Yoga and Diabetes
transcription of podcast with Rachel Zinman
Stephanie: We have a wonderful guest Rachel Zinman and Rachel was diagnosed with Type 1 l a diabetes in 2008 at the age of 42.She's been doing yoga since the age of 17 and she still practices and she's teaching other teachers and beginners alike in workshops trainings and retreats.Internationally she is a mother award winning musician and published writer.Her blog on yoga for diabetes was listed as one of the best blogs for January 2016 by Diabetes Mind. She's produced several other articles for other publications on diabetes.
Thank you Rachel for joining us today.
Rachel: Hi. It's great to be here.
Stephanie: Great. I looked at your blog and your web site. And I was very taken by a statement that you made in your video which was that when you first realized that you might have type 1 diabetes you were sure that you could cure it with your healthy lifestyle which of course included yoga.
And yet later on you had to start taking insulin. And I do something similar I'm sure that yoga is going to stop me from having all the awful things that happened with age. It doesn't. So what does that say about yoga. We think that it's almost a cure all for everything.
Rachel: I think it's a bit of a misinterpretation of of of the meaning of yoga. You know that we see that as some sort of a process or a path and this is something that I really had to come to terms with in my own life after the diagnosis was that yoga isn't really a process. Yoga is actually the nature of who we are and to understand the depth of the meaning of the word yoga. Yoga means oneness it doesn't mean steps along the road and understanding what Oneness is.
You know so for me it actually took me to study more. The Upanishads and the traditional meanings of yoga through the through the sacred texts rather than just you know my interpretation of it as a as a physical practice. But having said that I think yoga really does, as a practice, enable you to rejuvenate the body and support the body to really you know be as well as it can be. Considering that you're living with a chronic condition or you're dealing with aging or anything like that.
Stephanie: Could you first explain I type one diabetes I I sure that we all have general information about it but it would be good to be more informed I think before we go on with the conversation.
Rachel: Explanation of Diabetes OK so type 1 diabetes is an auto immune condition. They don't really know how it comes about. I mean this is the biggest sort of mystery in terms of this chronic illness because they don't know how it happens why it happens. And there really is still no cure. But basically what happens it's an auto immune disease which attacks the insulin producing cells in the pancreas which are called beta cells. So we all have these cells which produce insulin and insulin is used to bring the energy from food which becomes glucosate. The energy has to enter into the cell in order for the body to utilize the glucose and work properly. So these beta cells are very very important because they produce the insulin. Now what happens with type 1 diabetes is that something starts attacking the cells. These beta cells and they start to die and then you no longer produce insulin your pancreas is still working. But you're not producing the insulin. And so the build up of glucose in your system just increases and increases and increases. And when you have more glucose in your system it sort of acts like a corrosive and it starts to you know affect the small blood vessels in the body it starts to affect the organs and you know creates a lot of complications .
Stephanie: OK. Thank You. That's very helpful. You talk about insulin sensitivity. What is that and how does yoga address that?
Rachel: [00:05:23] OK so insulin insensitively that's very interesting because you know type there are type 1 diabetes and then there's type 2 diabetes. now type 2 diabetes is slightly different in that it's not an auto immune condition.
It's actually a condition where the body has gotten to the point where it resists the insulin that's being produced so the body still produces the insulin. But the cells resist the insulin. As I said you know the insulin is like a little door which allows the glucose to come into the cell. But if the body is resisting the insulin the cell becomes a shut door and you can't get that insulin into the cells. So first of all is or you know increasing insulin sensitivity is all about stopping that insulin resistance.
So the muscles are amazing because when the muscles are moving and working they act like insulin and they reduce the amount of sugar that's in the blood. So when you get your muscles active it increases your sensitivity to insulin. And then the cells are more likely to take the insulin into blood cells so that then they can help to reduce the level of sugar in the blood.
Stephanie: That's really helpful. Thank you. I teach seniors. I'm amazed that in 10 years I've been teaching how much diabetes has increased in that population group. Didn't see it very much at all and now I will have 2-3 students in class that have it. It is becoming much more prevalent. So this is a very important podcast I believe. You said that your yoga practice really helped you with the stress of having Type 1 diabetes. Can you expand on that statement. Is that one of many benefits of your goal for diabetes or is that the best one.
Rachel: Benefits of Yoga for Diabetes Oh gosh there's so many there's so many benefits. I mean you know like I said insulin sensitivity increasing your sensitivity to insulin is a benefit. your sleep habits really are changed so you sleep better when you do yoga because again it's you know releasing the stress out of the system. You know it's a great stress reliever. It's helps promote weight loss because you know you're basically focusing on your breath and moving and breathing and moving is fantastic again for you know just getting the heart rate up. It improves memory.
