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Effect of yoga on glycemia and lipid parameters in type-2 diabetes: a meta-analysis

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Abstract

Purpose

Prior systematic reviews on yoga and diabetes have given conflicting results. They have been limited by inclusion of uncontrolled unblinded single group observational studies. No reviews are available which have used the Cochrane methodology and GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. This meta-analysis evaluated the efficacy of yoga on glycaemia and lipids in T2DM using the Cochrane methodology and GRADE approach.

Methods

Major repositories were searched to pick randomized controlled trials involving T2DM patients receiving yoga. Primary outcome was to evaluate changes in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c). Secondary outcomes were to evaluate changes in post-prandial plasma glucose (PPG), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Sub-group analysis involving people undergoing structured exercise regimen (SER) versus those undergoing standard diabetes care in controls was done.

Results

Data from 13 studies involving 1440 patients were analysed. Compared to controls, individuals doing yoga had significantly lower FPG [mean difference (MD) -17.22 mg/dl (95% CI: −26.19 – −8.26 mg/dl); p < 0.01; considerable heterogeneity (CH); low certainty of evidence (LCE)], PPG [MD -27.77 mg/dl (95% CI: −35.73 – −19.81 mg/dl); p < 0.01; low heterogeneity; moderate certainty of evidence (MCE)], TC [MD -19.48 mg/dl (95% CI: −31.97 – −6.99 mg/dl); p < 0.01; CH; LCE], triglycerides [MD -12.99 mg/dl (95% CI: −23.74 – −2.25 mg/dl); p < 0.01; CH; LCE], LDL-C [MD -11.71 mg/dl (95% CI: −17.49 – −5.93 mg/dl); p < 0.01; I2 = 69% CH; LCE] and significantly higher HDL-C [MD 4.58 mg/dl (95% CI: 3.98–5.18 mg/dl); p < 0.01; low heterogeneity; MCE]. On sub-group analysis, where yoga was compared to SER, FPG was significantly lower in yoga group.

Conclusion

Yoga improves glycaemia and lipid parameters in T2DM with additional benefits seen both in people doing/not doing structured exercise.

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Author information

Authors and Affiliations

  1. Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis & Rheumatism (CEDAR) Super-speciality Clinics, Dwarka, New Delhi, 110075, India

    Deep Dutta

  2. Department of Endocrinology, Max Superspeciality Hospital, New Delhi, India

    Saptarshi Bhattacharya

  3. Department of Rheumatology, CEDAR Superspeciality Clinics, Dwarka, New Delhi, India

    Meha Sharma

  4. Department of Endocrinology, Maharaj Agrasen Hospital, New Delhi, India

    Deepak Khandelwal

  5. Department of Endocrinology, Manipal Hospitals, Dwarka, New Delhi, India

    Vineet Surana

  6. Department of Endocrinology, Bharti Hospitals, Karnal, India

    Sanjay Kalra

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  1. Deep Dutta
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Correspondence to Deep Dutta.

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DD, SB, MS, DK, VS and SK have no conflict of interests with regard to this research work and have nothing to declare.

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Supplementary Information

ESM 1

(DOC 64 kb)

Supplementary Table-1: Risk of Bias assessment table for the meta-analysis (DOCX 24 kb)

Supplementary Figure-1: Forest plot evaluating the impact of yoga on (a): fasting blood glucose with subgroup analysis; (b): glycated haemoglobin (Hba1c) with subgroup analysis; (c): post-prandial blood glucose with subgroup analysis; (d): total cholesterol with subgroup analysis

The sizes of the boxes are proportional to the weight of each individual study in the analyses. The summary effect size is represented by a diamond; Active exercise regimen controls represent the structured exercise regimen (SER) sub-group; Passive control group represent the standard diabetes care (SDC) sub-group (JPG 743 kb)

Supplementary Figure-2: Forest plot evaluating the impact of yoga on (a): triglycerides with subgroup analysis; (b): LDL-cholesterol with subgroup analysis; (c): HDL-cholesterol with subgroup analysis.

The sizes of the boxes are proportional to the weight of each individual study in the analyses. The summary effect size is represented by a diamond; Active exercise regimen controls represent the structured exercise regimen (SER) sub-group; Passive control group represent the standard diabetes care (SDC) sub-group (JPG 380 kb)

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Dutta, D., Bhattacharya, S., Sharma, M. et al. Effect of yoga on glycemia and lipid parameters in type-2 diabetes: a meta-analysis. J Diabetes Metab Disord 20, 349–367 (2021). https://doi.org/10.1007/s40200-021-00751-0

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