Diabetes is a serious, sometimes life threatening disease, affecting 422 million people in 2014 worldwide compared to 108 million in 1980, and causing 1.5 million deaths in 2012. According to the World Health Organization, separate global estimates of diabetes prevalence for type 1 and type 2 do not exist. However, the majority of people with diabetes are affected by type 2 diabetes. This type of diabetes used to occur nearly entirely among adults, but now occurs in children too which I find very disturbing.
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels. – WHO
Regular exercises, a healthy diet, avoiding smoking and controlling blood pressure and blood lipids (blood fats) are all key to combating diabetes; however, did you know massage therapy can also be of help to type 2 diabetic patients? Massage can enhance the quality of life for diabetic clients by improving their circulation, as well as help them cope with stress more effectively. In addition, massage tends to lower blood sugar levels by approximately 20 to 40 points. According to LMT, Mary Kathleen Rose, tracking blood glucose before and after the session, clearly demonstrate that blood sugars can and do change significantly in an hour.
In the clinic, we noted changes of as much as a 100-point decrease in an hour, as well as a 100-point increase! The more dramatic decreases could be partly accounted for by recent injections of insulin, or by vigorous exercise in the hours prior to the massage session. The dramatic increases could be due to the failure of the client to take his or her required dose of insulin. Or they may have eaten food not covered by adequate insulin. But as stated earlier, moderate drops of 20 to 40 points were the norm. – Mary Kathleen Rose
So, due to the unpredictability of massage on a diabetic client, blood glucose monitoring is crucial especially before going in for your session. I appreciate the advise Mary gives to diabetic clients to fully benefit from a massage session.
ADVICE: For example, “if I am 100 points or less before the session, I’ll drink a small glass of juice beforehand, or maybe have it in the room to drink during the session. If I have a reading ranging from 140 to 160 points, I will eat nothing, knowing I will drop into a more desirable range during the session. If higher than 160 points, I may take an extra injection of insulin, being careful to account for the likely drop due to massage. Sometimes I have observed the blood glucose lowering effect of the massage lasts for several hours. It is wise to continue with regular testing.”
Therapists should have a cup of fruit juice available just in case the blood sugar of the client drops too low and experiences a hypoglycemia attack. Many diabetics carry glucose tablets with them, so ask if they carry glucose tablets or gel and where they are in case of an hypoglycemic episode. It is important for massage therapists to be aware of signs and symptoms of hypoglycemia. Once any of these symptoms are observed, ask the client how he/she is feeling, and be observant. “Does he/she seem fully cognizant?” If there’s any doubt, be ready to treat!
Hypoglycemia Symptoms (According to the American Diabetes Association)
Shakiness Irritability or impatience
Nervousness or anxiety Confusion, including delirium
Sweating, chills & clamminess Hunger & nausea
Sleepiness Seizures Unconsciousness
Rapid/fast heartbeat Lightheadedness or dizziness
Weakness or fatigue Nightmares or crying out during sleep
Headaches Anger, stubbornness, or sadness
Blurred/ impaired vision Tingling or numbness in the lips or tongue
Lack of coordination
Additional Massage Considerations
- Ask about any complication like neuropathy or vision problems: if neuropathy use lighter pressure an if vision problems have unobstructed passage and allow more time for disrobing undressing and getting on and off the table.
- Avoid, and also inform, the client of any bruises or breaks in the skin, especially he feet.
- Vigorous massage, especially percussion, and vibration, must be carefully administer because it can damage already compromised blood vessel.
- Cannot massage over injection sires for over 24 hours.
- Avoid insulin pump and don’t get massage lubricant on pump.
- According to author, Mark F. Beck, therapists must also pay attention to the level of pressure being used as well as use of heat therapies, because many diabetic clients not only bruise easily but also have decrease sensation owing to neuropathies.
Massage can be extremely beneficial to a person with type 2 diabetes, and can relieve the stress and anxiety associated with the disease. Massage therapists please make sure to communicate with your clients and listen to their feedback.
Have comments or questions? Please leave them below.
Beck, Mark F. Theory & Practice of Therapeutic Massage. Fifth ed. Clifton Park: Cengage Learning (Milady), 2011. Print.
“Diabetes.” World Health Organization. World Health Organization, Reviewed: November 2016. Web.
“Endocrine System Pathologies.” Tennessee School of Therapeutic Massage. N.p., January 2016. Print.
Global Report on Diabetes. Geneva: World Health Organization, 2016. Web.
“Hypoglycemia (Low Blood Glucose).” American Diabetes Association. N.p., Last Edited: July 2015. Web.