Feasibility of Yoga for Type-2 Diabetes
- Conditions
- Type2 Diabetes
- Interventions
- Behavioral: Standard ExerciseBehavioral: Iyengar yogaBehavioral: Nutrition Counseling
- Registration Number
- NCT04982640
- Lead Sponsor
- The Miriam Hospital
- Brief Summary
This study will randomize 90 adults with type-2 diabetes (T2DM) from three different states (RI, MA, and AL) to a 12-week program of either (1) Iyengar yoga or (2) a Standard Exercise program. Follow up assessments occur at 3 and 6-months post-intervention. Results of this study will determine the ability to deliver these interventions with strong rigor and fidelity across multiple sites and will establish the feasibility and acceptability of this intervention across racially and ethnically diverse populations. The study will also examine factors (e.g., outcome expectations, barriers to home practice) that promote long-term adherence to yoga and/or physical activity.
- Detailed Description
Effective interventions are urgently needed to help adults with Type 2 diabetes (T2DM) achieve and maintain a healthy lifestyle. A significant and growing proportion of Americans, nearly 1 in 10, have T2DM. Uncontrolled diabetes causes serious damage to kidneys, eyes and nerves, and increases risk of heart disease and stroke. Controlling blood glucose is crucial to avoid these complications. Achieving glycemic control requires attention to multiple lifestyle behaviors including healthy eating and regular physical activity. However, only 39 percent of adults with diabetes are physically active. Traditional (western) exercise (e.g., walking and cycling) improves blood glucose levels in adults with T2DM. Long-term adherence is essential to maintain health benefits. However, individuals with T2DM face greater barriers to sustaining physical activity compared to their healthy peers due to the prevalence of overweight and obesity among those with T2DM and the co-morbidities of diabetes (e.g., poor circulation, foot care issues) that create more discomfort during exercise. Yoga is similar to traditional exercise in its ability to improve physical fitness but can be highly accommodating to those with physical limitations. Moreover, as a mindfulness practice, with emphasis on relaxation, meditation, and deep breathing, yoga's effects on stress reduction may have special relevance to people with T2DM. Increased mindfulness leads to improved self-care behaviors including physical activity. Recent meta-analyses suggest a beneficial effect of yoga on glycemic outcomes. However, existing studies have generally been of low quality and conducted with non-US populations.
This U01 application is the next logical step following successful conclusion of our pilot yoga intervention for adults with T2DM (R21AT008830). Feasibility and acceptability were high as measured by program attendance (\> 80% of sessions), study completion (92% of participants) and participant satisfaction (M=4.6, +/- 0.57, 1-5 scale). Yoga also improved diabetes selfcare, quality of life and led to reductions in emotional distress and HbA1c. The proposed study will build on these efforts by randomizing a diverse sample of 120 adults with T2DM from three different states (RI, MA, and AL) to a 12-week program of either (1) yoga or (2) Standard Exercise (SE) with follow up at 3 and 6-months post-treatment. Results of this study will determine our ability to deliver these interventions with strong rigor and fidelity across multiple sites and will establish the feasibility and acceptability of this intervention across racially and ethnically diverse populations. We will also examine factors (e.g., outcome expectations, barriers to home practice) that promote long-term adherence to yoga/physical activity. Successful conclusion of this U01 will strengthen future applications for a multi-site RCT to rigorously test the efficacy of yoga for improving HbA1c and diabetes management. If supported, yoga could offer an attractive, sustainable form of physical activity for future diabetes management programs.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 73
- Age 18 years and older
- Diagnosis of type-2 diabetes, stable on medications
- Physician clearance
- Serious comorbid condition (such as uncontrolled hypertension, glaucoma, heart failure).
- Complications of diabetes such as diabetic retinopathy, neuropathy and nephropathy
- Serious psychiatric disorder (e.g. psychosis, major depression, panic attacks, suicidality, or substance dependence).
- Extremely obese (i.e. Body Mass Index > 45 kg/m2)
- Currently engaged in yoga, Tai Chi, or other mindfulness-based practice the past six months
- Pregnant or trying to become pregnant
- Inability to read and write English
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Standard Exercise Nutrition Counseling 12-week, 60 minutes, twice weekly group-delivered aerobic exercise (e.g., walking) program Standard Exercise Standard Exercise 12-week, 60 minutes, twice weekly group-delivered aerobic exercise (e.g., walking) program Yoga Iyengar yoga 12-week program, 60 minutes, twice weekly group-delivered Iyengar yoga Yoga Nutrition Counseling 12-week program, 60 minutes, twice weekly group-delivered Iyengar yoga
- Primary Outcome Measures
Name Time Method Acceptability as indicated by participant satisfaction ratings 12 weeks The participant satisfaction scale contains 10 items using a Likert scale from 1 (not at all satisfied) to 5 (very satisfied). Scale items will be summed and averaged for each participant. Scores from all participants are averaged. If the overall average score from all participants is 4 or greater the program will be considered satisfactory.
Feasibility assessed as session attendance 12 weeks Each participant is scheduled for 36 classes in total. The percent of classes attended is calculated for each participant to determine feasibility. If the average percentage of classes attended for all participants exceeds 70% the intervention will be deemed feasible.
- Secondary Outcome Measures
Name Time Method Fasting Blood Glucose 12 weeks Blood samples taken after \> 12 hour fast are assessed using standard laboratory protocols. FBG levels measured as mg/dL at 12 weeks will be compared with baseline values.
Body Mass Index 6 months Measured as body weight in kilograms divided by height in meters squared. \[kilograms\]/ height \[meters2\]),
Diabetes Distress as measured by the Problem Areas in Diabetes Scale 12 weeks The problem areas in diabetes scale is a valid and reliable measure of diabetes-related emotional distress. It contains 20 items using a Likert scale from 0 (not a problem) to 4 (serious problem). Scale items are summed and averaged. Higher scores indicate more serious emotional distress associated with managing diabetes.
Hemoglobin A1c 6 months Changes in hemoglobin A1c (HbA1c) from baseline to 6 months follow up
Trial Locations
- Locations (1)
The Miriam Hospital- CORO building
🇺🇸Providence, Rhode Island, United States