Sailing from Galapagos to the Marquesas Islands in French Polynesia took us 17 days. It takes a lot of stamina to do such a crossing when there is just the two of you as there needs to be always someone on watch. It was hot and as such Brent drank large quantities of coca-cola. After a week into our crossing, he started feeling unwell. He was excessively tired, nauseous and had to urinate frequently. I suspected he had diabetes after consulting my first aid book and gave him insulin which improved his condition. Upon arrival in Nuku Hiva he was indeed diagnosed with diabetes type II.
What is diabetes type II?
Type II diabetes is what one could call a life style disease. The primary problem is that sugar is not broken down as the body does not produce enough insulin to function properly or the cells don’t react to insulin. This means that glucose stays in the blood and isn’t used as fuel for energy.
What are the causes of diabetes type II?
There are two interrelated causes of diabetes. Firstly lack of a good diet, instead eating foods with high sugar content, overeating and lack of exercise. High amounts of sugar in a daily diet overwork the pancreas, which has to secrete enormous amounts of insulin, and sooner or later it begins to tire. As a result the production of insulin becomes less and less and so the blood becomes saturated with sugar.
The second cause for diabetes is stress related and as a result of daily stresses too much adrenaline is produced. This in turn, urges the liver to release stored glucose into the blood stream.
What is the normal treatment for diabetes type II?
The normal treatment for type II diabetes is insulin in tablet form. This artificial insulin helps to push the sugar from the arteries into the body cells as such nourishing the cells and lowering the glucose level of the blood.
Without this insulin, the cells slowly starve, leading to excessive weight loss but also the muscle cells of the blood vessels walls slowly deteriorate leading to poor circulation, gangrene, strokes, heart disease, kidney failure and blindness. The eye growing many fine blood vessels to try and provide nutrients for the retina causes the latter as these blood vessels can bleed or leak fluids.
Is diabetes type II common?
Type II diabetes is unfortunately a common disease throughout the world. As such there is a wealth of research (PA Balaji et al. 2012, Malhotra V et al. 2005, Ramaiah SA 1986, Jerath RJ et al. 2006, Dr Swami Karmananda 1983) into the use of yoga asana (poses), pranayama (breathing) and meditation on type II diabetic patients.(1)
What are the most commonly used asanas in the treatment of diabetes type II?
The most commonly used asana in these studies were:
Surya Namaskara (sun salutations)
Followed by:
What is the most commonly used pranayama or breathing exercises in the yoga therapy for diabetes type II?
Mula Bandha (Root Lock), Jalandhara Bhandha (Chin Lock), Uddiyana Bhandha (Abdominal Lock)
What is the most commonly used meditation practice in support of treating diabetes type II?
Dr Swami Karmananda (1983) suggests that the above detailed practices should be supported by a meditation technique called Ajapa japa (stage 1 to 3). This meditation technique is the repetition of a mantra or divine name. The mantra or name may be spoken softly, enough for the practitioner to hear it or it may be spoken within the mind. There are several stages to the practice, which can be further explored by following the link.
Is nutrition important?
These yoga practices were in some cases combined with a focus on nutrition, namely the reduction of the consumption of refined carbohydrates and the absence of added sugar in the diet. This diet may sound simple but anyone who regularly reads the nutritional values on the back of commonly bought foods knows that it is not so easy to find sugar free products. Sugar-free often means that there is artificial sweetener in the food listed under such names as aspartame, sucralose, saccharin, neotame or acesulfame. Whereas these products can be used to transition from a high sugar content diet, they are unsuitable to use in the long term in particular in the form of diet soda as they trick the body into thinking that food is on its way. The body then produces a large amount of insulin, which increases our ability to store fat, and triggers our hunger reflex (Gameau D et al 2016). In other words they can lead to a weight gain, which is detrimental for diabetics.
What are the outcomes of the studies in the use of yoga practices in the management of diabetes?
Rejuvenation/regeneration of cells of pancreas due to asana such as parsvakonasana which squeeze one side of the trunk and as such restrict the blood flow and at the same time increase blood flow on the other side of the trunk (Simon Borg-Olivier et al. 2012) This promotes blood circulation in the pancreas region.
