Using mindfulness with Type 2 diabetes

By Matthew Solan
Posted on October 09, 2023

Lifestyle changes like regular exercise, a healthy diet and sufficient sleep are cornerstones of self-care for people with Type 2 diabetes.

But what about mind-body practices? Can they also help people manage or even treat Type 2 diabetes? An analysis of multiple studies published in the Journal of Integrative and Complementary Medicine suggests they might.

Researchers analyzed 28 studies that explored the effect of mind-body practices on certain people with Type 2 diabetes. Those participating in the studies did not need insulin to control their diabetes or had certain health conditions such as heart or kidney disease.

The mind-body activities used in the research included:

yoga,
qigong, a slow-moving martial art similar to tai chi,
mindfulness-based stress reduction, a training program designed to help people manage stress and anxiety,
meditation, and
guided imagery, or visualizing positive images to relax the mind.

How often and over what time period people engaged in the activities varied, ranging from daily to several times a week, and from four weeks to six months.

All methods helped

Those who participated in any of the mind-body activities for any length of time lowered their levels of hemoglobin A1C, a key marker for diabetes. On average, A1C levels dropped by 0.84%.

A1C levels are determined by a blood test that shows a person’s average blood sugar levels over the past two to three months. Levels below 5.7% are deemed normal, 5.7% to less than 6.5% are considered prediabetes, and 6.5% and higher are in the diabetes range.

While all the mind-body practices helped lower A1C levels, yoga had the greatest impact, with an average 1% reduction. This is similar to the effect of taking metformin (Glucophage), a first-line medication for treating Type 2 diabetes, according to the researchers.

How can mind-body practices help control blood sugar? Their ability to reduce stress may play a big part.

“Yoga and other mindfulness practices elicit a relaxation response — the opposite of the stress response,” said Dr. Shalu Ramchandani, a health coach and internist at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital.

“A relaxation response can lower levels of the stress hormone cortisol. This improves insulin resistance and keeps blood sugar levels in check, thus lowering A1C levels.”

A relaxation response can help people with diabetes in other ways, such as by improving blood flow and lowering blood pressure, which protects against heart attacks and strokes.

The results of studies like this suggest a link between mind-body practices and lower A1C levels but do not offer firm proof of it.

Even though yoga performed best, other mind-body practices also did well. Levels of participation varied, so it’s unclear which approach is best. Still, the researchers suggested that these types of activities could become part of diabetes therapy along with standard lifestyle treatments.

Could mind-body practices protect people against developing Type 2 diabetes, especially those at high risk? While this study wasn’t designed to look at this, Dr. Ramchandani again points to the long-range benefits of the relaxation response.

“Reducing and managing stress leads to improved moods and greater self-awareness and self-regulation,” she said. “This can lead to more mindful eating, such as fighting cravings for unhealthy foods, adhering to a good diet, and committing to regular exercise, all of which can help reduce one’s risk for Type 2 diabetes.”

Mind-body practices to try

There are many ways to adopt mind-body practices that can create relaxation responses. Here are some suggestions from Dr. Ramchandani:

Do a daily 10-minute or longer meditation using an app like Insight Timer, Calm or Headspace.
Attend a gentle yoga, qigong or tai chi class at a local yoga studio or community center.
Try videos and exercises to help
reduce stress and initiate relaxation
responses.
Practice slow, controlled breathing. Lie on your back with one or both hands on your abdomen. Inhale slowly and deeply, drawing air into the lowest part of your lungs so your hand rises. Your belly should expand and rise as you inhale, then contract and lower as you exhale. Repeat for several minutes.

Matthew Solan is the executive editor of Harvard Men’s Health Watch.