The benefits of massage therapy range from stimulating the lymph system, increasing circulation, lowering the heart rate, to reducing muscle tension. But how can massage effect someone with diabetes? Read on to find out about massage with diabetes – what you need to know.
What is diabetes?
Simply put diabetes is a group of diseases that result in too much sugar in the blood (high blood glucose). The most common types include;
- Type 2 diabetes – A chronic condition that affects the way the body processes blood sugar (glucose).
- Type 1 diabetes – A chronic condition in which the pancreas produces little or no insulin.
- Prediabetes – A condition in which blood sugar is high, but not high enough to be type 2 diabetes.
- Gestational diabetes – A form of high blood sugar affecting pregnant women.
How do you get diabetes?
Diabetes is a chronic disease that occurs because the body is unable to use blood sugar (glucose) properly. The exact cause of this malfunction is unknown, but genetic and environmental factors play a part. Risk factors for diabetes include obesity and high levels of cholesterol. The two main causes of diabetes are;
Lack of insulin production
This is primarily the cause of type 1 diabetes. Lack of insulin production occurs when insulin-producing cells are damaged or destroyed and stop producing insulin. Insulin is needed to move blood sugar into cells throughout the body. The resulting insulin deficiency leaves too much sugar in the blood and not enough in the cells for energy.
Insulin resistance
This is specific to type 2 diabetes. Insulin resistance occurs when insulin is produced normally in the pancreas. However, the body is unable move glucose into the cells for fuel. At first, the pancreas will create more insulin to overcome the body’s resistance. Eventually the cells “wear out.” At that point the body slows insulin production, leaving too much glucose in the blood. This is prediabetes. A person with prediabetes has a blood sugar level higher than normal but not high enough for a diagnosis of diabetes. Unless tested, the person may not be aware, as there are no clear symptoms. Type 2 diabetes occurs as insulin production continues to decrease and resistance increases.
What are the symptoms?
Symptoms for type 1 diabetes may occur suddenly and include:
- excessive thirst
- frequent urination including bedwetting
- excessive hunger
- unexplained weakness and fatigue
- unexplained weight loss
- blurred vision
- having cuts that heal slowly
- itching and skin infections
- mood swings
- headache
- dizziness
- leg cramps
- vaginal discharge or itch in young girls
- nausea and vomiting
Many people with type 2 diabetes have no symptoms, and if they do occur they often have a gradual onset. Symptoms include:
- blurred vision
- tiredness
- urinating more frequently
- feeling thirsty all the time
- numbness and tingling in the feet or legs
- recurrent infections
- always feeling hungry
- having cuts that heal slowly
- itching, skin infections
- blurred vision
- gradually putting on weight
- mood swings
- headaches
- feeling dizzy
- leg cramps
How is diabetes treated?
The major goal in treating type 1 and type 2 diabetes is to control blood sugar (glucose) levels within the normal range, with minimal excursions to low or high levels.
Type 1 diabetes is treated with:
- insulin,
- exercise, and a
- type 1 diabetes diet.
Type 2 diabetes is treated:
- A type 2 diabetes diet and exercise;
- Medications (oral or injected)when diet and exercise fail;
- Insulin if medications fail.
How can massage help?
Massage at an insulin injection site can significantly increase serum insulin action. Thereby decreasing blood glucose levels in people with type 1 diabetes. It is not well known if massage can improve insulin sensitivity. Therefore massage should be adjunct to the management of diabetes.
Uncontrolled studies suggest that massage may help normalise blood glucose and symptoms of diabetic neuropathy. Randomised, placebo-controlled studies are needed to clarify optimal massage treatment. Also to determine any short- and long-term benefits of massage as a complementary treatment for diabetes.
Massage can increase insulin uptake
Researchers observed patients with type 1 diabetes, using their usual dosages of regular and intermediate-acting insulins, who massaged their insulin injection sites with an electric vibrator for 3 min at 15 min post-injection, experienced higher insulin levels and lower serum glucose levels by 15 min after the start of massage and 29 min post-injection. At this interval, changes were not statistically significant. Serum glucose levels, however, fell 8.3% lower (P < 0.05) 30 min after massage and 44 min post-injection compared to the control day when participants did not massage their injection sites, and this was significant. At 45 min post-massage, the difference in glucose levels was even more striking (76 mg/dl ± 6%). When compared to the control day (89 mg/dl ± 4%).
Massage can help manage blood glucose levels
Trained clinical staff administered 15-min sessions of breathing instruction, light touch, and acupressure to diabetic patients for 6 consecutive weeks using a one-group, pre/post-test design (n = 12). Outcomes were blood glucose, persistence of physical symptoms, and perception of well-being. Patients experienced a reduction in blood glucose, anxiety, headaches, depression, work stress, and anger. Self-reports also indicated the patients were sleeping better and had improved relations with their families.
Massage can help manage the symptoms of diabetic neuropathy in diabetes
One trial assessed the effects of massage on the symptoms of diabetic neuropathy. This single-group, pre/post-test design assessed 25 patients with symmetrical diabetic neuropathy of the lower extremities and complaints of burning, tingling, pain, itching, restless legs, paresthesias, and often loss of reflexes. The duration of disease was 6–17 years, and the duration of neuropathic symptoms averaged 14 months. Massage was given every 2 days. The total number of treatments ranging from 20 to 30 in those who appeared to benefit. Therapy was stopped after the tenth treatment if they experienced no benefit.
Outcomes were described as; no effect, improved (decrease of patients’ symptoms to the extent that they considered the treatment worthwhile and wanted to continue it after the first 10 treatments), or good with a complete disappearance of symptoms or symptoms becoming so slight that patients considered themselves to need no further treatment. At the 1-month follow-up, results showed good response in 14 cases (56%), improvement in 8 cases (32%), and no effect in 3 cases (12%). [1]
Contraindications and precautions
Risk of inducing hypoglycemia in insulin-using patients has not been studied. Patients with diabetic neuropathy or peripheral nerve damage need to be treated with caution. They should only be treated with effleurage for the first seven to ten treatments.
Massage therapists need to be aware of how to maximise the benefits and minimise the risks of massage for diabetic patients. Timing, pressure, the site of massage and occurrence of massage needs to be carefully monitored. Patients should also monitor their glucose levels before and after massage as they do with mealtimes. Massage therapists should also book treatments when insulin is not at its peak activity.
