A randomised controlled trial to assess the effectiveness of tai chi for people with type 2 diabetes

Project Coordinator

Paul Lam, Sarah Dennis, Terry Diamond, Klaus Stelter, Nick Zwar.

Chief Investigators

Associate Investigators

Rationale

Type 2 diabetes is a significant health problem which costs the Australian community $7 billion per year in addition to the considerable suffering experienced by the affected individuals. Whilst exercise is essential to the management of the disease, many people do not adhere to formal exercising.

Tai Chi is a gentle exercise, well liked and adhered to by the older population. It has been shown to be effective in reducing cardiovascular risk, hypertension and stress along with improving other aspects of health. Therefore, it is reasonable to postulate that Tai Chi could improve cardiovascular risk and glucose control for people with type 2 diabetes.

Aims

Design and Method

A randomised controlled trial of Tai Chi training, involving two one-hour sessions per week for three months and thereafter one session per week for a further three months, versus usual care for six months.

Study subjects were adults aged 30 and over with type 2 diabetes attending general practice, primary care centres, or hospital outpatient clinics. The patients were asked to contact project officer (PO) if they were interested in taking part in the project.

Inclusion criteria: 1) Adults aged 30 or over with a doctor diagnosis of type II DM for 6 months or more.2) Baseline HbA1c of 7.5 or above.3) Those who are able to participate in Tai Chi classes twice a week for three months and once a week for the next three months. (Able to walk 10 minutes unaided, and have the time to participate).4) Subjects will be excluded if they have been enrolled in any other formal or specific regular physical exercise program during the previous six months. For example a normal active person is included; a person who registered and attended a gym exercise program for three times or more per week is excluded. The project officer who assessed the subjects was blind to whether the intervention.

Measurements were made at baseline and after the six-month course of Tai Chi, the measurements will include 1) Blood pressure and resting heart rate. 2) Body weight/ height (BMI), waist and hip circumferences. 3) Blood tests: glucose, HbA1c (required); glucose tolerance test at 0 and 2 hours, HOMA 4) Total cholesterol, triglycerides, LDL, HDL. 5) Balance (one leg standing with eyes open: seconds), 6 metre walking (seconds), flexibility (waist bending; cm), 6) Baseline questionnaire to include demographic questions, current health, current medications (including diabetes and cardiovascular). 7) Quality of life will be assessed using the SF36 and ATT 19.8) Record of attendance (log book).

Intervention: A short set based on the well-recognized Yang and Sun style Tai Chi forms, designed for people with Diabetes, will be used for this study in groups of 10 to 15 people per class. Instructors are trained, certified and approved by Diabetes Australia to teach this set of Tai Chi. Each class would last one hour, classes twice a week for the first three months and then cut down to once per week for the next three months. The subjects will be provided with a written program schedule—time, date, location including a map, and the tai chi instructional material (video and handbook). Subjects will be encouraged to practice at home and a log book is provided to enhance compliance. The control group will receive the routine care and education from primary health providers.

Key Publications

Tsang T, Rhonda Orr, Paul Lam, Elizabeth J Comino, Maria Fiatarone Singh. Health benefits of Tai Chi for older patients with type 2 diabetes: The “Move It for Diabetes Study” – A randomized controlled trial Clinical Interventions in Ageing, Dove Medical Press 2007; 2(3):429-439 Click here to download the article or here to view the weblink .