Effect of a Year-long Yoga-Based Lifestyle Intervention on Glycemic Control, Body Weight, Psychological Health, and Imaging Biomarkers in Adults with Type 2 Diabetes: A Randomized Controlled Trial.

Background: Type 2 diabetes mellitus is a major global health challenge, adversely affecting the quality of life. Objective: To evaluate a year-long yoga-based lifestyle intervention versus physical exercise and health education for glycemic control and comprehensive health outcomes in adults with Type 2 Diabetes Mellitus. Study Design: Two-arm, prospective, assessor-blinded, randomized controlled trial with a parallel-group superiority design and a 1:1 allocation ratio. Participants: 160 adults with Type 2 Diabetes Mellitus (mean age 53.34±8.97 years; 84 males) were randomized to yoga-based lifestyle (n=80) or physical exercise and health education (n=80) groups. Intervention: The yoga-based group received supervised yoga practice (1 hour/day, 5 days/week) for 4 weeks, followed by 11 months of tele-supervised practice with weekly yoga philosophy discussions. The physical exercise group received matched physical exercise and health education sessions. Assessments were performed at baseline, 6 months, and 1 year. Results: Although both interventions significantly reduced glycated hemoglobin levels and waist-hip ratio at 12 months, the yoga-based group demonstrated superior glycated hemoglobin reduction compared to theexercise group at 6 months (mean estimated difference of 0.80 unit greater reduction) and 1 year (mean estimated difference of 1.25 unit greater reduction), corresponding to a 22.06% greater decrease in HbA1C levels over the course of 1 year.. The yoga-based group also showed significant improvements in postprandial glucose, depression scores, and body mass index at 1 year compared to the exercise group. The yoga-based group showed significant improvements in the energy balance of several organs, including overall balance, right and left organ balance, digestive system balance, adrenal balance, cerebral cortex balance, and stress reduction compared to the exercise group. Additionally, the yoga-based lifestyle group exhibited significantly reduced medication use scores at 12 months. Conclusion: Yoga-based lifestyle interventions show superior efficacy over standard physical exercise programs for diabetes management, demonstrating improvements in glycemic control, psychological health, and novel biomarkers. These findings support integrating yoga interventions into comprehensive diabetes care, although further mechanistic studies are warranted. keywords: yoga, type 2 diabetes mellitus, glycemic control, glycated hemoglobin, depression, postprandial plasma glucose, thermal imaging, gas discharge visualization.