Enhancing Management of Type 2 Diabetes Mellitus Through Yoga

The holistic science of Yoga is the best lifestyle ever designed and is very effective in managing stress disorders and lifestyle disorders like diabetes. Modern research has focused on psycho-physiological beneficial effects of yoga which is more than a mere physical exercise (Innes and Vincent, 2007).

It has been reported that even a short lifestyle modification and stress management education program based on yoga reduces risk factors for cardiovascular disease and diabetes mellitus (DM) within a period of 9 days (Bijlani, 2005) while a systematic review of 32 articles published between 1980 and 2007 found that yoga interventions are effective in reducing body weight, blood pressure, glucose level and high cholesterol (Yang 2007).

Studies have shown that central nervous system processing also gets affected in diabetes mellitus and that a comprehensive six-week yoga therapy program produces a significant shortening in auditory reaction time in diabetic patients (Madanmohan, 1984; Madanmohan, 2012). It has also been reported that yoga improves nerve conduction  and biochemical profile  in patients of diabetes mellitus.

Yogic practices may have a role in prevention and management of diabetes and in co-morbid conditions like hypertension and dyslipidemia. Long-term yoga practice is associated with increased insulin sensitivity and attenuation of negative relationship between body weight or waist circumference and insulin sensitivity (Chaya, 2008).

With no appreciable side effects and multiple collateral benefits, yoga is safe, simple to learn and can be practiced by even ill, elderly or disabled individuals . Being safe, simple and economical therapy, it should be considered as a beneficial adjuvant for Diabetes patients .

A comprehensive review by Innes and Vincent (2007) found beneficial changes in several risk indices, including glucose tolerance, insulin sensitivity, lipid profile, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation and pulmonary function, as well as improvement in specific clinical outcomes. They suggested that yoga may improve risk profiles in adults with type 2 DM and may have promise for the prevention and management of cardiovascular complications in this population.

POSTULATED MECHANISMS BY WHICH YOGA CAN HELP REDUCE RISK FOR TYPE 2 DIABETES MELLITUS AND ITS COMPLICATIONS*

*Innes KE, Vincent HK. The Influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: A systematic review. eCAM 2007; 4: 469-86.

Yoga has a great potential in preventing and managing chronic diseases and Yogic lifestyle can make an appreciable contribution to improvement of health of our masses. Yoga has the potential to prevent progression of the disease and if started early, maybe even effect a cure (Bhavanani, 2013).

Basic Yogic principles that are used in management of DM include:

1.      Psychological reconditioning and development of appropriate attitudes such as yama-niyama, chaturbhavana, pratipaksha bhavanam etc

2.      Stress management through counseling, jathis (loosening techniques), asanas (postures), Kriyas (systematic rational breath-body coordination movements) and pranayama (breath-energy harmonizing techniques).

3.      Helping utilizing the glucose better through physical activity such as surya namaskar, asanas, kriyas, pranayama  etc

4.      Relaxation, visualization and contemplative practices to induce a sense of inner calmness and wellbeing.

YOGA THERAPY FOR DIABETES:

Yoga can play a major role in the prevention and control of diabetes mellitus that is turning out to be one of the major killers of the modern world. Yoga is of special value in those suffering from Type-II or Non Insulin Dependent Diabetes as it helps to sensitize the body cells to the insulin and helps the body fight the hyperglycemic state in a more effective manner. The healthy exercise and weight loss produced by Yoga as well as the dietary aspects when followed religiously and regularly can help prevent and control this disorder to a great extent.

