Thursday, August 31, 2017

Can Mindfulness Lower Your Level of Blood Sugar?


More than 29 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention. And about three times that number – or 86 million American – have prediabetes, with higher than normal blood sugar levels that raise their risk of developing diabetes.

If it’s not managed properly, diabetes can raise blood sugar high enough to lead to serious problems, ranging from increasing risk for heart attack and stroke to causing blindness.

But proper management and prevention of the chronic condition isn’t as simple as taking a pill or making a single lifestyle change. Comprehensive changes are often needed to keep from developing the condition and to properly control blood sugar. Given the poor Western diet that’s high in sugar, Americans' typically low activity rates and that a majority of adults in the U.S. are overweight or obese, which increases the risk for diabetes, experts say the need for such comprehensive lifestyle changes is pressing.

Some clinicians have started stressing mindfulness to support thoughtful decision-making – like being choosy about foods. The practice of mindfulness calls for staying present in the moment, and non-judgmentally observing one’s thoughts and feelings in order to be healthier in general. The growing focus on mindfulness has begun to extend into preventing diabetes as well.

A recent study in the journal Obesity, which was first published online in July, found that women who were overweight or obese who practiced mindfulness-based stress reduction saw not only their stress levels go down, but their fasting blood sugar decrease as well. This was measured at eight weeks, when the MBSR program concluded, and eight weeks after that (or at 16 weeks from when the study began). Study participants in the MBSR group were taught about mindful ways to cope with stress, such as through meditation and paying attention to their breathing. Study participants in a health education group who learned about things like exercises, dietary changes and general stress management did not see their blood sugar levels decrease significantly. Both groups saw some benefits, including lowered psychological distress and decreased sleep-related issues.

The study’s lead author Dr. Nazia Raja-Khan, an associate professor of medicine and obstetrics and gynecology at Penn State University College of Medicine in Hershey, Pennsylvania, emphasized that the findings are preliminary. More research is needed to replicate the results and to determine if practicing mindfulness could have a long-term impact on blood glucose levels. “But I do think that overall the implications of this study suggest that there may be a role for mindfulness in the prevention and treatment of diabetes,” Raja-Khan says – “as one of the tools that can help patients struggling with obesity or diabetes.”

How exactly mindfulness might lower blood sugar is not clear from the study. But past research of MBSR – which the researchers describe as the most studied mindfulness-based intervention – offers some clues. These range from possible physiological pathways, like changes in the so-called stress hormone cortisol to helping with self-regulation and bolstering a person’s resilience and ability to make meaningful lifestyle changes, such as being more active or eating better, all which could potentially influence blood sugar levels.

“Did they just eat better? Did they exercise more? We didn’t really track it in this study. So it’s certainly possible that the mindfulness would help them not only lower stress, but adopt [a] healthy lifestyle,” Raja-Khan says. “But our study seems to suggest that there’s an independent sort of effect of mindfulness that’s not related to body weight, because body weight didn’t really change in the study.”

Whatever the mechanism, the preliminary finding adds to limited research indicating mindfulness may help with glucose regulation, as noted in a study published last year in the American Journal of Health Behavior. “We found that those who had higher levels of mindfulness were more likely to have glucose in the ‘normal’ range,” says Eric Loucks, an associate professor of epidemiology at Brown University in Providence, Rhode Island, who led that research. “Normal plasma glucose,” according to the American Diabetes Association criteria referred to in the research, is under 100 milligrams per deciliter. “It just seemed that they were able to keep their glucose levels in check.”

Though a little more research has been done regarding the use of mindfulness to manage diabetes, compared with preventing the chronic disease, researchers echoed the need for further study in both areas.

As far as diabetes management goes, what seems to be most effective are mindfulness-based interventions customized to managing the disease, though that still needs to be tested further, says Loucks, who has reviewed the research in this area. Such customized approaches involve not just being more mindful in general but specifically examining, for example, “how well we’re monitoring our glucose levels or taking our diabetes medication or doing the behavioral things that help manage it or prevent it,” he says. “I think that’s where the effects may really start to appear.” He notes also how mindfulness has been shown to help with weight loss; and shedding extra pounds can lower a person's risk of developing diabetes.

Aliza Phillips-Stoll, a clinical psychologist at the Joslin Diabetes Center in Boston, and an instructor in psychology at Harvard Medical School, sees that kind of practical benefit to incorporating mindfulness in helping some patients with diabetes. “Diabetes is a tough disease to manage, and it requires a lot of a person,” she says. “People who live with diabetes have a lot to do in their everyday lives to manage their health: They need to eat right, they need to exercise, they need to remember to take their medicine – often multiple medicines.” Developing a presence of mind and learning to slow down and be in the moment can be very helpful for reducing the stress associated with keeping up that level of self-care and optimizing diabetes management, Phillips-Stoll says.

“Research has shown that mindfulness has beneficial effects, in terms of reducing anxiety, depression and somatic distress,” she adds. “Research has also found that stress is linked to blood glucose control, and that various forms of stress reduction can contribute to glucose control. So it doesn’t seem far-fetched at all to say that practicing mindfulness could help in that area as well.”

Best Hospitals for Diabetes & Endocrinology

Rank Hospital Name Location
Mayo Clinic Rochester, MN
Massachusetts General Hospital Boston, MA
Cleveland Clinic Cleveland, OH
Johns Hopkins Hospital Baltimore, MD
New York-Presbyterian Hospital New York, NY
University of Colorado Hospital Aurora, CO
UCSF Medical Center San Francisco, CA
Hospitals of the University of Pennsylvania-Penn Presbyterian Philadelphia, PA
UPMC Presbyterian Shadyside Pittsburgh, PA
Stanford Health Care-Stanford Hospital Stanford, CA

Hospitals Ranking information as of August 30th, 2017



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