It just increases your flexibility and your strength. I think those just exercise in general is just so good for you.
It helps in that way. I mean you know any benefits of yoga are going to help you if you're living with any type of diabetes really.
Stephanie: I watched a video of one of your students it's really fascinating what you're doing which is that you're working with people who have diabetes and this individual had type 1.
I don't know if you're working with people who have the other type but she had type 1. You actually worked with her one on one too really create a practice that was good for her given her diabetes but given what kind of body and all of that. And then she got a video that helped her. But what I really like about it was that when you first worked with her so she knew how to do it.
I think there is a little bit of danger in videos with people don't quite know what to do with yoga.
I was very impressed that you did that as a two-step process. She seem very very happy with that. Are there other students that you have that you can tell us about.
Rachel: Yeah. I mean it was it was a trial that I did because you know I am actually just a yoga teacher and I don't normally work. Well I haven't worked just with people who live with diabetes. I mean I've worked with people for years just training them to be teachers and you know and also working one on one. That was something that I did in New York I was a private yoga teacher for five years just running all over the city teaching you.
So but this was a very specific process that I did and I worked with three or four people.
Actually I only worked at that time with type 1 and I started with a questionnaire. The questionnaire was asking them about you know how are they coping managing with their diabetes. What is their emotional relationship to their diabetes. How would they like to improve their relationship. It was a very extensive you know personal questionnaire. And then we went through in our Ayurvedic questionnaire to determine the type of constitution that they had what kind of sort of emotional habits mental habits physical habits and then just looking at body type. And then once I'd done that I said I thought OK I want to create a sequence for them. So then I recorded the sequence and then we met and we went through the sequence but we didn't just go through the sequence once together. I met with them every week for weeks and weeks and weeks so they would have they would meet with me and we'd sort of tweak the practice and go through the practice and then they'd have the sequence on video and say they could do it at home. But what was essential was for me to really make sure that they were physically aligned and that they were safe during the practice.
So I work with someone who was a little bit you know maybe bigger in bones. And so you know a stronger type and so that person had a very sort of a much more vigorous practice with backbends. Then I worked with someone who was actually dealing a lot with very high blood sugar levels who wasn't on insulin who needed a more calming more restorative practice.
And for her that we added a very specific meditation, a very specific breathing practice to kind of slow her down and calm her down and get her more relaxed. And that was you know really beneficial to her.
We also worked with a guy who had a lot of physical strength that he was dealing with a lot of unstable blood sugars. They were sort of you know he would drop really low in the middle of the class or he would you know go really hard and that was the other reason why it was really important to work with him one on one and not just through online. So the story because you know I knew to be right there to help him or to say hey let's check your blood sugar you know let's make sure it's still OK. And then he didn't have to have a juice or something like that to bring his blood sugar back up. So I think when you're working with people with diabetes it is important to be physically with them. Also just touch is so important and adjusting and just making sure that they're safe because it's very calming.
I think you can do the online thing and I do do it but I want to have a connection with the person first I agree with you are.
Stephanie: I think it's really important to have that connection first especially although I haven't had any one that had any problems in my class who had diabetes. But I would I would certainly get nervous if I were trying to teach older people just on a video. It's very difficult thing to do.
I really admire that you put so much time into developing these very unique practices for each person and I think that's really admirable because I'm sure it took a lot of time and effort.
Rachel: It was actually a lot of fun. I just want to say that I think yoga teaching is a really fun thing to do. And you know it's if you love it it's a total joy you don't mind putting in the time.
Stephanie: I agree. I said on a podcast where I was a guest that yoga people are good people.
You said there are sleep issues with diabetes. Could you explain that and what you've been doing with yoga to help with that.
Rachel: Sleep Issues with Diabetes So you know I think depending on the type of diabetes you have I think this is something that just comes up as you know especially if you're dealing with unstable blood sugars you you're either up at night because you know you're going into a low, your pump is going off, you know a lot of people use pumps to deliver the insulin. You can over deliver the insulin you can under deliver the insulin.