1. Regular Exercise: It is important to use up the excess blood sugar by regular exercise. Walk whenever possible and skipping or swimming are good adjuvant to Yoga therapy.
2. Moderate Diet:
• Regular small meals with complex carbohydrates.
• Avoid refined foodstuffs and junk foods.
• Take lots of green vegetable salads, bitter gourd and Neem.
• Maintain good hydration.
3. Suryanamaskar: Performance of three or six rounds of the Suryanamaskar helps to utilize the excess glucose and also to help speed up metabolism and weight loss.
4. Yoga Asanas:

·         Twisting poses:

¨      Standing: Trikona Asana, Ardha Kati Chakrasana

¨      Sitting: Vakrasana, Ardha Matsyendra Asana, Bharatwaja Asana, Shashanga Asana

¨      Reclining: Jatara Parivartan Asana

·         Abdominal pressure poses:

¨      Sitting: Utkat Asana, Janu Sirasa Asana, Paschimottana Asana, Nava Asana, Yoga Mudra Asana, Stambam Asana and Mayura Asana.

¨      Reclining: Pavana Mukta Asana, Dhanura Asana, Bhujanga Asana, Shalaba Asana, Nouka Asana

·         Topsy turvy: Sarvanga Asana, Janu Sirasa In Sarvanga Asana, Karna Pida Asana and Hala Asana

5. Pranayamas:
• Vibhaga and Pranava Pranayamas with special emphasis on Adam Pranayama and AAA sound.
• Bhastrika Pranayama to help utilize the blood glucose better
• Savitri Pranayama, Chandra Anuloma Pranayama, Nadi Shuddhi Pranayama for stress reduction
6. Shoddana Kriyas: Kunjal, Nauli, Kapalabhati, Agnisara, Shanka Prakshalana
7. Mudras and Bandhas:
• Viparita Karani and Maha Mudra.
• Uddiyana, Moola and Jalandhara Bandhas.
8. Relaxation: Shava Asana, Makara Asana, Kaya Kriya and Yoga Nidra.
9. Dharana: Mandala Dharana on all Chakras with emphasis on Manipura Chakra and the sound of RAM (RUNG)
10. Dhyana: Om Japa, Ajapa Japa, Prana Darshana and Pranava Dhyana.

National Mission for Clean Ganga: The challenges ahead

Before the advent of the National Mission for Clean Ganga (NMCG), Ganga, the most revered and national river of India, was facing the challenge to its existence due to discharge of increasing quantities of sewage, trade effluents and other pollutants on account of rapid urbanization and industrialization. The stretch of Ganga covers a length of 2525 kilometers across five states namely Uttarakhand, Uttar Pradesh, Bihar, Jharkhand and West Bengal. It has a catchment area of 8,61,404 square km covering over a quarter of country’s land area and sustaining 46% of the total population of the country. It touches 118 towns and 1657 Gram Panchayats across 66 districts of 5 states of India. 

The National Mission for Clean Ganga (NMCG), created in June, 2014, is being supported by State level Programme Management Groups (SPMGs) of Uttar Pradesh, Uttarakhand, Bihar, Jharkhand and west Bengal. The main activities undertaken under Namami Gange include sewage and effluent management including creation of new and rehabilitation of existing STPs, complete sanitation coverage of Gram Panchayats, development of model cremation/dhobi ghats, development of decision support system in GIS platform for efficient planning and monitoring and creation of an IT based monitoring centre with capabilities of real time alerts and prediction. For long term protection and rejuvenation, a provision has been made for 100% funding for the entire life time cost of the treatment of assets created including O&M cost for 10 years. Due importance has also been accorded to bio diversity, conservation, maintenance of flow in the river and afforestation along river side with medicinal and native plant species along with conservation of aquatic species.

The expenditure incurred on Namami Gange in the first three years, (ie; 2014-2015 to 2016-17) is Rs 3673.00 crore. For the current year (2017-18), an amount of Rs 2300 crore has been allocated in the budget. It is however, observed that the pace of utilization of fund under this programme has not been satisfactory. The slow implementation of project is attributed to delay in tendering, retendering, non- availability of land, legal issues, natural calamities, delay in permission for road cutting, crossing, local festivals, higher fund requirement and pending  approvals of state Cabinet etc.  Regular monitoring meeting of NMCG with concerned state is expected to help in expediting the pace of the projects implementation and eliminating bottlenecks in making land available and clear the projects through tendering.