Various studies (Sahay BK et al.1988, Njunata S et 2005, Ramaiah SA. 1986) indicate that this improved blood circulation can promote the sensitivity of the insulin producing cells (beta cells) of the pancreas to the glucose signal. In addition, the direct stimulation of the pancreas through the massaging effect of asana such as dhanurasana, pavanamuktasana rejuvenate its capacity to produce insulin possibly through the stimulation of the meridian of the pancreas. (2)
The asana used in these studies furthermore promote relaxation, blood flow strength and stability of the opposing muscle groups through the concept of reciprocal relaxation (Simon Borg-Olivier et al. 2012). This spinal reflex, without use of the brain, ensures that blood flows away from the contracted muscle towards the opposing relaxed muscle. According to Chandratreya S. 2016, muscular relaxation, development and improved blood supply to muscles might enhance insulin receptor expression on muscles causing increased glucose uptake by muscles and thus reducing blood sugar. (3)
Why would pranayama have such a positive impact on type II diabetes patients?
The answer may lie in the reduction of the ‘fight or flight response’. As discussed earlier, stress triggers high glucose levels in the blood and activates the sympathetic nervous system. This causes a decreased blood flow to the gastrointestinal (GI) tract and prolonged high blood pressure. Pranayama breathing appears to activate the parasympathetic nervous system; enhancing digestion and promoting blood flow to the GI track. Wilson A 2014 claims that also certain parts of the brain are activated, dampening fear response and increasing areas responsible for reflection. This leads to more mindful responses and a greater feeling of calm, thus reducing stress and the reduction of glucose levels. (4)
How can we summarize the impact of yoga on diabetes type II?
More active practices followed by relaxing ones such as in the suggested asana, pranayama exercises and meditation appear to lead to deeper relaxation than meditation alone. Dr. T McCall explains that through the activation in turn of the sympathetic nervous system and then the parasympathetic nervous system, the latter allows again for increased blood flow around the liver, the pancreas, the heart and the lungs as a relaxed trunk allows for fresh clean blood to refresh the organs. At the same time, the presence of stress hormones leads to increased glucose levels, whereas the reduction of stress hormones after the practice of asana, pranayama and meditation, reduces glucose levels. Last but not least it appears that yoga and pranayama allow the brain to rewire itself, which allows us to drop bad habits and to make significant changes to lifestyle enabling better management of diabetes. (5)
In conclusion, it is clear that yogic management of diabetes, together with good nutrition is successful and that scientific research supports a case for including yoga in the daily treatment of diabetes type II. This does not mean that all artificial insulin can necessarily be taken away, but largely reduced doses are common.
References
- PA Balaji, Smitha R Varne, Syed Sadat Ali
N Am J Med Sci 2012 Oct 4 (10)442 – 448
Physiological effects of yogic practices and transcendental meditation in Health and disease.
Malhotra V Singh S Tandon OP Sharma SB Nepal Med. Coll. J 2005 Dec 7 (2) 145-7 The beneficial effects of yoga in diabetes.
Ramaiah SA. Yoga Therapy for Diabetes: Washington, D.C. Study, International Conference on Traditional Medicine, 1986, Madras. Madras, India: Published by Siddha Medical Board, Govt. of Tamil Nadu;
Jerath RJ, Edry VA, Barnes VA, Jerath V. Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow breathing shifts the autonomic nervous system. Med Hypotheses. 2006;67:566–71.
Yogic management of common diseases Dr Swami Karmananda 1983
- Sahay BK, Murthy KJR. Long term follow up studies on effect of yoga in diabetes. Diab Res Clin Pract. 1988;5(suppl.1):S655.
Njunata S, Vempati RP, Ghosh D, Bijlani RL. An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects. Indian J Physiol Pharmacol. 2005;49:319–24.
Ramaiah SA. Yoga Therapy for Diabetes: Washington, D.C. Study, International Conference on Traditional Medicine, 1986, Madras. Madras, India: Published by Siddha Medical Board, Govt. of Tamil Nadu;
Gameau D et al, That Sugar Guide 2016
- Chandratreya S. Diabetes & Yoga. [Accessed March 2016) at http://www.yogapoint.com/therapy/diabetes_yoga.htm.
- Wilson A Yogic Breathing: The Physiology of Pranayama (Accessed March 2016) http://www.huffingtonpost.com/kripalu/yoga-practice_b_4762303.html
- McCall T. The Scientific Basis of Yoga Therapy ( Accessed March 2016) http://www.yogajournal.com/for_teachers/2016
Catamaran Impi 