Consultation on Diabetes Exercise and Yoga Treatment

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Why yoga is great for people living with diabetes

What I like about yoga is that you spend 60-90 minutes focusing on your breathing, stretching, and, in the case of Bikram yoga, sweating. The benefits of yoga are plentiful, and I have several friends within the diabetes community who practice yoga on a regular basis and they look and feel great. Some of my favorite diabuddie yogis have even designed practices for Diabetes Strong that you can find here:

  • Yoga is for everyone by Rachel Zinman
  • Yoga-Inspired Flexibility Training by Lauren Bongiorno

The primary benefits of yoga that lured me in were the increased flexibility (something I need to continue working on) and the sense of relaxation afterward. It can also help with reducing stress, thereby lowering cortisol levels, which is great for blood sugar management.

A further benefit of yoga is that you learn breathing and relaxation methods that can use every time life gets overwhelming.

How Vinyasa Yoga affects my blood sugar

Vinyasa yoga is the type of yoga you are most likely to encounter in mainstream gyms in the US. It’s typically a fairly quick flow of poses accompanied by coordinated breathing.

How inspiring the practice is and how it will affect blood sugars depend a lot on the instructor. Because Vinyasa doesn’t have a standardized set of poses, no two classes are ever alike. Vinyasa can be everything from a relaxing flow of poses all the way up to “power yoga” that will push your strength and endurance to the limit.

I’ve been in a few classes where the flow was very fast, making the blood sugar impact similar to what I’d expect from a cardio session, but most often, it’s a more slowly paced flow meaning limited impact on my blood sugars.

So, if I know the type of flow the instructor is teaching, I’ll adjust my meal bolus prior to the practice accordingly:

  • If I expect it to be a fast-paced yoga flow (or don’t know what to expect), I’ll do a 25-30% bolus reduction with my last meal before the practice
  • If I expect a slower flow, I’ll do a 0-20% reduction.

Of course, the exact reduction depends on what my blood sugar is before the workout. If it’s higher than want it to be, I will reduce my bolus less than normal.

I haven’t found that any post-yoga reductions in bolus or basal is necessary. Yoga doesn’t affect my blood sugar for hours afterward like resistance training does.

How Bikram Yoga affects my blood sugar

Bikram yoga is different from Vinyasa since it’s a 90-minute class and takes you through the 26 different Bikram poses in a heated room.

I rather like the heated room (I tend to get cold very easily), but it can make blood sugar management harder because I can’t rely on the senses I usually rely on to tell me whether my blood sugar is running low. The heat in the room makes me sweat and elevates my heart rate, which are my two main indicators of a low blood sugar. Because of that, I am not sure I would feel it if my blood sugar was dropping during a Bikram yoga class. So for Bikram yoga, I’ll rely heavily on my CGM (Continuous Glucose Monitor).

The first time I tried Bikram yoga, I wasn’t wearing a CGM so I manually tested my blood sugars before we got started, after an hour, and then again after class. To my surprise, my sugars were….. perfectly stable (!). When class started, my blood sugar was 116 mg/dL (6.4 mmol/L) and after 90 minutes, it was 123 mg/dL (6.8 mmol/L). This was with a 20% bolus reduction before the class.

I had expected a larger impact on my blood sugar because of the heat and because the class was 90 minutes, but I have taken several other Bikram classes now and the result has always been the same. Apparently, the Bikram classes I take simply don’t affect my blood sugar very much so, I’ve stuck with a ~20% bolus reduction for this type of yoga.

Hypertension can be diagnosed by taking your blood pressure. A blood pressure reading measures two things: systolic pressure and diastol pressure. Systolic refers to the maximum pressure in your heartbeats. Diastolic pressure refers to the lowest pressure in your arteries between heart beats. Typically, a person under age 60 who has three blood pressure readings of 140/90 is said to have hypertension. For people over 60, a reading of 150/90 qualifies as high blood pressure.

    Treatment for your hypertension depends on the cause(s). It may include :

  • Treating the underlying conditions that are causing your hypertension
  • Managing your diet
  • Changing your medications
  • Adjusting your lifestyle