The Effect of Qi-Gong Relaxation Exercise on the Control of Type 2 Diabetes Mellitus: A randomized controlled trial

doi:10.2337/diacare.25.1.241

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Letters: Observations
Letter

The Effect of Qi-Gong Relaxation Exercise on the Control of Type 2 Diabetes Mellitus

A randomized controlled trial

Takuya Tsujiuchi, PHD¹, Hiroaki Kumano, PHD¹, Kazuhiro Yoshiuchi, PHD¹, DeGuang He, MD¹, Yuko Tsujiuchi, MD¹, Tomifusa Kuboki, PHD¹, Hiroyuki Suematsu, PHD² and Koichi Hirao, PHD³

¹ Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo, Japan
² Japanese Society of Psychosomatic Medicine, Tokyo, Japan
³ Institute of Diabetes Mellitus and Obesity Treatment, Health Education Center, Science Clinic, Yokohama, Japan

Qi-gong relaxation exercise is one of the traditional Chinesehealth care self-management technique. It consists of two aspects,controlled synchronized breathing with slow body movements asan aerobic exercise, and relaxation (1). The purpose of thisstudy was twofold: to examine the effects of Qi-gong and toidentify biological and psychological characteristics associatedwith a positive response to therapy.

The study used a paired group design with age- and sex-matchedparticipants randomly assigned to one of two groups. Of the554 eligible patients, 36 type 2 diabetic subjects were randomizedto the study. This study was ethically approved by the boardof directors of the Science Clinic, and informed consent wasobtained from all 36 patients. For a variety of reasons, 10of these subjects were excluded from analysis, resulting indata reported on 26 participants. Group 1 (16 patients, aged65.3 ± 7.7 years) received the initial 4-month intervention,whereas group 2 (10 patients, aged 59.1 ± 9.0 years)served as a control group. Then, the intervention was repeatedfor the second group. Weekly 2-h Qi-gong group sessions wereheld by a Chinese Qi-gong doctor, and subjects were also requestedto practice Qi-gong at home. Conventional diabetes therapies,such as pharmacotherapy band dietary and exercise treatment,were not modified during the study period.

HbA_1c levels were measured. It changed as follows: 8.13 ±1.73 before treatment and 7.33 ± 1.09 after treatmentin group 1, and 8.29 ± 1.63 before the control period,8.17 ± 1.30 before treatment, and 7.23 ± 0.90after treatment in group 2. Compared with the control periodof group 2, the group 1 patients demonstrated significant improvementin HbA_1c level (P < 0.01) by analysis of covariance usingpretreatment HbA_1c as a covariate. In group 2, HbA_1c levelssignificantly decreased by the delayed treatment, indicatedby a one-way layout analysis of variance (F = 7.26; P < 0.005).Using Tukey’s HSD multiple comparison test, no significantchange was found between values before and after the controlperiod, but a significant improvement was ascertained betweenvalues before control and after treatment (P < 0.01) andbetween values before and after treatment (P < 0.05). Thechanges in other biological and psychological factors in thecombined data of groups 1 and 2 were compared using paired ttests or Wilcoxon signed-rank tests. Whereas there were no significantchanges in caloric intake, caloric consumption, BMI, and lipidmetabolism, significant improvements in C-peptide (P < 0.05)were demonstrated. Some psychological improvements were demonstrated,including the anxiety index (P < 0.05) and total scores (P< 0.05) of the Mood Inventory (2). The improvement in HbA_1ccould be predicted (total 86.3% variance; F = 25.145; P <0.0001) by higher pretreatment HbA_1c (70.8%; P = 0.0001), youngerage (6.6%; P = 0.002), trend of obesity (2.2%; P = 0.01), strongerself-efficacy (3) (2.5%; P = 0.08), and weaker personality traitof alexithymia, which means difficulty in identifying and describingone’s own emotions (4) (1.9%; P = 0.04), on multiple regressionanalysis.

Because obese patients benefited more and the significant decreasein C-peptide was demonstrated in this study, Qi-gong may improveinsulin resistance. On the other hand, several studies describedthe effects of relaxation training for type 2 diabetes (5,6,7,8);thus, Qi-gong can improve glucose metabolism by the benefitsof relaxation response. In conclusion, these findings suggestthat Qi-gong relaxation exercise may be a beneficial adjunctivetreatment for individuals with type 2 diabetes.

Footnotes

Address correspondence and reprint requests to Takuya Tsujiuchi,Institute of Total Stress Research, Kenseikai Clinic, 3-10-6-4FYushima, Bunkyo-ku, Tokyo, 113-0034, Japan. E-mail: taku-tj{at}gw5.gateway.ne.jp.

References

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