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Evidence Based Outcomes
Slow breathing benefits patients living with diabetes
Slow breathing is the quickest way to “flip the switch” and restore balance to your cardiovascular, autonomic, and respiratory systems. Slow breathing also helps with stress, anxiety, and panic attacks. All of these changes have profound benefits for diabetes.
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Evidence Based Outcomes
Slow breathing and diabetes
By downregulating the nervous system, hormones are produced which help to reduce inflammation in the body and normalize physiological measures, such as blood pressure, heart rate variability, and blood sugar levels.
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Stress
Stress can make managing chronic disease an overwhelming prospect, causing a feedback loop of distress.
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Elevated Sugar
The effects of stress on the body can cause elevated blood sugar levels, or cause blood sugar levels to change.
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Insulin Resistance
High levels of stress hormones can prevent insulin producing cells in the pancreas from working properly.
How it helps people with Diabetes?
Practices have been extensively tested for use as an adjunctive treatment for Diabetes
In 5 min.
Decrease in anxiety levels
By stimulating the calming parasympathetic nervous system, slow breathing reduces stress and anxiety in as little as 5 minutes.
In a week
Decrease baseline stress levels and
sleep better
Slow breathing can change the baseline function of the nervous system toward a calmer state, helping you lower everyday stress levels and sleep deeper.
In 5 weeks
15% reduction in risk of heart disease
Slow breathing can lower blood pressure, improve blood flow, and enhance heart rate variability, all of which are critical to maintaining healthy cardiovascular function.
In 3-12 months
0.5% ... 2.0% reduction in HbA1c levels
Long-term use of slow breathing and relaxation can improve blood sugar regulation through holistic improvements in stress management, emotional regulation, and physical health.
How does it work?
The Impacts of Our Supplementary Intervention
Heart Rate Variability
One way that slow breathing improves cardio-autonomic balance is by increasing heart rate variability (HRV). HRV measures the beat-to-beat variation in heart rate and serves as a general indicator of cardiovascular health. When you breathe at a rate of about 4-6 breaths per minute, HRV increases. These improvements persist if slow breathing is practiced regularly.
Parasympathetic Nervous System
Slow breathing also increases the tone of the parasympathetic (rest & digest) nervous system (PNS). This is especially important for people with diabetes. Due to our fluctuating blood sugars and resting tissue hypoxia, we have an increased sympathetic tone (freeze, fight, or flight). This puts us in a chronic low-grade state of stress. By activating the PNS, slow breathing helps us restore autonomic balance.
Tissue Oxygenation
When oxygen molecules enter the tissues of humans, it is called tissue oxygenation. This includes oxygen entering into blood in the lungs. Slow breathing improves tissue oxygenation by keeping the arteries healthy and strong, and allows for greater surface area of oxygen exhange to occur in the lungs because of a slower breath. Slow breathing can also increase the production of Nitric Oxide, which is a substance that helps release oxygen from the red bloods cells to enter our cells.
Baroreflex Sensitivity
BRS measures your heart’s ability to adjust blood pressure in response to changing conditions. It is an early indicator of cardiovascular and autonomic dysfunction. Even two minutes of slow breathing can raise BRS levels to those seen in non-diabetic healthy individuals. Results such as these suggest that some diabetic complications could be functional and therefore reversible.
Arterial Function
Arteries carry oxygen-rich blood from our heart to every tissue of our body. Slow breathing impacts arterial function in several ways. It improves blood oxygenation by increasing the ventilation and perfusion of oxygen into the blood. It activates the parasympathetic branch of the autonomic nervous system, and has been shown, in some cases, to reduce the stiffness that can occur with cardiovascular disease. Slow breathing has been shown to impact blood pressure in some hypertensive patients, and also improves baroreflex sensitivity. Taken all together, this lead to greater arterial health and longevity.
The Breathing App is all you need for a deep dive in breathing and mindfulness and a tool for changing your whole life for the better.
Kaia, Pre-diabetes, Germany
Start TodayFacts and References
People with diabetes have autonomic nervous system imbalance.
Slow breathing increases the activity of the parasympathetic (rest and digest) branch of the nervous system, restoring balance to the nervous system in people with diabetes.
