Kumar Ramesh, Dhamija Puneet, Vardhan Gyan, Kant Ravi, Singh Yogesh, Yadav Raj Kumar, Rudra Bhandari, Pathania Monika
Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND.
General Medicine, All India Institute of Medical Sciences, Rishikesh, IND.
Cureus. 2024 May 29;16(5):e61329. doi: 10.7759/cureus.61329. eCollection 2024 May.
Diabetic autonomic neuropathy (DAN) is a prevalent yet often overlooked complication of diabetes mellitus (DM), impacting multiple organs and substantially elevating the risk of morbidity and mortality. This study aimed to assess the effectiveness of yoga-based intervention (YBI) compared to the American Diabetes Association exercise regimen (ADA Ex. Regime) and standard care for treating autonomic neuropathy in type 2 DM.
This open-label exploratory clinical trial featured two parallel study arms: Group A (Intervention), which received YBI alongside standard care, and Group B, which adhered to the ADA Ex. Regime in conjunction with standard care. A total of 80 participants aged 35-60, diagnosed with type 2 DM and autonomic neuropathy, were equally allocated to both groups. Data collection included nerve conduction velocity (NCV) tests, autonomic function tests (AFTs), as well as evaluations of depression and quality of life.
YBI demonstrated a drop in parasympathetic tone compared to the ADA Ex. Regime. Following a six-month intervention, the sympathetic activity indicator (SD2) exhibited a significantly lower value in the YBI group than in the ADA Ex. Regime group, indicating a positive effect (p < 0.05), while the ADA Ex. Regime showed more improvement in certain areas of NCV (e.g., left and right peroneal NCV, right and left peroneal F-latency), notable differences were observed in alkaline phosphatase levels, depression scores, and WHO-5 wellness, all reaching statistical significance at p < 0.05.
The study findings observed that a 24-week YBI significantly reduced in symptoms of diabetic neuropathy and stress. Although the ADA Ex. Regime demonstrated greater improvement in specific aspects of NCV compared to YBI, YBI outperformed the ADA Ex. Regime in enhancing WHO-5 wellness and reducing depression symptoms.
糖尿病自主神经病变（DAN）是糖尿病（DM）常见但常被忽视的并发症，影响多个器官，并显著增加发病和死亡风险。本研究旨在评估基于瑜伽的干预措施（YBI）与美国糖尿病协会运动方案（ADA运动方案）及标准护理相比，在治疗2型糖尿病自主神经病变方面的有效性。
这项开放标签的探索性临床试验设有两个平行研究组：A组（干预组），接受YBI并结合标准护理；B组，遵循ADA运动方案并结合标准护理。共有80名年龄在35至60岁、被诊断为2型糖尿病和自主神经病变的参与者被平均分配到两组。数据收集包括神经传导速度（NCV）测试、自主神经功能测试（AFT），以及抑郁和生活质量评估。
与ADA运动方案相比，YBI显示副交感神经张力下降。经过六个月的干预，交感神经活动指标（SD2）在YBI组中的值显著低于ADA运动方案组，表明有积极效果（p<0.05），而ADA运动方案在某些NCV区域（如左右腓总神经NCV、左右腓总神经F波潜伏期）有更多改善，在碱性磷酸酶水平、抑郁评分和WHO-5健康状况方面观察到显著差异，均在p<0.05时达到统计学意义。
研究结果表明，为期24周的YBI显著减轻了糖尿病神经病变和压力症状。尽管ADA运动方案在NCV的特定方面比YBI有更大改善，但YBI在提高WHO-5健康状况和减轻抑郁症状方面优于ADA运动方案。
