Prevention and Effective Management of type 2 Diabetes in India - A Protocol of Community Based Yogic Lifestyle Intervention

Abstract

Background: India has the second largest number (>61 million) of people with Type 2 Diabetes Mellitus (T2DM), which is expected to double by 2030. Lifestyle interventions such as yoga are found to be safe and cost-effective for T2DM. The major challenge is to translate yoga intervention into prevention programs at the national level which would reach every individual in the community. In this context, the researchers of this paper developed a community based yoga protocol for detection, prevention and effective management of T2DM in India. Methods/Design: Review of protocols in T2DM and multiple rounds of discussion with 6 experts (epidemiologist, medical physician, yoga expert, researchers and field survey analyst) helped develop the current ‘Stop Diabetes Movement (SDM)’ protocol. Results: The main protocol was divided in two protocols viz. clinical and research protocol, each containing sub-protocols. Clinical protocol included a sub-protocol on testing the effectiveness of the yogic lifestyle intervention in people at risk of T2DM or diagnosed with prediabetics/ T2DM using pre-post experimental design with long term follow up. It included another sub-protocol on training of trainers who would teach the yoga intervention in the local community. The research protocol was divided into three phases. Phase1 included 5 subprotocols on epidemiological survey of prevalence of T2DM and pre-diabetes in different localities in India. Phase 2 included sub-protocol on intervention study using matched control design with long term follow up and a sub-protocol on training of the trainers same as in clinical protocol. Phase 3 included re-assessing the prevalence of T2DM post provision of yoga modulein different localities in India (using the same sub-protocols as Phase 1). Conclusion: The SDM protocol is logically- scientifically designed and methodologically sound. The effective implementation of this protocol in the community in India could help in the ultimate goal of prevention and effective management of T2DM in India.