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Yoga offers benefits for people with diabetes
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In this issue, Susan Weiner, MS, RDN, CDE, CDN, talks with yoga instructor and author Rachel Zinman, who was diagnosed with type 1 diabetes in 2008.
Yoga and diabetes are not two words I would easily associate with each other, what inspired you to bring these two together?
Zinman : I started yoga when I was 17 years old, long before it was popular or a health craze. I was a dancer and wanted a practice that would heal injury and support me mentally. I had suffered from anxiety, and my chiropractor told me that yoga and meditation would help. Within a few short years I was completely immersed in the practice and, having reaped the benefits, wanted to teach and share. I ended up making it my life’s career and truly believed it made me invincible. Then almost 25 years into my career, I was diagnosed with diabetes.
At first, I was angry. I had put so much of my belief in yoga as a cure-all, and I felt that my years of practice had failed me. I didn't know much about diabetes, and from what I had heard via the media and friends, I thought it was something that I could reverse or cure. Rather than give up on yoga, I dove in even deeper, exploring the sister science of yoga, Ayurveda, which I discovered has been working with diabetes for over 4,000 years.
Ayurveda means “science of life” and is based in the five elements: earth, water, fire, air and space. The theory is that each one of us has a unique combination of these elements within us. I might have more fire, and someone else more water and earth. The way we approach life physically, mentally and emotionally comes from this unique mix. For example, being fiery, I might be more driven, suffer from burnout and even have physical symptoms like heartburn or rashes. Whereas someone with more water and earth in their system might have more patience, but lack motivation and struggle with being overweight.
Rather than categorizing diabetes into type 1 or type 2, Ayurveda considers the constitution first. Once the constitution is determined, then appropriate practices and treatments, such as yoga, breathing, meditation, massage therapy and lifestyle guidelines are suggested alongside allopathic medications like insulin.
What are the benefits of yoga specifically for someone living with any type of diabetes?
Zinman : Yoga reduces stress by reducing the cortisol levels associated with the stress from the day-to-day management of the disease. Through guided breath and movement coordination, the mind is brought to the breath and away from the need to identify with stressful thoughts about the disease.
Studies suggest that yoga can increase insulin sensitivity. The practice engages the musculoskeletal system, hugging muscles to bones, and moving isometrically improves insulin resistance, which in turn, enables those of us with either type of diabetes to take up insulin more efficiently.
Yoga may help promote weight loss. Depending on the type of yoga and the dedication of the practitioner, a regular flowing physical practice tones muscles, organs and reduces fat.
Yoga can improve sleep. One of the challenges of living with any type of diabetes is the stress of unstable blood glucose levels — waking up at all hours of the night to check our levels, treat a low blood sugar, take insulin or change a pump site wreak havoc with our circadian rhythms. Yoga practices like yoga nidra (a guided relaxation technique) and deep breathing with an emphasis on exhalation calm the nervous system and promote deep rest.
Yoga promotes a positive outlook and enhances happiness. People living with diabetes often struggle with anxiety and depression. Add a stressful job, lack of sleep and a host of other issues into the mix, and you have a million reasons to feel overwhelmed. Yoga emphasizes the connection between mind, body and breath and gently guides the person to let go and accept what is. For instance, in a challenging posture, rather than pushing too hard, it’s better to let go, soften and surrender. The Zen koan “Be like bamboo, bend with the wind” is a reminder that no matter what diabetes throws at us we have the resilience to handle it.
I love yoga, but I wasn’t a big fan at first. How would you encourage someone to start?
Zinman : A lot of people think that they either aren’t flexible enough for yoga, or they’ve tried it once and it was too challenging. When I first tried yoga, I was stiff and weak. I couldn’t touch my toes or hold myself up in an arm-balancing position. I would fall over all the time and felt inadequate and embarrassed. But as much as I found yoga frustrating, I also felt the benefits. After a few weeks of practice, I was resting and digesting better and had less anxiety.
Yoga isn’t just about having physical strength and flexibility. It’s primarily about rest and recovery. That's why it’s called Hatha yoga. The “Ha” means sun, energy, physicality. The “Tha” means moon, restoration, surrender. Yoga is the dance between the two.
Some people, particularly those living with type 1 diabetes, may benefit more from the restorative aspects, such as breath work, yoga nidra, meditation and contemplation. Others need to work with a style that gets them moving and sweating. This might be more appropriate for those with type 2 diabetes who benefit from any form of physical exercise. No matter what the diabetes type, there is a style appropriate to them. It’s important to find the right style and teacher to suit the individual.
The best way to start is to encourage the person to try a beginner yoga class. It’s important that they share with the teacher that they live with diabetes and are new to yoga. Enlisting a friend or your partner to come along can feel supportive, too. I always encourage my students to start slowly and gently. To rest when they need to and not expect too much from themselves. It takes time to build strength and flexibility.
It's like the first time we learned to ride a bicycle. We had to find our balance, pedal and steer all at the same time. Eventually, we mastered the technique. It’s exactly the same with yoga. By investing the time and finding the right practice, anyone living with any type of diabetes will reap the rewards.
For more information:
Susan Weiner, MS, RDN, CDE, CDN, is the 2015 AADE Diabetes Educator of the Year and author of The Complete Diabetes Organizer and Diabetes: 365 Tips for Living Well. She is the owner of Susan Weiner Nutrition, PLLC and is the Endocrine Today Diabetes in Real Life column editor. She can be reached at susan@susanweinernutrition.com.
Rachel Zinman is an internationally known yoga teacher and author of Yoga for Diabetes, How to Manage Your Health with Yoga and Ayurveda. She was diagnosed with diabetes in 2008 and started her Yoga For Diabetes blog to share with the diabetes online community how yoga has helped her manage diabetes. She can be reached at www.yogafordiabetesblog.com or info@rachelzinmanyoga.com.
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Disclosures: Weiner reports she is a clinical adviser to Livongo Health. Zinman reports no relevant financial disclosures.