REFERENCES:
Bianchi L, Porta C, Rinaldi A, Gazzaruso C, Fratino P, DeCata P, Protti P, Paltro R, Bernardi L. Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia. Int J Cardiol. 2017 Oct 1;244:254 259. doi: 10.1016/j.ijcard.2017.06.047. Epub 2017 Jun 15. PMID: 28666602.
Esposito P., Mereu R., De Barbieri G., Rampino T., Di Toro A., Groop P.H., Dal Canton A., and L. Bernardi (2016), Trained breathing induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease, Acta Diabetologica, 53(2), 217 226, doi: 10.1007/s00592 015 0765 5.
Bernardi L, Gordin D, Bordino M, Rosengård Bärlund M, Sandelin A, Forsblom C, Groop PH. Oxygen induced impairment in arterial function is corrected by slow breathing in patients with type 1 diabetes. Sci Rep. 2017 Jul 20;7(1):6001. doi: 10.1038/s41598 017 04947 4. PMID: 28729675; PMCID: PMC5519543.
Bianchi L, Porta C, Rinaldi A, Gazzaruso C, Fratino P, DeCata P, Protti P, Paltro R, Bernardi L. Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia. Int J Cardiol. 2017 Oct 1;244:254 259. doi: 10.1016/j.ijcard.2017.06.047. Epub 2017 Jun 15. PMID: 28666602.
Esposito P., Mereu R., De Barbieri G., Rampino T., Di Toro A., Groop P.H., Dal Canton A., and L. Bernardi (2016), Trained breathing induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease, Acta Diabetologica, 53(2), 217 226, doi: 10.1007/s00592 015 0765 5.
Bernardi L, Gordin D, Bordino M, Rosengård Bärlund M, Sandelin A, Forsblom C, Groop PH. Oxygen induced impairment in arterial function is corrected by slow breathing in patients with type 1 diabetes. Sci Rep. 2017 Jul 20;7(1):6001. doi: 10.1038/s41598 017 04947 4. PMID: 28729675; PMCID: PMC5519543.
Diabetes is associated with reduced blood flow.
Slow breathing synchronizes the heart, lungs, and nervous system (a state of resonance), which enhances blood flow and allows the body to function efficiently and optimally.
REFERENCES:
Donald E McMillan; The Effect of Diabetes on Blood Flow Properties. Diabetes 1 June 1983; 32 (Supplement_2): 56–63. https://doi.org/10.2337/diab.32.2.S56
Evgeny G. Vaschillo, Bronya Vaschillo, and Paul M. Lehrer, (2006) Characteristics of resonance in heart rate variability stimulated by biofeedback, Applied Psychophysiology and Biofeedback, 31 (2), 129 142, DOI: 10.1007/s10484 006 9009 3.
Donald E McMillan; The Effect of Diabetes on Blood Flow Properties. Diabetes 1 June 1983; 32 (Supplement_2): 56–63. https://doi.org/10.2337/diab.32.2.S56
Evgeny G. Vaschillo, Bronya Vaschillo, and Paul M. Lehrer, (2006) Characteristics of resonance in heart rate variability stimulated by biofeedback, Applied Psychophysiology and Biofeedback, 31 (2), 129 142, DOI: 10.1007/s10484 006 9009 3.
People with diabetes suffer from higher rates of stress & anxiety.
By eliciting the relaxation response, slow breathing reduces stress and anxiety in as little as 5 minutes.
REFERENCES:
Li, C., Barker, L., Ford, E.S., Zhang, X., Strine, T.W. and Mokdad, A.H. (2008), Diabetes and anxiety in US adults: findings from the 2006 Behavioral Risk Factor Surveillance System. Diabetic Medicine, 25:878 881. https://doi.org/10.1111/j.14645491.2008.02477.x Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res. 2002 Dec;53(6):1053 60. doi: 10.1016/s0022 3999(02)00417 8. PMID: 12479986.
