Zen and the art of diabetes management: Yoga improves glycemic control more effectively than walking Original paper

In this meta-analysis of randomized controlled trials, yoga or walking both improved glycemic control in the context of type 2 diabetes. In direct comparison, yoga outperformed walking in at least one key marker.

The effect of yoga or walking on various markers of glycemic control.

A total of 1,820 participants (ages 17–75; 58% men, 42% women) with type 2 diabetes.

This meta-analysis of 16 randomized controlled trials assessed the effect of yoga or walking on glycemic control compared to no intervention and compared to another intervention (i.e., yoga vs. walking) in the context of type 2 diabetes.

Glycemic control was measured using 5 markers: fasting insulin, fasting glucose, postprandial (postmeal) blood glucose, HOMA-IR, and HbA1c ( an indicator of long-term blood glucose levels, which reflects average glycemic control over the past 2–3 months).

The yoga interventions ranged from 2 to 7 sessions per week, lasting 30 to 115 minutes each, over a period of 8 to 24 weeks. Walking interventions occurred 3 to 6 times per week, with walks lasting 30 to 60 minutes, spanning a period of 8 to 16 weeks.

Yoga had a strong improvement effect on 4 markers of glycemic control, namely, fasting blood glucose (−31 mg/dL), postprandial blood glucose (−26 mg/dL), HbA1c (−0.73%), and fasting insulin (−7 µIU/mL).

Walking improved two markers of glycemic control, namely, fasting blood glucose (−12 mg/dL) and HbA1c (−0.35%).

In direct comparison, yoga was more effective than walking in reducing HbA1c (−0.2%). Moreover, yoga was nonsignificantly superior to walking at improving fasting blood glucose (−12 mg/dL; p-value of 0.05) and fasting insulin (−10 µIU/mL; p-value of 0.15).

So why is yoga better than walking for improving glycemic control? Although the answer is not clear based on the current evidence, it’s possible that the benefits of yoga stem from its multifaceted approach, which incorporates stress reduction, mind-body connection, and potential physiological benefits specific to insulin sensitivity.

Another possible explanation could be differences in the duration of the interventions and length of the individual sessions. In some trials yoga was practiced for extended durations (8–24 weeks) in contrast to walking (8–16 weeks), and was also performed by lengthier sessions (30–115 min vs. 30–60 min).