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Tai Chi for Diabetes

Public Health Report: Type 2 Diabetes and Tai Chi
Author: Eric L. Zielinski


Introduction

 

According to the Centers for Disease Control and Prevention (CDC), “From 1980 through 2011, the number of Americans with diagnosed diabetes has more than tripled (from 5.6 million to 20.9 million).” Currently nine percent of U.S. citizens have diabetes and of this group, 90 to 95 percent have the type 2 form. Since the two most common factors leading to type 2 diabetes is excess weight and inactivity, it is of vital importance for people who are battling this disease to focus on scientifically proven activities like Tai Chi in an effort to stop and even reverse its progression

 

Type 2 Diabetes 

 

The body metabolizes sugars and starches from the foods we eat into glucose. Normally, insulin – a hormone produced by the pancreas – causes liver, skeletal muscle and fat tissue cells to absorb glucose from the blood to supply the energy they need for normal function. When glucose builds up in the blood, however, it can lead to diabetes complications. 

 

Type 2 diabetes usually develops later in life and is associated with chronic inflammation caused by increased blood glucose levels – known as hyperglycemia. Unlike type 1 diabetes – in which people are born with or develop the inability to produce insulin due to viral infection – type 2 diabetes is caused primarily by lifestyle decisions that disable the body to use insulin properly.

 

The World Health Organization (WHO) reports the following key facts related to diabetes:

 

  • 347 million people worldwide have diabetes.
  • Diabetes is projected to be the 7th leading cause of death in 2030.
  • Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent type 2 diabetes.
  • Until recently type 2 diabetes was seen only in adults, but it is now also occurring in children.
  • Fifty percent of people with diabetes die of cardiovascular disease, primarily heart disease and stroke.
  • Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.
  • Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-standing damage to the small blood vessels in the retina. 
  • One percent of global blindness can be attributed to diabetes.
  • Diabetes is among the leading causes of kidney failure.
  • The overall risk of dying among people with diabetes is at least double the risk of people without diabetes.




Medical Research and Management

 

The Mayo Clinic state that “treatment for type 2 diabetes requires a lifelong commitment to: blood sugar monitoring, healthy eating, and regular exercise.” Moreover, they claim that, “Some people who have type 2 diabetes can manage their blood sugar with diet and exercise alone, but many need diabetes medications or insulin therapy” to help control disease progression.

 

Generally, people who are newly diagnosed type 2 diabetes will be prescribed metformin – for example Glucophage and Glumetza – a medication that enhances the body’s sensitivity to insulin and lowers glucose production in the liver. For severe or unresponsive cases, medications that stimulate the pancreas to produce and release more insulin are prescribed. These include: glipizide (Glucotrol), glyburide (Diabeta, Glynase) and glimepiride (Amaryl). In addition, other drugs may be given that inhibit the action of enzymes that break down carbohydrates in the intestine, such as acarbose (Precose), or make your tissues more sensitive to insulin, such as metformin (Glucophage) or pioglitazone (Actos). 

 

Some of the various side effects of type 2 diabetes medications include:

 

  • Back pain
  • Dizziness
  • Low blood glucose
  • Nausea, diarrhea, or an upset stomach 
  • Skin rash
  • Sore throat
  • Weight gain
  • Potentially fatal conditions like anemia, lactic acidosis and congestive heart failure.

 

Recently, as cases tend to get worse as America’s health and lifestyles deteriorates, some patients are given insulin therapy; an intervention usually reserved for type 1 diabetics. Another recent trend is that more people are having bariatric surgery in an effort to shave off the pounds, which is quite costly and comes with significant risks.

 

All in all, these medical interventions come at a significant coast and only mask the symptoms. I is only by addressing the root cause of disease that conditions like type 2 diabetes will ever be corrected.

 

Research showing Tai Chi’s ability to affect Type 2 Diabetes

 

Equally as complex as the diseases it is heralded to help, it has been proven by research trials that Tai Chi is a viable prevention and treatment tool for people with type 2 diabetes. 

 

