tissu oxygenation

Breathing Restores Autonomic Control in Type-2 Diabetics with Complications

 

Quit worrying about your health. It’ll go away.” - Robert Orben

 
 

As people with diabetes (type 1 or 2), we know our bodies are under extra stress. This is due to things like fluctuating blood sugars and chronic inflammation. These factors can gradually accumulate into nerve damage and a variety of other long-term complications.  

However, we have recently learned that some “long-term complications” are functional and reversible (at least in their early stages). One way to reverse them is slow breathing.

Slow breathing treats the root cause of many complications, tissue hypoxia, which then restores autonomic functioning. This has been proven in several studies involving people with type-1 diabetes. However, most participants had not yet developed severe complications.

Putting Slow Breathing to the Test

It seems reasonable to assume that slow breathing would have the same effects in type 2s. But, what if these people with type-2 diabetes have chronic kidney disease? With a severe complication such as this, could slow breathing still have the same benefits?

 
 

 
 

Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease

Published in Acta Diabetologica, 2016

Click Here to Read the Full Summary

 
 

 
 

The Study Group and Breathing Protocol

This study had 26 type-2 diabetic patients, 12 of which had diabetic kidney disease, and 24 non-diabetic controls. The protocol was simple: They had the participants lay down and breathe normally for five minutes, followed by two minutes of slow breathing at 6 breaths per minute.

The primary outcome was a change in baroreflex sensitivity (BRS). BRS measures your body’s ability to quickly adjust blood pressure to meet the current demands of your situation. It is thought to be an overall measurement of autonomic and cardiovascular control. In general, diabetics have lower BRS scores than non-diabetics.


Slow Breathing Improves Autonomic Function in Diabetics With Kidney Disease

At baseline, the type-2 diabetics had a lower resting oxygen saturation and lower BRS. When they switched to breathing at 6 breaths per minute, their oxygen saturation and BRS both increased significantly. Their blood pressure also reduced.

Perhaps most importantly, these same changes were observed in the diabetics with kidney disease. Both sets of diabetics (kidney disease and no complications) showed similar increases in BRS and oxygen saturation.  This indicates that, even in diabetics with severe complications, slow breathing can acutely reverse autonomic dysfunction.


Getting Back to Tissue Hypoxia

The authors suggest that these improvements in autonomic function were due to increases in tissue oxygenation. Similar to the study we featured on type-1 diabetes, they indicate that by increasing tissue oxygen levels, sympathetic activity is reduced, and autonomic balance is restored.


A New Model of Diabetic Complications

These results again indicate that autonomic dysfunction is not an expression of nerve damage. Instead, it is a reversible phenomenon that might actually be the precursor to nerve damage.  This paradigm-shifting view opens the door to new opportunities for treating autonomic dysfunction in diabetics.


In good breath,

Nick

P.S. A Zoom Meeting I would Look Forward To.


P.P.S. James Nestor’s new book, Breath: The New Science of a Lost Art, comes out tomorrow. I don’t know James, but from the podcast interviews I’ve heard so far, this sounds like a must-read if you’re into all this “breathing” stuff :)

And if you really want to geek out, James and Patrick McKeown got together for an hour long conversation on all things breathing. Watch/Listen Here.


 
 

The One Percent Rule of Breathing (& Bravest Podcast Interview)

 
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Craig Kasper invited me on his podcast, Bravest, to discuss all things breathing and diabetes. It should be released later today.

Craig is a type-1 diabetic and a genuinely good person. We had a lot of fun, and I hope you’ll give it a listen. 

Listen Here: Bravest


The Pareto Principle, or 80/20 rule, states that 20% of your efforts get you 80% of your results. Twenty percent of your customers account for 80% of your profit. A small number of NBA teams hold a majority of the titles. This rule holds true in many fields of life (here is an excellent article about the 80/20 rule) [1].

For breathing, I believe we can take this even farther.

The One Percent Rule of Breathing

In “To Sell is Human,” [2] Dan Pink describes a lesson he received during law school that stuck with him the rest of his life:

“Don’t get lost in the crabgrass of details, he urged us. Instead, think about the essence of what you’re exploring—the one percent that gives life to the other ninety-nine.”

“The one percent that gives life to the other ninety-nine.” I love that exaggeration of the Pareto Principle. In breathing, that one percent is your nose.

So Simple - So Complex

Slow breathing is simple and takes minimal effort. But, if you get “lost in the crabgrass of details,” it can become extremely complex.

But none of it would matter without the nose. The nose is the hidden engine driving all the benefits of “breathing.” Whether it’s slow breathing, sleep, or exercise, simply using your nose is the 1% that allows the other ninety-nine to occur.

How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing

(Click Here to Read Full Summary)

Slow breathing has many benefits, which we covered in the infographic last week. To name a few: it reduces blood pressure, increases heart rate variability, enhances baroreflex sensitivity, improves arterial function, and increases tissue oxygenation.

The paper above concluded that the nose is the link connecting slow breathing to these benefits. It’s not just slow breathing; it’s nose breathing.

In good breath,
Nick

P.S. Coffee at home for me.


References

[1] I cannot overstate how much I enjoy James Clear’s work.

[2] To Sell is Human

 

Are Long-Term Diabetic Complications Reversible?

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As a person with type-1 diabetes, long-term complications are like the boogeyman. I hide under the covers, turn off the lights, and they can’t get me. I am healthy, after all. Right?

But the truth is, diabetic complications are more common than I would like to admit. There are, however, two pieces of good news.  

There is Always Good News

First, a popular study showed that for every 1% reduction in HbA1c, there was a significant reduction in the risk of many diabetic complications.  

For example, in type-2 diabetics, a 1% drop in HbA1c was associated with a 14% drop in heart attacks. Because we know that slow breathing can help reduce HbA1c, this is more motivation to be consistent with our breathing practice (and exercising, eating healthy, and sleeping more).

Second, the study I’m sharing this week found that some diabetic complications are reversible by slow deep breathing:


Deep breathing improves blunted baroreflex sensitivity even after 30 years of type 1 diabetes

(Click Here to Read Full Summary)

Journal: Diabetologia, Volume 54, Article number: 1862 (2011)

Baroreflex sensitivity (BRS) measures your heart’s ability to adjust your blood pressure in response to changing conditions. It’s also an early indicator of autonomic dysfunction. People with diabetes typically have reduced BRS, even before other complications show up.

This study found that slow breathing at six breaths/min restored BRS to normal levels, even in long-duration type-1 diabetics (>30 years). These results indicate that reduced BRS in diabetics is partially functional and hence partially reversible.

How did slow breathing do this? The authors showed that it increased heart rate variability and parasympathetic tone, leading to improved cardiovascular and autonomic functioning.


More Benefits of Slow Breathing for Diabetics

While getting this post ready, I was considering all of the research showing the benefits of slow breathing for diabetes. This inspired me to create this little graphic, which I think sums it up succinctly.

 
 
Benefits_of_Slow_Breathing.png
 
 


The earlier we address the adverse effects of diabetes, the better our chances are of avoiding complications.

In good breath,
Nick

P.S. That is trust.

P.P.S. My stats for this week:

Average BOLT Score: 30 sec (Min: 26 sec, Max: 36 sec)
Average CO2 Tolerance: 64 sec (Min: 54 sec, Max: 82 sec)
Average Blood Sugar: 102 mg/dL (Min: 47 mg/dL, Max: 230 mg/dL)