Smith KJ, Béland M, Clyde M, Gariépy G, Pagé V, Badawi G, Rabasa Lhoret R, Schmitz N. Association of diabetes with anxiety: asystematic review and meta analysis. J Psychosom Res. 2013 Feb;74(2):89 99. doi:10.1016/j.jpsychores.2012.11.013. Epub 2012 Dec 28. PMID: 23332522.Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep. 2021 Sep 29;11(1):19267.doi: 10.1038/s41598 021 98736 9. PMID: 34588511; PMCID: PMC8481564.
Li, C., Barker, L., Ford, E.S., Zhang, X., Strine, T.W. and Mokdad, A.H. (2008), Diabetes and anxiety in US adults: findings from the 2006 Behavioral Risk Factor Surveillance System. Diabetic Medicine, 25:878 881. https://doi.org/10.1111/j.14645491.2008.02477.x Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res. 2002 Dec;53(6):1053 60. doi: 10.1016/s0022 3999(02)00417 8. PMID: 12479986.
Smith KJ, Béland M, Clyde M, Gariépy G, Pagé V, Badawi G, Rabasa Lhoret R, Schmitz N. Association of diabetes with anxiety: asystematic review and meta analysis. J Psychosom Res. 2013 Feb;74(2):89 99. doi:10.1016/j.jpsychores.2012.11.013. Epub 2012 Dec 28. PMID: 23332522.Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep. 2021 Sep 29;11(1):19267.doi: 10.1038/s41598 021 98736 9. PMID: 34588511; PMCID: PMC8481564.
People with diabetes face daily emotional stressors associated
with the disease.
with the disease.
Slow breathing boosts heart rate variability (HRV) and mental resiliency, allowing people with diabetes to handle and bounce back from daily diabetic stressors easier.
REFERENCES:
Skinner TC, Joensen L, Parkin T. Twenty-five years of diabetes distress research. Diabet Med. 2020 Mar;37(3):393 400. doi: 10.1111/dme.14157. Epub 2019 Oct 31. PMID: 31638279.Laborde S, Allen MS, Borges U, Dosseville F, Hosang TJ, Iskra M, Mosley E, Salvotti C, Spolverato L, Zammit N, Javelle F. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta analysis. Neurosci Biobehav Rev. 2022 Jul;138:104711. doi: 10.1016/
j.neubiorev.2022.104711. Epub 2022 May 24. PMID: 35623448. Perna G, Riva A, Defillo A, Sangiorgio E, Nobile M, Caldirola D. Heart rate variability: Can it serve as a marker of mental health resilience?: Special Section on "Translational and Neuroscience Studies in Affective Disorders Section Editor, Maria Nobile MD, PhD. J Affect Disord. 2020 Feb 15;263:754 761. doi: 10.1016/ j.jad.2019.10.017. Epub 2019 Oct 12. PMID: 31630828.
Skinner TC, Joensen L, Parkin T. Twenty-five years of diabetes distress research. Diabet Med. 2020 Mar;37(3):393 400. doi: 10.1111/dme.14157. Epub 2019 Oct 31. PMID: 31638279.Laborde S, Allen MS, Borges U, Dosseville F, Hosang TJ, Iskra M, Mosley E, Salvotti C, Spolverato L, Zammit N, Javelle F. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta analysis. Neurosci Biobehav Rev. 2022 Jul;138:104711. doi: 10.1016/
j.neubiorev.2022.104711. Epub 2022 May 24. PMID: 35623448. Perna G, Riva A, Defillo A, Sangiorgio E, Nobile M, Caldirola D. Heart rate variability: Can it serve as a marker of mental health resilience?: Special Section on "Translational and Neuroscience Studies in Affective Disorders Section Editor, Maria Nobile MD, PhD. J Affect Disord. 2020 Feb 15;263:754 761. doi: 10.1016/ j.jad.2019.10.017. Epub 2019 Oct 12. PMID: 31630828.
Diabetes is associated with chronic inflammation.
Through stimulation of the vagus nerve and activation of the relaxation response, slow breathing reduces inflammation and oxidative stress.