You might have a just lot of stress associated with it. So sleeping through the night is not necessarily a given. And you might wake up sometimes you might have overdosed overdosed too much you know taking too much insulin and you've got to stay up and eat. Or you can be woken up at 3:00 a.m. And have you know your pump goes off and it's like you're on a you're on a low and you've got to get up and eat drink some juice or take some glucose tabs or you go to eat. Often there is a bit of a joke that people end up you know freaking out and eating the whole fridge and things like that. So that's something that happens. But just in general it's not easy. And also if you're older you might be going through something like menopause that really affects your blood glucose levels as well. So they could be very up and down and you can be waking up all night with that. So I think you know the big thing about yoga is that yoga is about the combination of breath and movement. It's not just physical exercise in the sense that you're just moving the body you're actually also taking the breath and marrying it to the movement so that it's a continuous flow. And when you do that it literally calms the nervous system and brings you out of that fight or flight which is what's waking you up all night is the body isn't naturally relaxed, you're in your fight or flight.
No they say that we're supposed to spend 80 percent of our time in the relaxed part of our nervous system the parasympathetic nervous system and we're supposed to spend 20 percent in fighter flight so that we have all the energy available to us that we need if a tiger is chasing us or if we need to get out of a stressful situation. But of course in our modern day society with all the stress that's placed on us physically, environmentally, emotionally. We spend 80 percent of the time in our fight or flight. So that is obviously going to spill over into our sleep time. So what yoga does by marrying the breath to the movement is it calms the nervous system down and it trains the body to kick in that parasympathetic nervous system more often. And I think that's what really helps promote sleep.
And also I think you know another thing is that yoga practice is not just ha it's not just physical. They call it ha ta yoga. It's also ta it's mood. So that's our forward bends. It's the stretching it's you know that it's restorative You know it's all those fancy names that we've given the yoga where we're kind of just lying around and relaxing the part of the practice that's like.
Stephanie: Which is a really good hard practice too I think.
I watched your videos. I recommend that everybody watch them just because they're absolutely beautiful of you doing I believe it was for legs and they were just they were absolutely gorgeous. You move so beautifully.
But are those the kinds of movements that you would be giving to someone you had to help them move the muscles so the cells are more open to the glucose.
Rachel: you know that so depends on the person.
And of course that practice that you watch. It's very it's a quite a strong advance practice so not everybody could do that.
I have to be honest and often you know when I'm sharing a little video like that on Facebook or you know on my blog or whatever it's a little bit like OK it's a challenge it's like a teaser or you know like OK you know this would be this would be great if you had that flexibility with some wrote straightaway and said look I can't do that.
And I was like yeah I know.
Strengthening the Legs And so I think any there's some very simple things you can do to really keep that strength you know to work the legs. And one of them is that you know a basic posture like Warrior II. You can do things like chair at the wall. I think I actually did that in the sequence. You can do things like just pulling up your legs so that your heel touches your buttocks and you're stretching the front of your thigh muscle and then you're just straightening your leg and lifting your leg out in front of you so that you're you know working the fine muscle. So stretching and strengthening and you can even do some of those things lying down like drawing one you know knee in towards you and hugging the shin and then straightening the leg while you can bicycle the legs. Know there's just so many things that you can do simply lying down or seated in a chair that will also work those thigh muscles. So one of my goals is once I've sort of teased everybody and gotten everybody excited by just showing them something totally you know that could be challenging is also to just create something very very simple as the alternative to that as well. And it all comes down to time when it comes to doing stuff that people can see online is that it takes time to record those things and and put it all together so it sort of looks you know palatable.
But yeah there's just lots and lots of ways that you can increase that insulin sensitivity where you don't have to be doing some sort of full on athletic practice.
Stephanie: One other thing that I always do is I work on the quads, the thighs. Those are your independence muscles when you're older and those are the ones that allow you to get up and down from sitting, in the toilet, out of bed. And if you don't have a strength in those legs you will have to have some kind of care. So I do a lot of those things too. And it's good to know that it flows over and really also good to people with diabetes because I will have people who have diabetes in the class. Thank you for giving the poses and will be grateful to have those poses if they have diabetes. You do workshops internationally; do have workshops to teach teachers about diabetes? You said they do workshops and training internationally. Do you have workshops on how you teach people. How to teach teachers about diabetes or are those workshops on something else.
Rachel: Well this is my plan is to eventually be able to share with yoga teacher is how to support people who are living with diabetes.
I've written a book. The book's going to be published in October 2017 this year. It's not a book for yoga teachers but I think yoga teachers would love the book because it really explains diabetes from the Ayurvedic perspective which is the sister science of Yoga. It looks at you know how to work what that person needs that gives a very specific sequence for what that person needs. So it can be used for people who are living with diabetes Type 1 and Type 2 and it can also be used by yoga teachers. Eventually from the publishing of the book and stuff I would like to have a ongoing seminar or a workshop very specific because I've even just had someone approach me and say look you know I have a lot of people with diabetes who are coming to my class and you know I'd love to have a private with you about how to how to work with them.