The Order issued through the Gazette of India on 7^thOctober, 2016 constituting River Ganga (Rejuvenation, Protection and management) Authorities under the Environment (Protection) Act, 1986 lays down a new institutional structure for policy and implementation in fast track manner and empowers NMCG to discharge its functions in independent and accountable manner. The said Authority has its jurisdiction spread over 5 states along the main stem of Ganga and 5 states and Union territory of Delhi along the major tributaries of the river Ganga.

The key principles identified for the Authority are:

1)      Maintaining the continuity of the flow without altering the natural season variations.

2)      Restoring and maintaining the integral relationship between the surface flow and sub-surface water (ground water),

3)      Restoration and maintenance of the property and quality of water in time bound manner.

4)      Regenerating and maintaining the lost natural vegetation in catchment area,

5)      Regeneration and conservation of the aquatic and riparian biodiversity in river Ganga basin,

6)      To keep the bank of river Ganga and its floodplains as construction free zone to reduce pollution sources and maintain its natural ground water recharge functions 

7) Making public participation as integral part of process of rejuvenation, protection and management of the river.

River surface cleaning work has been undertaken in major cities on the bank of River Ganga in collaboration with Corporate bodies and Public Sector undertakings. Under Rural Sanitation programme, NMCG has provided Rs 263 Crore to Ministry of Drinking Water &Sanitation for construction of toilets. About 11 lakh toilets have been constructed so far. For renovation/modernization and construction of crematoria based  on standard design, initially, 20-25 urban local bodies (ULBs) are being taken up  with the target of developing 100 crematoria in a year’s time.

River front/ ghat development work has been taken up in 7 towns of Kedarnath, Haridwar, Delhi, Allahabad, Kanpur, Varanasi & Patna in addition to repair and modernization of existing ghats. Under medium term plan Effluents Management activity, real Time Effluent Monitoring stations have been installed in 508 out of 764 grossly polluting industries of distillery, pulp and paper; tanneries; textile and sugar. Regarding Zero Liquid Discharge, action plan has been under implementation for distilleries since the last quarter of 2016. Vigilance squad of Central Pollution Control Board is closely monitoring for improved compliance.

Biodiversity Conservation is being implemented in association with Wildlife Institute of India to cover Golden Mahaseer, Dolphins, Crocodiles, Turtles and Otters etc under conservation programme. 30,000 Hectares of land is targeted to be covered under afforestation programme. For water quality monitoring, in addition to 57 Manual monitoring stations, 113 Real-time monitoring stations are being set up with display boards at selected locations. Steps are being taken for public outreach. Resource materials such as posters, flyers, brochures, pamphlets, hoardings etc. have been circulated/displayed among stake holders.

                                                                     

Awareness activities are taken up through Pad Yatras, cleanliness drives, painting competitions for children, shramdaan, talk-shows and dialogues etc. Namami Gange song has been released and played on digital media and during public events. In addition to that featured articles and advertorials through audio-visual media have also been introduced. Regular updates are shared on Social Media platforms like Facebook, Twitter and You tube etc. Mass awareness campaigns, photo exhibitions , setting up Pavilions/Stalls at national/ International events have also been organized. For involvement of public in monitoring of pollution entering into the river Ganga, Bhuvan-Ganga Web App and mobile app have been launched.

In view of multi stakeholder  nature of the Ganga rejuvenation challenge, 7 Ministries of Govt of India are working together on an action plan since June,2014. Besides, MoU has also been signed between NMCG and 11 Ministries of the Govt of India to ensure convergence of their activities in protection and rejuvenation of river Ganga. MoU has also been signed with National Remote Sensing Centre, a department under Indian Space Research Organization ISRO.

For Pollution abatement and cleaning exercise  in river Ganga, the policy making authorities at higher level have emphasized the need of close monitoring, focus on minimizing waste generation and disposal of waste in eco- friendly manner and  publicizing the use of electric crematoria for enhancing its acceptability  among the masses. Uploading the monitoring reports in public domain has been recommended.

