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
- 1Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo, Japan
- 2Japanese Society of Psychosomatic Medicine, Tokyo, Japan
- 3Institute of Diabetes Mellitus and Obesity Treatment, Health Education Center, Science Clinic, Yokohama, Japan
Qi-gong relaxation exercise is one of the traditional Chinese health care self-management technique. It consists of two aspects, controlled synchronized breathing with slow body movements as an aerobic exercise, and relaxation (1). The purpose of this study was twofold: to examine the effects of Qi-gong and to identify biological and psychological characteristics associated with a positive response to therapy.
The study used a paired group design with age- and sex-matched participants randomly assigned to one of two groups. Of the 554 eligible patients, 36 type 2 diabetic subjects were randomized to the study. This study was ethically approved by the board of directors of the Science Clinic, and informed consent was obtained from all 36 patients. For a variety of reasons, 10 of these subjects were excluded from analysis, resulting in data reported on 26 participants. Group 1 (16 patients, aged 65.3 ± 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 repeated for the second group. Weekly 2-h Qi-gong group sessions were held by a Chinese Qi-gong doctor, and subjects were also requested to practice Qi-gong at home. Conventional diabetes therapies, such as pharmacotherapy band dietary and exercise treatment, were not modified during the study period.
HbA1c levels were measured. It changed as follows: 8.13 ± 1.73 before treatment and 7.33 ± 1.09 after treatment in group 1, and 8.29 ± 1.63 before the control period, 8.17 ± 1.30 before treatment, and 7.23 ± 0.90 after treatment in group 2. Compared with the control period of group 2, the group 1 patients demonstrated significant improvement in HbA1c level (P < 0.01) by analysis of covariance using pretreatment HbA1c as a covariate. In group 2, HbA1c levels significantly decreased by the delayed treatment, indicated by a one-way layout analysis of variance (F = 7.26; P < 0.005). Using Tukey’s HSD multiple comparison test, no significant change was found between values before and after the control period, but a significant improvement was ascertained between values before control and after treatment (P < 0.01) and between values before and after treatment (P < 0.05). The changes in other biological and psychological factors in the combined data of groups 1 and 2 were compared using paired t tests or Wilcoxon signed-rank tests. Whereas there were no significant changes in caloric intake, caloric consumption, BMI, and lipid metabolism, 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 HbA1c could be predicted (total 86.3% variance; F = 25.145; P < 0.0001) by higher pretreatment HbA1c (70.8%; P = 0.0001), younger age (6.6%; P = 0.002), trend of obesity (2.2%; P = 0.01), stronger self-efficacy (3) (2.5%; P = 0.08), and weaker personality trait of alexithymia, which means difficulty in identifying and describing one’s own emotions (4) (1.9%; P = 0.04), on multiple regression analysis.
Because obese patients benefited more and the significant decrease in C-peptide was demonstrated in this study, Qi-gong may improve insulin resistance. On the other hand, several studies described the effects of relaxation training for type 2 diabetes (5,6,7,8); thus, Qi-gong can improve glucose metabolism by the benefits of relaxation response. In conclusion, these findings suggest that Qi-gong relaxation exercise may be a beneficial adjunctive treatment for individuals with type 2 diabetes.
Address correspondence and reprint requests to Takuya Tsujiuchi, Institute of Total Stress Research, Kenseikai Clinic, 3-10-6-4F Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan. E-mail:.