And I've also I'm also working on a webinar for you of Australia on that topic as well and I've written articles for them.
You know this for me this is a project that you know I was diagnosed in 2008. I was in denial for about six years. I refused to believe that I even had diabetes. It was a huge shock for me and I didn't really want to accept it. And then finally six years later I said OK yes it's true it's real it's happening. And then from that point I started to slowly kind of realize that I might have something to offer to the diabetes community. And then from there I wrote the book and now working with clients who have diabetes and then slowly slowly slowly so that's one of my new next goals is to have sort of physical workshops where people can come and learn from me about you know what is the disease.
How does it work how can we help them. And that's all sort of coming along the road.
StephanieI understand. Yes. What's the title of the book.
Rachel: The title of the book is Yoga for Diabetes: how to manage your health with yoga and Ayurvada.
Stephanie: So everybody in October 2017 you can get this book .
Rachel: Yeah. It'll be released worldwide through distribution and the publishers monkfish monkfish publishing. Yeah and I will just say no.
Basically if people go to my blog www.yogafordiabetesblog.com that there's information about the book. There it just says yoga for diabetes book and people can click there and get on the mailing list and find out all about what it's going to be released and where and how they can get it.
Stephanie: I learned so much today. I am going to switch you here a little bit. I really appreciate you talking about your journey with diabetes. And you said that it took you what I believe six years to really accept that you had it. Is that a common response when someone finds out that they might have not only diabetes probably a chronic condition of any kind.
I think I was lucky because it was such a slow onset. So for a long time I had the you know the blood tests and I had sort of it told me that I had you know my body was telling me was telling the doctors that I had diabetes but I wasn't having symptoms and because I was asymptomatic. It was much easier for me not to accept it because you know my blood sugar levels were not high they were sort of pretty stable and I was kind of controlling it.
But then it got to the point where my body started I started losing a lot of weight. I started getting thirsty. I was up all night you know urinating. I started having a lot of fatigue. And then it was like OK now this is not good. Oh and the big thing was that I started having neuropathy in my hands which meant that my hands were tingling and buzzing all the time that I was touching things.
And I went to and I still thought oh maybe it's B-12 deficiency you know I was just in this big denial thing. And then I went to the neurologist and he said well hang on a minute your blood sugars are really high and now you've got the beginning of nerve damage and I think you better you know do something about it. So you know a lot of people when they have adult onset type 1 diabetes it comes on very quickly like all of a sudden they lose a lot of weight, they start urinating, they have all the fatigue, they feel like you know their body feels like sludge. Then you know they go to the doctor and it's like wow you need insulin straight away. But because that didn't happen to me because it was a very slow onset. It was much easier for me to avoid it. Maybe in the type 2 community and I don't want to speak for the type 2 community because I'm much more keyed in with what goes on with type 1. I think people you know they get they get a bit of a wakeup call they get shocked because their blood sugars are a little bit higher than they go on go on a diet. They start exercising and their blood sugars come back down because the insulin is getting into the cells because they're. You know increasing their insulin insulin sensitivity through the exercise. So it's much easier for type 2,s to kind of to OK well I've got things under control.
Maybe then they go a little bit longer without checking their blood sugars or not worrying so much about it. And that's why there's such an emphasis in the type 2 community for people to keep an eye on their blood sugars and to really not stop testing and see you know is my blood sugar going up again. Do I need to go back to the doctor. Do I need to keep an eye on this whereas in type one because you are insulin dependent. You're keeping an eye on your blood sugar like 15 to 20 times a day you might even be wearing a monitor on your arm to make sure that you know your you know your blood sugars are steady where you know things like that. So it really depends on the type of diabetes and the modicum of control that you have as to whether you're going to be in denial long time or not.
Stephanie All right well I can understand that it if you really don't have symptoms it's kind of hard to believe it's just a test. OK so I just want to reiterate that if you want to explore any other things that we've talked about today you go to www.rachelzinmanyoga.com or her blog www.yogafordiabetesblog.com
And she's also on Facebook. If you have questions and want to explore anything else, please go to those addresses. I really want to thank you. Rachel has been a great guest and very helpful and I'm sure a lot of people including myself have learned a lot from her today.
Rachel: Thanks so much. It's been really fun to be here.