So this is where my story comes in. I had been suffering independently with all of the previous symptoms of GI distress and uncontrollable blood sugar numbers for years. Digestion time was something that I could never anticipate. Very regularly I would take the correct dose of insulin to carbohydrate ratio and would crash and subsequently skyrocket. Its onset was cyclical but unpredictable. In addition, stomach pains, gas bloating were chronic.
This is where we fuse yoga therapy and diabetes. Here’s what we know so far: gastroparesis is caused by higher blood sugars that damage the vagus nerve, a side effect of gastroparesis is higher blood sugars and the vagus nerve is important to our body’s ability to regulate stress. The key to healing the body’s response to stress is by improving vagal tone. You can stimulate vagal tone and reduce gastroparesis flare-ups by specific yoga therapy techniques that aid in parasympathetic activation.
Breathing: If you monitor your heart rate while breathing you will find that when you inhale your heart rate rises and when you exhale, your heart rate lowers (1). In yoga we apply a specific breathing method called ujjayi pranayama or victorious breath, which allows for a larger threshold of breath and improved control of breath. Ujjayi pranayama is a slight valve of the glottis in the back of your throat. Breathe in and out the nose by slightly closing the glottis opening versus breathing from the nostrils.
- Spend a few minutes watching your breath. Progressively lengthen your exhale so it become twice as long as your inhale. Make sure you do this without strain or you will trigger a stress response. Stay for 5 minutes.
Yoga poses: If exhale is calming, so too are twists and forwards bends. Always move into twists and forward bends on exhale. Try moving into a standing forward bend or twist on exhale, lengthening your exhale each time, then stay for several breaths maintaining ujjayi awareness (sign up for newsletter for more specific practices).
Meditation: Meditation is good for everyone, but just like flossing your teeth most of us do not do it enough. After you practice some dynamic forward bends and twists, sit and practice your breathing exercises. Next, relax your breath and simply feel your breath move in and out without trying to breathe. Watch what arises in the field of your attention. Your breath affects your mind and your mind affects your breath.
Other Helpful Yogic Techniques
Nauli: Even Dr. Bernstein refers to nauli as a way to stimulate the stomach to release. Nauli is considered a purification technique. There are many versions of nauli and can be quite complicated for even an experienced yoga practitioner. I recommend starting simple as once again you do not want to induce a stress response.
- Stand with your feet slightly wider than hip width distance.
- Bend your torso forward about 1/3 of the way placing your hand on your thighs.
- Exhale completely and pause after exhalation.
- While you pause, deeply draw your abdominal muscles in and up towards the ribcage.
- Hold empty a few seconds before you release.
Diabetic tip: Don’t take your insulin all at once.
If you know that you are having a flare up try the various bolus programs on your insulin pump. Dual wave boluses and square wave boluses can be a diabetic savior when you are slow to digest. When I notice that I am experiencing symptoms of gastroparesis (most often its low and then high after eating) I will use a square wave bolus on my insulin pump. This means that rather than taking the insulin all at once, I take it slowly over 2 hours.
A Word of Caution
Hypothyroidism is another side affect of living with type 1 diabetes for many years. If you are experiencing gastroparesis like symptoms it would be worth it to get a full thyroid panel done by your doctor. I found out that I was hypothyroid at the same time as gastroparesis. Going on thyroid medicine mitigated some symptoms associated with gastroparesis, but not all. I believe in yoga therapy and alternative medicine but also firmly believe that medicine like insulin and thyroid replacement is necessary as it is replaces a hormone that you do not naturally produce.
Just like yoga therapy, type 1 diabetes and gastroparesis do not have a one-size fits all cure. We cannot cure type 1 diabetes (yet) but we can manage its symptoms and side effects with patience, curiosity and kindness. Be patient with the process as it will not be automatic. With practice you will become progressively more aware of not only gastroparesis onset but also how other factors in your life (and low vagal tone) may in fact be contributing to your level of suffering. Yoga therapy teaches anyone with a chronic condition how to live resiliently in the face of change. With time you will begin to see how you too have the power to change your life and your relationship to type 1 diabetes. If you want to learn more about how to use yoga therapy to manage type 1 diabetes or any other chronic condition, please join my newsletter. I send a free monthly practice with top-notch instruction about how to do this for yourself! Now, that’s power.
4. Bernstein, Richard K. The Diabetes Solution. Little Brown Publishers. 1997.