The Impact of Yoga as an Adjunct to Standard Care on Glycemic Control, Insulin Resistance, Oxidative Stress, and Quality of Life in Individuals with or at Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

INTRODUCTION

Type 2 Diabetes Mellitus (T2DM) is marked by insulin resistance and chronic hyperglycemia. Yoga, a complementary therapy, may improve metabolic outcomes when used with standard care. This systematic review and meta-analysis aimed to evaluate the effects of yoga on glycemic control, insulin resistance, oxidative stress, and psychological well-being in individuals with or at risk of T2DM.

METHODS

We conducted a systematic search in PubMed, CAM-QUEST®, and the Cochrane Central Register following PRISMA guidelines. We included randomized controlled trials (RCTs) assessing yoga interventions (asanas, pranayama, kriyas, and meditation) alongside standard care. Primary outcomes were fasting blood glucose (FBS), postprandial blood glucose (PPBS), HbA1c, serum insulin, and HOMA-IR. Secondary outcomes included oxidative stress markers (glutathione, malondialdehyde [MDA], superoxide dismutase [SOD]) and psychological outcomes. Meta-analyses were conducted using random-effects models in RevMan 5.4.1.

RESULTS

Fourteen RCTs (n = 1,629 participants) were included. Yoga combined with standard care significantly improved FBS (SMD = -1.60; 95% CI: -2.27 to -0.92), PPBS (SMD = -2.16; p = 0.03), HbA1c (SMD = -0.92; 95% CI: -1.59 to -0.26), and HOMA-IR (SMD = -1.28; p = 0.002). MDA levels were significantly reduced, though glutathione and SOD showed no significant changes. Psychological well-being improved in several trials.

DISCUSSION: Yoga appears effective in improving glycemic outcomes and insulin resistance in patients with or at risk of T2DM. It may also reduce oxidative stress and enhance psychological well- being, highlighting its potential as a holistic intervention.

CONCLUSION

Yoga, when integrated with standard care, offers clinically relevant benefits in managing T2DM and related metabolic risks. Further high-quality, multi-centered trials using standardized protocols are needed to validate and generalize these findings.