A study on the effect of integrated yoga program on self satisfaction among T2DM patients of Mongoloid origin attending JNIMS, Imphal

Abstract

Background Type 2 Diabetes mellitus (T2DM) is becoming a leading metabolic disorder characterised by a chronic hyperglycaemic condition and change in lipid profile resulting from insufficient action of insulin. Many studies on the beneficial effects of yoga on T2DM patients of different races and ethnic groups of urban and semi-urban areas of developed and developing countries have been widely reported. However, there is lack of systematic research work on the efficacy of yoga on management of patients with T2DM of Mongoloid race of North-East India. Aim and objectives The present study aimed to investigate the efficacy of yoga lifestyle intervention on clinical outcome measures coupled with evaluation of Health Satisfaction and Quality of Life using appropriate self-reported questionnaires among the T2DM patients of mongoloid race of Oriental region of Manipur, a remotest boundary state of India neighbouring to Myanmar. Methods The current study was a randomized control study. Of the 1980 candidates enrolled for treatment of diabetes as OPD patients at the Endocrinology Department of JNIMS Hospital, 450 patients proved to be T2DM based on the clinical tests data and anthropometric characteristics were screened out for randomization. On further examination applying inclusive and exclusive criteria, three hundred and four patients confirmed for T2DM of both sexes were randomized into 151 experimental group (EG) and 153 control group (CG).The experimental yoga group was prescribed oral anti-glycaemic agents and in addition followed an ideal yoga module intervention for one and half hour daily for 6 days a week for 4 months. The control group was prescribed oral anti-glycaemic agents only and did not perform any type of exercise during the period. Before and after intervention Glycaemic status, Lipid parameters and information on Health Satisfaction and Quality of Life questionnaires were collected. Results Primary outcome measures of Glycaemic indices had significant reduction in (p < 0.001) in both groups. There was a significant reduction in Group x Time interaction for HbA1c [p< 0.001, η2 = 0.179], FBG [p<0.001, η2 =0.054] and PPBG [p <0.001, η2 = 0.029]. Significant reduction (p < 0.001) was observed in Lipid parameters except HDL that indicated significant increase (p < 0.001). There was a significant reduction in Group x Time interaction for TC [p < 0.001, η2 = 0.061], TG [p < 0.001, η2 = 0.097], LDL [p <0.001, η2 = 0.067], and VLDL [p < 0.001 η2 = 0.038], and increase in HDL [p< 0.001, η2 = 0.198]. The secondary outcome measures such as SBP, DBP had significant reduction (p <0.001) in both groups. But BW and BMI had significant reduction (p< 0.001) in the yoga group but negatively significant (p< 0.001) in the control group. Group x Time interaction also showed significant positive reduction in BMI [p < 0.001, η2 = 0.300], SBP [p< 0.001, η 2 = 0.060] and DBP [p< 0.001, η 2 = 0.034] whereas BMI showed negatively significant in control group. Overall comparison of the results, the yoga intervention group outperforms over the control group. Conclusions: The study inferred that the T2DM patients of mongoloid race could manage diabetes in improving hormonal homeostasis and controlling the glycaemic status with the life style modification through yoga practice. The study supports yoga as body and mind medicine leading to balancing and harmonising the physical and psychological stress holistically. The study discusses how the T2DM patients achieve the treatment goal of self-satisfaction through yogic life style which could reduce or stop the conventional medication treatment. Keywords: T2DM, Glycaemic control, Lipid profile, Current Health Satisfaction, Quality of Life, Self satisfaction