REFERENCES:
Domingueti CP, Dusse LM, Carvalho Md, de Sousa LP, Gomes KB, Fernandes AP. Diabetes mellitus: The linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. J Diabetes Complications. 2016 May-Jun;30(4):738 45. doi: 10.1016/ j.jdiacomp.2015.12.018. Epub 2015 Dec 18. PMID: 26781070. Li TT, Wang HY, Zhang H, Zhang PP, Zhang MC, Feng HY, Duan XY, Liu WB, Wang XW, Sun ZG. Effect of breathing exercises on oxidative stress biomarkers in humans: A systematic review and meta analysis. Front Med (Lausanne). 2023 Apr 5;10:1121036. doi: 10.3389/fmed.2023.1121036. PMID: 37122322; PMCID: PMC10132211. Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, Fricchione GL, Benson H, Libermann TA. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PLoS One. 2013 May 1;8(5):e62817. doi: 10.1371/journal.pone.0062817. Erratum in: PLoS One. 2017 Feb 21;12 (2):e0172873. PMID: 23650531; PMCID: PMC3641112.
Domingueti CP, Dusse LM, Carvalho Md, de Sousa LP, Gomes KB, Fernandes AP. Diabetes mellitus: The linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. J Diabetes Complications. 2016 May-Jun;30(4):738 45. doi: 10.1016/ j.jdiacomp.2015.12.018. Epub 2015 Dec 18. PMID: 26781070. Li TT, Wang HY, Zhang H, Zhang PP, Zhang MC, Feng HY, Duan XY, Liu WB, Wang XW, Sun ZG. Effect of breathing exercises on oxidative stress biomarkers in humans: A systematic review and meta analysis. Front Med (Lausanne). 2023 Apr 5;10:1121036. doi: 10.3389/fmed.2023.1121036. PMID: 37122322; PMCID: PMC10132211. Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, Fricchione GL, Benson H, Libermann TA. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PLoS One. 2013 May 1;8(5):e62817. doi: 10.1371/journal.pone.0062817. Erratum in: PLoS One. 2017 Feb 21;12 (2):e0172873. PMID: 23650531; PMCID: PMC3641112.
Diabetes complications are partially caused by lack of oxygen at the cellular level (tissue hypoxia).
Slow nasal breathing improves blood flow and harnesses nitric oxide, increasing oxygen uptake in the blood and improving whole-body oxygenation.
REFERENCES:
Bianchi L, Porta C, Rinaldi A, Gazzaruso C, Fratino P, DeCata P, Protti P, Paltro R, Bernardi L. Integrated cardiovascular/ respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia. Int J Cardiol. 2017 Oct 1;244:254 259. doi: 10.1016/j.ijcard.2017.06.047. Epub 2017 Jun 15. PMID: 28666602. Sánchez Crespo A, Hallberg J, Lundberg JO, Lindahl SG, Jacobsson H, Weitzberg E, Nyrén S. Nasal nitric oxide and regulation of human pulmonary blood flow in the upright position. J Appl Physiol. 2010;108:181–188. Lundberg JO, Settergren G, Gelinder S, Lundberg JM, Alving K, Weitzberg E. Inhalation of nasally derived nitric oxide modulates pulmonary function in humans. Acta Physiol Scand. 1996 Dec;158(4):343 7. doi: 10.1046/j.1365201X.1996.557321000.x. PMID:8971255.
Bianchi L, Porta C, Rinaldi A, Gazzaruso C, Fratino P, DeCata P, Protti P, Paltro R, Bernardi L. Integrated cardiovascular/ respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia. Int J Cardiol. 2017 Oct 1;244:254 259. doi: 10.1016/j.ijcard.2017.06.047. Epub 2017 Jun 15. PMID: 28666602. Sánchez Crespo A, Hallberg J, Lundberg JO, Lindahl SG, Jacobsson H, Weitzberg E, Nyrén S. Nasal nitric oxide and regulation of human pulmonary blood flow in the upright position. J Appl Physiol. 2010;108:181–188. Lundberg JO, Settergren G, Gelinder S, Lundberg JM, Alving K, Weitzberg E. Inhalation of nasally derived nitric oxide modulates pulmonary function in humans. Acta Physiol Scand. 1996 Dec;158(4):343 7. doi: 10.1046/j.1365201X.1996.557321000.x. PMID:8971255.
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