Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis

Abstract

Background A daily habit of yogic practice or walking, along with an oral hypoglycemic agent (OHA) could be beneficial for better control of type 2 diabetes mellitus (T2DM). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to find out the efficiency of yoga or walking on glycemic control in T2DM. Methodology The present systematic review and meta-analysis were completed according to the PRISMA guidelines. The risk of bias in included studies was evaluated, by using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analysis was implemented using RevMan software. Forest plots were used to illustrate the study findings and meta-analysis results. Results Sixteen studies were included in this systematic review, where 1820 participants were allocated to one of the following interventions: yoga, walking, and without any regular exercise (control group). Participants were between 17–75 years of age. Compared to the control group, the yoga group had a significant reduction in fasting blood glucose (FBG) by 31.98 mg/dL (95% CI = –47.93 to –16.03), postprandial blood glucose (PPBG) by 25.59 mg/dL (95% CI = –44.00 to –7.18], glycosylated hemoglobin (HbAlc) by 0.73% (95% CI = –1.24 to -0.22), fasting insulin by 7.19 μIU/mL (95% CI = –12.10 to –2.28), and homeostatic model assessment for insulin resistance (HOMA-IR) by 3.87 (95% CI = –8.40 to -0.66). Compared to the control group, the walking group had a significant reduction in FBG by 12.37 mg/dL (95% CI = –20.06 to –4.68) and HbA1c by 0.35% (95% CI = –0.70 to –0.01). Compared to the walking group, the yoga group had a significant reduction in FBG by 12.07 mg/dL (95% CI = –24.34 to – 0.20), HbA1c by 0.20% (95% CI = –0.37 to –0.04), fasting insulin by 10.06 μIU/mL (95% CI = –23.84 to 3.71) and HOMA-IR by 5.97 (95% CI = –16.92 to 4.99). Conclusions Yoga or walking with OHA has positive effects on glycemic control. For the management of T2DM, yoga has relatively more significant effects on glycemic control than walking. Review registration number: PROSPERO registration number CRD42022310213