Summary: In a single-centre trial in type 2 diabetes, adding the diabetes-specific qigong Sanxiao Jiuzhi Gong to standard care produced larger falls in fasting and postprandial glucose and HbA1c, plus higher exercise self-efficacy, than standard care alone, though the size of the glycaemic effect is implausibly large and warrants caution.
PICO Summary
| Element | Detail |
|---|---|
| Population | 60 adults with type 2 diabetes; single-centre randomised controlled trial, China. |
| Intervention | 12-week Sanxiao Jiuzhi Gong qigong programme, 45 minutes 3×/week, added to routine care (n=30). |
| Comparison | Routine diabetes care (diet, psychological support, standard aerobic exercise) without SJG (n=30). |
| Outcome | SJG versus control: fasting glucose -3.28 vs -1.18 mmol/L (difference 2.10; p<0.05), 2-hour postprandial glucose -6.05 vs -2.03 mmol/L (p<0.001), HbA1c -2.73% vs -1.53% (difference 1.20%; p<0.05). Exercise self-efficacy rose 2.54 points with SJG (p<0.001) but not significantly in controls. No adverse effects. |
Sanxiao Jiuzhi Gong qigong in type 2 diabetes
RCT · type 2 diabetes · 12 weeks
Adding Sanxiao Jiuzhi Gong qigong lowered HbA1c and glucose more than routine care and raised exercise self-efficacy, but the glycaemic effect size is implausibly large and needs independent replication.
Expert Commentary
This trial reports an appealing result that I would nonetheless treat with deliberate skepticism, and the discrepancy in effect size is the reason. An HbA1c reduction of 2.73% from a mind-body exercise is far beyond what either typical exercise trials or pooled meta-analyses of Tai Chi and qigong show, which cluster around 0.3 to 0.6%, and even the control group’s 1.53% fall is large. Effect sizes several times the established range usually signal something about the study population, baseline control, or methodology rather than a uniquely potent intervention, and that caveat should travel with the headline. The psychological finding is more readily believable and genuinely useful: building exercise self-efficacy plausibly supports adherence, which is often the real bottleneck in diabetes lifestyle change. The limitations are substantial, a small single-centre sample, no blinding of a behavioural intervention, a culturally specific practice, and no assessment of whether benefits persist. Can I use this with my patients? Cautiously and for the right reasons. I would offer qigong or the more widely available Tai Chi as an accessible, low-impact option that may aid confidence and adherence, while being honest that the dramatic glycaemic numbers here need independent replication and that I would adjust glucose-lowering drugs as control improves to avoid hypoglycaemia.
References
Zhang X, Ge JJ, Li YY, et al. The effects of Sanxiao Jiuzhi Gong on blood glucose levels and exercise self-efficacy in type 2 diabetes patients: a randomized controlled trial. Medicine (Baltimore). 2025;104(38):e44572. doi:10.1097/MD.0000000000044572