  • In 2006, the British Journal of Sports Medicine published a study in which researchers from Taiwan investigated the effects of a 12-week program of regular Tai Chi on key risk factors associated with type 2 diabetes; functional mobility, beliefs about benefits of exercise on physical and psychological health, and immune regulation in middle aged volunteers. Recruiting 14 men and 23 women who were considered of normal health, it was shown that “regular [Tai Chi] exercise had a highly significant positive effect on functional mobility, and beliefs about the health benefits of exercise, in the 37 participants. Total white blood cell and red blood cell count did not change significantly, but a highly significant decrease in monocyte count occurred. A significant increase in the ratio of T helper to suppressor cells was found, along with a significant increase in CD4CD25 regulatory T cells. Production of the regulatory T cell mediators transforming growth factor β and interleukin 10 under specific antigen stimulation (varicella zoster virus) was also significantly increased after this exercise program.” The researchers – concluding that “a 12 week program of regular TCC exercise enhances functional mobility, personal health expectations, and regulatory T cell function” – were thus able to prove that Tai Chi can play a significant role in addressing key risk factors related to type 2 diabetes. 
  • One year later, the same researchers published a paper in which they measured fasting blood glucose, A1C (three month blood glucose) levels, complete blood counts, and T-lymphocyte subsets in blood before and three days after a similar 12-week Tai Chi program. The article – published in Diabetes Care – reported that, “After the 12-week [Tai Chi] exercise, the A1C levels revealed a significant decrease, but were not clinically normalized…Analysis of lymphocyte subpopulations showed that percentages of both CD4 and CD8 lymphocyte subpopulations significantly decreased after the [Tai Chi] exercise.” Although, “The effect of [Tai Chi] exercise on the increase in regulatory T-cells may indirectly be due to better cardiopulmonary fitness after exercise,” researchers proposed that, “Another possibility is that a regular [Tai Chi] exercise can improve glucose metabolism, resulting in less glycosylated proteins, which benefit immune regulatory function in type 2 diabetic patients.” Since it is well-known that glycosylated modulation of leukocyte surface receptors and soluble cytokines significantly change immune functions, the researchers conclude that, “Studies are needed to explore the glycosylated proteins other than A1C in type 2 diabetic patients that are involved in the improvement of immune functions after [Tai Chi] exercise. Moreover, an appropriate combination of the [Tai Chi] exercise program with diabetic medications may improve both glucose metabolism and immunity of type 2 diabetic patients.
  • The British Journal of Sports Medicine published a study in 2009 testing how type 2 diabetes patients on diabetes medication would respond to a 12-week Tai Chi Chuan program. They evaluated the following lab values: fasting blood glucose, HbA1c (three month blood glucose), and various immune response mediators – interleukin-12, interleukin-4, transforming growth factorβ, transcription factors (T-bet, GATA-3 and FoxP3), and Th1/Th2/T regulatory reaction. The results were quite encouraging and gives hope to those suffering from type 2 diabetes and are taking drugs because of it. The researchers stated, “A 12-week [Tai Chi] exercise programme decreases HbA1c levels along with an increase in the Th1 reaction,” thus proving that a combination of [Tai Chi] with medication significantly improves both metabolism and immunity of patients with type 2 diabetes.

 

It remains unclear, however, what the long-term effects of Tai Chi are on diabetes patients and studies need to confirm whether or not it can help people discontinue medical therapy. In addition, it remains to be seen how these factors would affect type 2 diabetic patients who are not on medication. Although, it is safe to assume that the results would be similar if not more favorable for a group not taking diabetes drugs as the immune system is comprised due to the process needed to metabolize pharmaceuticals and manage the side effects.

 

  • In 2010, the British Journal of Sports Medicine published a preliminary study of the effects of Tai Chi and Qigong on indicators of metabolic syndrome – a group of symptoms including hypertension and high blood glucose which are associated with coronary artery disease, stroke and type 2 diabetes. Specifically, the researchers evaluated for body mass index (BMI); waist circumference; blood pressure; triglycerides; HDL-cholesterol; glucose control (three month glucose levels, fasting insulin); insulin resistance; health-related quality of life; stress and depressive symptoms. Thirteen participants with metabolic syndrome were recruited to be part of a 12-week program of Tai Chi and Qigong for 1 to 1.5 hours up to three times a week. In addition, they were encouraged to perform the exercises outside of the study.  After the 12 weeks, significant improvements were recorded in four of the seven indicators of metabolic syndrome including: BMI (losing on average 3 kg per), waist circumference (2.80 cm average decrease), systolic and diastolic blood pressure decrease (11.64 mmHg, 9.73 mmHg) and glucose control (0.32 percent decrease in three month glucose test. In addition, insulin resistance fell, indicating a decreased predisposition for type 2 diabetes and the participants claimed the following: decreased stress, less depression symptoms, overall increased mental health, increased vitality, better sleep, less pain, and fewer cravings for food while participating in the program. Notably, three patients no longer met the criteria for metabolic syndrome after this test.

 

Conclusion

 

It is of the utmost importance that for the type 2 diabetes epidemic to be reversed, Americans need to embrace activities that will help shed the pounds and cause them to be more active. Tai Chi is a primary illustration of the far-reaching effects mind-body exercises can have on diabetes. Tai Chi has been studied extensively and has been proven to not only help mitigate these risk factors, it has even been shown to improve the overall health and immunity profile of type 2 diabetes patients. By doing so, it is suspected that people who regularly practice Tai Chi can actually experience complete remission if they concurrently change their dietary habits.



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