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.
Hypoglycemia is another potential problem for people with diabetes. It can develop quickly if the schedule of eating and medication is disrupted in such a way that insulin levels are high, but not enough sugar enters the bloodstream from the intestines. Symptoms include confusion, dizziness, shakiness, alterations in vision and hearing, headache, and irritability. Pale skin, racing pulse, sweating, and weakness are also possible. Hypoglycemia can be dangerous and can lead to loss of consciousness and coma. More often, it simply calls for ingesting some easily absorbable simple sugar in a hurry.
Another type of diabetes is gestational diabetes, which is transient and occurs during pregnancy.
Fast-acting and slow-acting insulin by injection, inhalation, pen, or pump (insulin cannot be administered orally) to reduce blood sugar
Medications to stimulate insulin release and insulin uptake (type 2 diabetes only)
Medications to address hyperlipidemia
Medications to address other complications of diabetes
Rachel Canaway, Lenore Manderson, and Brian Oldenburg, “Perceptions of Benefit of Complementary Therapy Use among People with Diabetes and Cardiovascular Disease,” Complementary Medicine Research 21, no. 1 (February 2014): 25–33, https://doi.org/10.1159/000358725.
Taeho G. Rhee, Sarah M. Westberg, and Ila M. Harris, “Complementary and Alternative Medicine in US Adults with Diabetes: Reasons for Use and Perceived Benefits,” Journal of Diabetes 10, no. 4 (April 2018): 310–319, https://doi.org/10.1111/1753-0407.12607.
Adelaida María Castro-Sánchez et al., “Connective Tissue Reflex Massage for Type 2 Diabetic Patients with Peripheral Arterial Disease: Randomized Controlled Trial,” Evidence-Based Complementary and Alternative Medicine 2011 (2011): 804321, https://doi.org/10.1093/ecam/nep171.
Natália Chantal Magalhães da Silva et al., “Foot Reflexology in Feet Impairment of People with Type 2 Diabetes Mellitus: Randomized Trial,” Revista Latino-Americana de Enfermagem 23, no. 4 (July/August 2015): 603–610, https://doi.org/10.1590/0104-1169.0036.2594.
Uraiwan Chatchawan et al., “Effects of Thai Foot Massage on Balance Performance in Diabetic Patients with Peripheral Neuropathy: A Randomized Parallel-Controlled Trial,” Medical Science Monitor Basic Research 21 (April 2015): 68–75, https://doi.org/10.12659/MSMBR.894163.
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