   

A number of decisions taken recently indicate that the pace of project implementation has picked up momentum for pollution abatement and making the flow of river incessant. State Ganga Committees and District Ganga Committees have been formed to ensure effective implementation and Participation of people in protection &rejuvenation of Ganga.

Ministry of Earth Sciences Achieves New Heights in Three Years.

What is our earth like? What all does she hold? What is going to be the future of earth? And how should humans act with the elements of earth? Our mother earth is undergoing upheavals in a tremendous way following heightened aspirations of human civilization. Above all, the spectre of climate change is looming over us. Knowing about the vagaries of nature is yet another formidable challenge. To comprehend these critical issues of humanity, the Ministry of Earth Sciences (MOES) of the Government of India has been following scientific researches in India and outside India with considerable achievement during the last three years.

  

At a height of 4000m in Spiti in Himachal Pradesh, a research station has been built. Himalayan glaciers are being monitored from this research station called HIMANSH, literally meaning, a slice of ice. Over a stretch of 130km of Chandra River, water level recorders have been installed at five locations for studying hydrological balance. Using Terrestrial Laser Scanners and Unmanned Aerial Vehicles, the glacier motion and snow cover variations can be surveyed and digitalized.

Besides, 150 ablation stakes over six glaciers are installed to know its mass balance to further on the knowledge of changing climate system. Ground Penetrating Radar is computing the estimated mass volume that can reveal this mass balance. HIMANSH has Automatic Weather Station, Steam Drill, differential global positioning system, flow tracker among other advanced scientific gadgets.

India’s first Moored Observatory in the Arctic at a water depth of 180m has come up. This mooring can enable acquiring data of sub-surface parameters during winter when the surface is frozen. The long term collection of the data can help understanding variability of processes due to climate change and also the understanding of atmospheric processes over the Indian sub-continent.

To get a glimpse of the interiors of the earth is a fabled wish of scientists and the lay alike. Last year, India’s Borehole Geophysics Research Laboratory has undertaken scientific deep drilling of the earth’s crust in Koyna, Maharashtra and its pilot borehole has now gone up to a depth of 2662m. This study will provide insight to the physics of reservoir triggered earthquakes and thereby prepare a predictive model.

For the first time, a deep sea drilling program was conducted in the Arabian Sea in 2015 as part of International Ocean Drilling Program. This was to document the co-evolution of mountain building, weathering, erosion, and climate over a range of timescales including the study of evolution of continental breakup between India and Seychelles and its relationship to the plume related volcanism of the Deccan Plateau. 

India has been accorded observer status in the Arctic Council in recognition of her scientific contributions and endeavours in polar research. India’s Antarctic scientific expedition in its 35^th and 36^th edition had expedition members representing different organizations with projects covering upper atmosphere, astrophysics, geophysics, meteorology, glaciology, geology, biology, environmental sciences, human physiology and medicine. Last year, climate change and glaciology were stressed upon. The 3^rd Indian Permanent Research Station Bharati has commenced its operations to study glaciology, atmosphere, paleo-climate and polar biology.

In 2015, Polar Remotely Operable Vehicle was launched successfully in the Antarctica waters at 100 m depth. It is a technological tool to help carry out explorations in the Polar Regions and at water depths up to 500m. In 2016, it was successfully deployed in the Andaman coral islands and the vehicle was successfully maneuvered in the undulating reef terrain to record high quality underwater visuals of coral reef biodiversity with spectral irradiance.

India became a member of the International Energy Agency –Ocean Energy Systems (IEA-OES). With this, India will have access to advanced R & D teams and technologies across the world. The Ministry of Earth Sciences signed a 15-year contract with the International Seabed Authority (ISA), for exploration of Poly-Metallic Sulphides (PMS) in Indian Ocean. The ISA is an institution set up under the Convention on Law of the Sea to which India is a party.

