Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis

BACKGROUND: A daily habit of yogic practice or walking, along with an oral hypoglycemic agent (OHA) could be beneficial for better control of type 2 diabetes mellitus (T2DM). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to find out the efficiency of yoga or walking on glycemic control in T2DM. METHODOLOGY: The present systematic review and meta-analysis were completed according to the PRISMA guidelines. The risk of bias in included studies was evaluated, by using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analysis was implemented using RevMan software. Forest plots were used to illustrate the study findings and meta-analysis results. RESULTS: Sixteen studies were included in this systematic review, where 1820 participants were allocated to one of the following interventions: yoga, walking, and without any regular exercise (control group). Participants were between 17–75 years of age. Compared to the control group, the yoga group had a significant reduction in fasting blood glucose (FBG) by 31.98 mg/dL (95% CI = –47.93 to –16.03), postprandial blood glucose (PPBG) by 25.59 mg/dL (95% CI = –44.00 to –7.18], glycosylated hemoglobin (HbAlc) by 0.73% (95% CI = –1.24 to -0.22), fasting insulin by 7.19 μIU/mL (95% CI = –12.10 to –2.28), and homeostatic model assessment for insulin resistance (HOMA-IR) by 3.87 (95% CI = –8.40 to -0.66). Compared to the control group, the walking group had a significant reduction in FBG by 12.37 mg/dL (95% CI = –20.06 to –4.68) and HbA1c by 0.35% (95% CI = –0.70 to –0.01). Compared to the walking group, the yoga group had a significant reduction in FBG by 12.07 mg/dL (95% CI = –24.34 to – 0.20), HbA1c by 0.20% (95% CI = –0.37 to –0.04), fasting insulin by 10.06 μIU/mL (95% CI = –23.84 to 3.71) and HOMA-IR by 5.97 (95% CI = –16.92 to 4.99). CONCLUSIONS: Yoga or walking with OHA has positive effects on glycemic control. For the management of T2DM, yoga has relatively more significant effects on glycemic control than walking. Review registration number: PROSPERO registration number CRD42022310213