Intervention
hypoglycemic, diabetes
DIABETES, CLAP, DIABETES
All participants continued to receive standard therapy for diabetes as they received before the study began. The control group continued the standard therapy and the intervention group received the standard therapy plus the laughter yoga program. Standard therapy included taking oral hypoglycemic medications, receiving advice from the doctor in charge of dietary modifications and physical activity in accordance with the “Treatment Guide for Diabetes” in Japan (The participants in the intervention group received laughter yoga program once a week during the first 4 weeks and then every other week during the last 8 weeks. In total, eight sessions over 12 weeks were provided. The duration of laughter yoga intervention in previous studies ranged from 4 weeks to 8 weeks (Laughter yoga is a kind of exercise consisting of deep breathing and voluntary laughter in a sitting or standing position. Each laughter yoga session consisted of warm up exercises, deep-breathing exercise, laughter exercise, and calming activity. At the beginning, the participants were asked to clap their hands along with saying the phrase “Ho, Ho, Ha, Ha, Ha,” as a warm up exercises. Then, deep breathing with laughter were performed. Subsequently, the participants were asked to participate in voluntary laughing imaging in a variety of situations, including 5-min break. For example, when doing the “milkshake laughter,” participants were asked to imagine that they have a glass of milk in their right hand and a glass of their favorite fruit juice in their left hand. They pretended to pour the milk from one glass into the other and pour it back into the first glass (to mix them). Then, they pretended to drink the milkshake, with a laugh. Finally, the participants were asked to close their eyes and relax.