Earth Science has also been directly sending advisories to the common people, be it for improved weather and cyclone predictions and improved monsoon predictions that have brought a tremendous benefit not just to agriculture but water resources, power generation, transport and certainly the Indian economy.

Fishermen in India have been relying on their instincts that become a delimiting factor for a good catch.  The Indian National Centre for Ocean Information Services (INCOIS) provides potential fishing zone advisories to 2.75 fishermen on a daily basis to help them to easily locate the areas of abundant fish in the ocean. Advisory maps are made by utilizing data from multiple satellites. These advisory maps also include information on Indian Exclusive Economic Zone (EEZ) boundary to avoid fishermen crossing across and surface currents of oceans.

MOES along with Indian Council of Agricultural Research (ICAR) is providing Agromet Advisory Services in vernacular languages to 21 million farmer in130-agro-met zones across 608 districts of the country.

The Climate Centre at India Meteorological Department (IMD), Pune has now been recognized as the Regional Climate Centre by the World Meteorological Organization (WMO) for providing regional climate services to South Asian countries. An Earth System Model developed by the scientists at the Indian Institute of Meteorology, Pune will be the first climate model from India to contribute to the forthcoming sixth IPCC climate change assessment process. The model can be further used to develop future regional climate change scenarios at 25 km resolution and conduct climate impact assessment studies. 

Scientific achievements done at the expense of the state should bear tangible benefits for people. Science should augment societal causes and bring benefits to all. There are certain researches that take considerable time but their future societal impact is assessed beforehand. India’s scientific acumen has led to participation in several international organizations with redoubtable contribution to make a better habitation.

Key Performance Indicator of composite Water Management Index developed by NITI AAYOG

