers should be excluded as they were not primary research studies (i.e., protocol papers; n = 6), unable to retrieve the full-text record (n = 8), they did not meet the inclusion criteria (e.g., the population included men or women but did not isolate results for women, the intervention was not lifestyle related, or was not designed for women with [29,[34][35][36]39], two originated from Europe (one from Italy [37] and one from Turkey [42]), six originated from Iran [26,27,[30][31][32][33] and the remaining three RCTs originated from Asia (one from India [38], Japan [28], and Thailand [41]). The trial conducted in India was a three armed RCT and the one conducted in Japan was a Crossover RCT.…”

“…versus home-based exercise therapy program, and three studies implemented aerobic exercise three times weekly [32,33,35]. Several studies compared less vigorous exercise interventions including Sreedevi [38] who trialled a yoga intervention, Youngwanichsetha [41] who trialled five weekly tai chi qigong sessions over 12 weeks, and Yucel [42] examined the impact of regular pilates for 12 weeks. Finally, Sentinelli [37] investigated the impact of increasing volumes of supervised Nordic walking for 12 weeks on body composition.…”

“…Only five studies provided details of blinding of outcome assessors [34,36,38,39,41]. Around half of the studies either failed to blind study personnel and/or the outcomes, or provided insufficient information to determine whether blinding had occurred [25,27,28,31,32,35,37,40,42], while two studies had a high risk of bias of blinding participants/ personnel for outcomes [26,33].…”

Perceived Risk and Abilities for Health Practices Related to Prevention of Type Ii Diabetes Mellitus Among Postnatal Mothers With Gestational Diabetes Mellitus

“…Numerous research studies in the general population have identified that adoption of a healthy lifestyle such as healthy diet, exercise, and weight loss can prevent GDM, however, there are limited researchers who can focus on usual healthy practices in women with GDM [4]. Most researchers have focused on glycemic control [5] throughout the pregnancy for positive maternal and fetal outcomes, but management has been lacking after childbirth to prevent or delay the development of DM in childbearing women [6]. Hence, the researchers decided to assess the perceived risk and abilities for health practices related to prevention of Type II DM among postnatal mothers with GDM.…”