Diabetes mellitus

A group of related disorders that all result in hyperglycemia, or excessive sugar in the blood. There are two main varieties of diabetes: type 1 diabetes is an autoimmune disease connected to genetic background and an immune system mistake leading to the destruction of insulin-producing cells; type 2 diabetes is more likely related to genetic predisposition along with diet and lifestyle factors that vary individually, and are often controllable.

  • The risks of massage therapy for a person who has advanced or poorly managed diabetes are substantial. Cardiovascular disease, kidney disease, skin ulcerations, and neuropathy comprise a short list of common complications that alter bodywork choices.
  • Timing bodywork choices around insulin doses is preferable to avoid triggering a hypoglycemic episode.
  • Injection sites or insulin pump attachment sites are local contraindications. Massage therapists should be aware that the skin and subcutaneous tissues at insulin injection sites can become irritated, inflamed, scarred, or otherwise altered. In the absence of research about massage therapy in the presence of recent injection sites, it is probably best to avoid them for several inches in all directions in order to not influence the normal uptake of the insulin dose.
  • Because massage has been seen to decrease blood sugar, it is a good idea to try to schedule massage or bodywork sessions when levels are most stable: in the middle of a cycle, rather than just after or just before administering insulin.
  • It is also wise to ask clients who have diabetes how they want to handle a hypoglycemic episode before starting bodywork. Some people keep sugar tablets with them; others prefer milk, juice, or other options.
  • When working with this client, be aware of their skin health. Therapists might be the first to see foot ulcers, a common issue for people with diabetes.
  • An active client who has healthy, responsive tissue and well-controlled diabetes with no contraindicating complications can enjoy the same benefits from bodywork as the rest of the population.
  • Some research has found that light massage, compared to relaxation exercises, led to some significant changes in diabetes biomarkers.
This is a sample, the full program is available as part of ABMP membership.