Sr. No.	Key Performance Indicator (KPI)
1	2
	A.  Source Augmentation (Restoration of Water Bodies)
1 (a)	Number of water bodies restored during the Financial Year 2015-16 as compared to total number of water bodies identified for restoration.
1 (b)	Number of water bodies restored during the Financial Year 2016-17 as compared to total number of water bodies identified for restoration.
	B. Source Augmentation (Groundwater)
2 (a)	Percentage of over-exploited and critical blocks to total blocks as on 31.03.2016
2 (b)	Percentage of over-exploited and critical blocks to total blocks as on 31.03.2017
3 (a)	Percentage of areas of major groundwater re-charging identified and mapped for the State as on 31.3.2016?
3 (b)	Percentage of areas of major groundwater re-charging identified and mapped for the State as on 31.3.2017
4 (a)	Percentage of mapped area covered with infrastructure for re-charging groundwater to the total mapped area as on 31.03.2016.
4 (b)	Percentage of mapped area covered with infrastructure for re-charging groundwater to the total mapped area as on 31.03.2017
5	Has the State notified any Act or a regulatory framework for regulation of Groundwater use/ management?
	C. Major and Medium Irrigation - Supply Side Management
6 (a)	% of Irrigation Potential Utilized (IPU) to Irrigation Potential Created (IPC) as on 31.03.2016
6 (b)	% of Irrigation Potential Utilized (IPU) to Irrigation Potential Created (IPC) as on 31.03.2017
7 (a)	Total number of major and medium irrigation projects in the State
7 (b)	Number of projects assessed and identified for the IPC-IPU gap in the State?
8	Expenditure incurred on works (excluding establishment expenditure) for maintenance of irrigation assets per hectare of command area during the Financial Year 2016-17?
9 (a)	Total length of canal and distribution network in the state vis-à-vis the length of the canal and distribution network lined as on 31.03.2016
9 (b)	Total length of canal and distribution network in the state vis-à-vis the length of the canal and distribution network lined as on 31.03.2017
	D. Watershed Development - Supply Side Management
10	Area under rain-fed agriculture as a percentage of the net cultivated area as on 31.3.2016 or previous year
11	Number of water harvesting structures constructed or rejuvenated as compared to the target (sanctioned projects under IWMP, RKVY, MGNREGS and other schemes) during the Financial Year 2016-17.
12 (a)	Assets created under IWMP
12 (b)	Percentage of assets created under IWMP geo-tagged as on 31.03.2016
12 (c)	Percentage of assets created under IWMP geo-tagged as on 31.3.2017.
	E. Demand Side Management – Participatory Irrigation Practices
13	Has the State notified any law/ legal framework to facilitate Participatory Irrigation Management (PIM) through Water User Associations (WUAs)?
14 (a)	Irrigated Command Area in the State as on 31.03.2016
14 (b)	Percentage of irrigated command areas having WUAs involved in the O&M of irrigation facilities (minor distributaries and CAD&WM) as on 31.3.2016
14 (c)	Irrigated Command Area in the State as on 31.03.2017
14 (d)	Percentage of irrigated command areas having WUAs involved in the O&M of irrigation facilities (minor distributaries and CAD&WM) as on 31.3.2017
15 (a)	Total irrigation service fee collected during the financial year 2015-16
15 (b)	Percentage of Irrigation Service Fee (ISF) retained by WUAs as compared to the fee collected by WUAs during the Financial Year 2015-16.
15 (c)	Total irrigation service fee collected during the financial year 2016-17
15 (d)	Percentage of Irrigation Service Fee (ISF) retained by WUAs as compared to fee collected by WUAs during the Financial Year 2016-17.
	F. Demand Side Management – Sustainable on-farm Water Use Practices
16 (a)	Area cultivated by adopting standard cropping pattern as per agro-climatic zoning, to total area under cultivation as on 31.03.2016
16 (b)	Area cultivated by adopting standard cropping pattern as per agro-climatic zoning, to total area under cultivation as on 31.03.2017
17 (a)	Has the State segregated agriculture power feeder?
17 (b)	Area in the State covered with segregated agriculture power feeder as compared to the total area under cultivation with power supply.
18 (a)	Is electricity to tube wells/ water pumps charged in the State?
18 (b)	If yes, then whether it is charged as per fixed charges?
18 (c)	If yes, then whether it is charged on the basis of metering?
19 (a)	Total Irrigated Area in the State as on 31.03.2016
19 (b)	Area covered with micro-irrigation systems as compared to total irrigated area as on 31.03.2016.
19 (c)	Total Irrigated Area in the State as on 31.03.2017
19 (d)	Area covered with micro-irrigation systems as compared to total irrigated area as on 31.03.2017
	G. Rural Drinking Water
20 (a)	Proportion of total rural habitations fully covered with drinking water supply as on 31.03.2016.
20 (b)	Proportion of total rural habitations fully covered with drinking water supply as on 31.03.2017.
21 (a)	% reduction in rural habitations affected by Water Quality problems during the Financial Year 2015-16
21 (b)	% reduction in rural habitations affected by Water Quality problems during the Financial Year 2016-17
	H. Urban Water Supply and Sanitation
22 (a)	% of urban population being provided drinking water supply as on 31.03.2016
22 (b)	% of urban population being provided drinking water supply as on 31.03.2017
23 (a)	Total estimated generation of waste water in the urban areas as on 31.03.2016
23 (b)	Capacity installed in the state to treat the urban waste-water as a proportion of the total estimated waste water generated in the urban areas of the state as on 31.03.2016
24 (a)	% waste-water treated during 2015-16
24 (b)	% waste-water treated during 2016-17
	I. Policy and Governance
25	Whether the State has enacted any legislation for protection of water bodies and water-supply channels and prevention of encroachment into/on them?
26	Whether the State has any framework for rain water harvesting in public and private buildings?
27 (a)	Percentage of households being provided water supply and charged for water in the urban areas as on 31.3.2016?
27 (b)	Percentage of households being provided water supply and charged for water in the urban areas as on 31.3.2017?
28 (a)	Does the State have a separate integrated Data Centre for water resources?
28 (b)	Whether the data is being updated on the integrated data centre on a regular basis?