Cardiologue et Directeur de la prévention, Institut de Cardiologie de Montréal. Professeur titulaire de clinique, Faculté de médecine de l'Université de Montréal. / Cardiologist and Director of Prevention, Montreal Heart Institute. Clinical Professor, Faculty of Medicine, University of Montreal.See all articles
Only 51% of patients with type 2 diabetes succeed in properly controlling their blood sugar, i.e., reaching the therapeutic target of <7% glycated hemoglobin (HbA1c). The quantification of glycated hemoglobin is a reflection of long-term blood glucose (about 2–3 months), unlike fasting blood glucose, which is a snapshot of the glycemic state. Thus, the higher the blood sugar level over a prolonged period in an individual, the higher the proportion of glycated hemoglobin (containing a sugar) will be. The normal HbA1c value is between 3.5% and 6%.
Why do half of patients with type 2 diabetes fail to control their blood sugar, despite the wide variety of medications available to manage high blood sugar? Several factors contribute to this inadequate glycemic control, including polypharmacy (use of multiple drugs), socio-economic status, psychiatric disorders, and health disparities.
One way to improve blood sugar control by people with diabetes is through holistic activity (involving the body and the mind), such as yoga, qigong, guided imagery, mindfulness-based stress reduction (MBSR), and other forms of meditation. Researchers recently conducted a systematic review and meta-analysis of studies on the effect of holistic interventions on glycemic control in diabetics. The results of the meta-analysis, which included 28 intervention studies published between 1993 and 2022, indicate that, overall, holistic practices significantly lower the level of glycated hemoglobin or HbAc1 by 0.84%. Reductions in HbAc1 (and therefore better glycemic control) were observed for all types of intervention: MBSR: -0.48%; qigong: -0.66%; and yoga: -1.00%. The duration of yoga sessions did not have a significant effect on the HbAc1 level, but the frequency did: for each additional day with a yoga session, the HbAc1 level decreased by an average of 0.22%. Fasting blood glucose was also significantly improved following the holistic practices, with an average decrease of 22.81 mg/dL.
These reductions in glycated hemoglobin and fasting blood glucose levels are clinically significant, suggesting that mind-body practices may be effective complementary non-pharmacological interventions for people with diabetes.