**Qigong for the Management of Type 2 Diabetes** Qigong for the Management of Type 2 Diabetes

#### **Mellitus** Mellitus

Guan‐Cheng Sun, Catherine Osgood and

Harold Ryan Lilly Guan-Cheng Sun, Catherine Osgood and Harold Ryan Lilly

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/67065

#### Abstract

Type 2 diabetes mellitus (T2MD) is a complex, chronic, metabolic disease with hyperglycemia arising from insulin resistance, progressive pancreatic beta cell failure, insufficient insulin secretion and increased hepatic glucose output. In the Chinese medicine theory, T2DM is often referred to as a form of Xiao Ke (消渴) or "wasting-thirst disorder." Genetic, dietary, lifestyle and environmental factors play a role in T2DM. People with a family history of diabetes or who are obese are at the highest risk of developing the disease. T2DM is often associated with hypertension, dyslipidemia and atherosclerosis and if not managed can lead to complications including cerebrovascular accident, peripheral vascular disease and nephropathy. T2DM can be well managed with biomedical and Chinese medicine treatment approaches. Lifestyle changes including appropriate diet and exercise are paramount in managing T2DM. Regular Qigong practice can be a beneficial part of one's exercise routine for T2DM self-care. Qigong exercise has shown promising results in clinical experience and in randomized, controlled pilot studies for affecting aspects of T2DM including positive associations between participation in Qigong and blood glucose, triglycerides, total cholesterol, weight, BMI and insulin resistance. This chapter looks at how traditional Chinese medicine (TCM) views diabetes as well as new understandings of how Qigong can support the management of T2DM.

Keywords: medical Qigong, Qigong exercise, type 2 diabetes management, Xiao Ke, acupuncture and oriental medicine, traditional Chinese medicine (TCM) nutrition natural medicine, integrative medicine, Yi Ren® Qigong

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited.

#### 1. Introduction

Qigong (pronounced "chee gung") is the authentic cultivation of "Qi" (or "Chi") which means "vital energy of the body." In Chinese, "gong" means the skill and achievement cultivated through regular and disciplined practice. Qigong is an important part of traditional Chinese medicine (TCM) for maintaining wellness, preventing disease and treating disease through self-care practice or by receiving external Qi from a Qigong therapist. In ancient China, the practice of authentic Qi cultivation was associated with the theory of energy flow within the body, described in the Suwen (Basic Questions) of the Huangdi Neijing (The Inner Classic of the Yellow Emperor) and with the discovery of acupuncture meridians as described in the Ling Shu (The Spiritual Pivot). The practice of Qigong combines breathing, movement and meditation and therefore is often classified by Western providers under the category of "mind/body medicine." Qigong is an ancient technology of mind-body management and the refinement of one's vital energy for optimal health and for personal development [1]. Previous studies suggest that Qigong may be a beneficial adjunct treatment for individuals with type 2 diabetes mellitus (T2DM) and have shown consistent and statistically significant positive associations between participation in Qigong and blood glucose, triglycerides and total cholesterol [2]. Qigong has also been associated with trends in weight loss, reduced BMI and improved insulin resistance in people with T2DM [3]. Systematic reviews have found support for a role of Qigong in the management of T2DM [4, 5].

T2DM is a complex, chronic metabolic disease with hyperglycemia arising from insulin resistance, progressive pancreatic beta cell failure and insufficient insulin secretion. According to the International Diabetes Federation (IDF), more than 371 million people worldwide have diabetes and over 550 million people are projected to have diabetes by 2030 [6]. In adults, T2DM accounts for about 90–95% of all diagnosed cases of diabetes [7]. Common symptoms of T2DM include excessive thirst, frequent urination, excessive hunger, fatigue, weight loss, blurry vision, slow-healing sores, frequent infections (bacterial, yeast, or fungal overgrowths thrive on excess sugar in the body) and areas of darkened skin, usually in the armpits and neck which can be a sign of insulin resistance [8]. T2DM is often associated with hypertension, dyslipidemia and atherosclerosis and if not managed can lead to complications including stroke, cardiovascular disease, peripheral vascular disease, neuropathy and kidney failure [9]. Concurrent hypertension with diabetes significantly raises the risk of coronary artery disease, stroke, retinopathy and sexual dysfunction [10]. According to the American Diabetes Association, having diabetes nearly doubles the chance of having a heart attack [9]. Diabetes causes more deaths a year in the United States than AIDS and breast cancer combined [11]. In 2010 in the United States alone, about 73,000 lower-limb amputations were performed on adults with diabetes and peripheral vascular disease [12]. T2DM can substantially diminish quality of life, decrease life expectancy and increase health problems and healthcare costs. A study reported that the estimated total economic cost of diagnosed diabetes in 2012 in the United States was \$245 billion. This estimate highlights the substantial burden that diabetes imposes on society [13]. The incidence of T2DM continues to rise by epidemic proportions and has emerged as a global health crisis.
