Category Archives: Diabetes

Massage Therapy for Diabetes

Massage Therapy for Diabetes

November is Diabetes Awareness Month. The health benefits of massage are varied, but can it help in the management of diabetes? Find out what’s proven to work best, and what should you know about massage therapy for diabetes.

As more Americans incorporate CAM modalities into their health care, people with diabetes are also looking to complement their lifestyle with integrated medical care. Massage Therapy is a commonly-used modality for patients with diabetes. Learn how it can help you or a loved one with diabetes.

Abstract in Brief

Massage is among the fastest growing CAM therapies used in the United States. Here we present a brief review of the available evidence on potential benefits and adverse effects of massage for people with diabetes: Massage at injection sites may increase insulin absorption; uncontrolled studies suggest that massage may have a positive effect on blood glucose levels and symptoms of diabetic neuropathy; randomized, placebo-controlled studies are needed to confirm any short- and long-term benefits of massage as a complementary treatment for diabetes and to further define an optimal massage treatment.

This article aims to clarify what is and is not known about the use of Massage Therapy for people with diabetes, with 4 frequently asked questions.

1. Can Massage Improve Insulin Absorption?

Our search found one study on insulin absorption in Type 1 diabetes. No studies were found on insulin absorption in Type 2 diabetes. Dillon observed that eight lean, well-controlled patients with Type 1 diabetes who massaged their insulin injection sites with an electric vibrator for 3 minutes at 15 minutes post-injection, experienced higher insulin levels and lower serum glucose levels by 15 minutes after the start of massage and 29 minutes post-injection, but these changes were not statistically significant. More significantly, serum glucose levels fell 8.3% lower (P < 0.05) 30 minutes after massage and 44 minutes post-injection compared to the control day when participants did not massage their injection sites. At 45 minutes 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%).

The same report revealed 2-year follow-up data on these eight patients, as well as on 18 others who had been massaging their injection sites for 3 minutes at each meal in order to achieve a  beneficial postprandial rise in insulin levels. After 3–6 months of massage, the mean HbA1 for the 26 patients fell from 10.56 ±1.73 to 8.55±1.69%. (Normal HbA1 was <8.2% according to the laboratory assay used.) After 12-18 months of injection-site massage, 8 patients had normal HbA1 levels, and the remaining 18 patients had mean HbA1 levels of 8.41 ±1.58%, a significant improvement from baseline (P < 0.001). Dillon proposed that injection-site massage can improve conventional insulin therapy by increasing the bioavailability of insulin in the postprandial state.

2. Can Massage Help Normalize Blood Glucose Levels?

Three published results of two trials and one unpublished preliminary study have examined the effects of massage on normalizing blood glucose.

Fields and colleagues, describing a single-group, pre/post-test design in two publications of the same study population, reported that after 1 month of parents administering nightly full-body massage to their  diabetic children (n = 14), the children’s glucose levels decreased from an average of 158 to 118 mg/dl. The authors also reported that both parents’ and children’s anxiety and depression levels decreased immediately after massage.

Vest trained clinical staff to administer 15-minute 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). Patients had a reduction in blood glucose, anxiety, headaches, depression, work stress and anger. Self-reports also indicated the patients were sleeping better and had improved family relations. No P values were cited.

Preliminary data were available from one small trial comparing people with Type 2 diabetes receiving 45-minute full-body massage three times a week for 12 weeks (n = 6) to similar patients on a waiting list for massage (n = 2). Researchers found that of the 6 patients receiving massage, HbA1c decreased in 3 patients from a baseline of 7.9, 8.3, and 9.8% to 7.3, 8.1, and 8.6%, respectively. In the other three patients receiving massage, HbA1c increased from a baseline of 7.4, 8.2, and 8.0% to 7.9, 10.0, and 8.5%, respectively. These patients, whose glycemic control deteriorated while receiving massage, were obese, injecting insulin, or both. None of the group whose glycemic control improved with massage had either of these characteristics. In the waiting list control group, HbA1c level also declined from 7.3 and 8.6% to 6.9 and 8.4%, respectively.

3. Can Massage Provide Relief for Symptoms Associated With Diabetic Neuropathy?

Our search found one trial assessing 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, paresthesia and loss of reflexes. The duration of disease was 6–17 years, and the duration of neuropathic symptoms averaged 14 months. Massage was administered every 2 days, with the total number of treatments ranging from 20 to 30 in those who appeared to benefit. Therapy was discontinued after the tenth treatment for those who experienced no benefit.

Subjective outcomes were defined as no effect, improved or good. 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%).

Question #4: What Contraindications or Precautions Are Related to Massage for People With Diabetes?

A potential adverse effect of massage for diabetes appears to be the risk of inducing hypoglycemia in insulin-using patients. This risk is extrapolated from massage studies using healthy volunteers. None of the studies of massage and diabetes reports adverse effects.

In the study of massage for diabetic neuropathy, Kurashova specifically cites contraindications and precautions for people with diabetes. In the beginning, it is recommended to use only continuous effleurage. Massage should begin with 5-7 minutes on the back, then proceed to the posterior thigh and calf. 20-30 minutes total on the posterior body; then 10–15 minutes on anterior extremities. For patients with peripheral nerve damage, gentle friction of the lower extremities can be added only after 7–10 treatments of effleurage have been completed.

Because vascular dysfunction may render the tissues fragile, friction should be light to avoid vascular damage or bruising. In swollen areas, friction should be avoided because the direct pressure into the tissues that is characteristic of friction may further close the dysfunctioning vessels. Pressure should be sufficiently light to cause no pain.

SUMMARY

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 unknown whether massage can improve insulin sensitivity and therefore be a useful adjunct to management of Type 2 diabetes.

Uncontrolled studies suggest that massage may help normalize blood glucose and symptoms of diabetic neuropathy. Randomized, placebo-controlled studies are needed to further clarify what an optimal massage treatment might be and to elucidate any short- and long-term benefits of massage as a complementary treatment for diabetes.

How Massage Helps People with Diabetes

How Massage Helps People with Diabetes

Image result for diabetes monthIn recognition of November as Diabetes Awareness Month, we explore the benefits of massage therapy for people with diabetes. According to the American Diabetes Association, one out of every 11 people currently has diabetes. But what is more worrisome, is that one out of every four of people in the United States do not know they have diabetes.

Diabetes comes in two forms: Type I, which is not preventable and in which the body does not produce enough insulin, or Type II, which is preventable and in which the body cannot process insulin correctly.

A sedentary lifestyle combined with consuming more processed foods high in sugar and high fructose corn syrup are cited as common causes of the rise in Type II diabetes in the U.S. The cost of lost work time and healthcare associated with diabetes is an estimated $245 billion a year. This is a serious condition that is impacting the quality of life for many Americans.

Early symptoms of diabetes include: Frequent thirst, dramatic mood swings, chronic cold feet, tender areas of the body, leg cramps, puffy feet and loss of sensitivity in the feet. These symptoms are very representative of some of the complications that people living with diabetes experience: nerve damage, foot problems and skin conditions.

Nerve damage from diabetes is called diabetic neuropathy. About half of all diabetics have some degree of nerve damage. Regulating blood glucose levels is the best way to delay diabetic neuropathy or prevent further damage. The most common form of neuropathy is called peripheral neuropathy, which affects the legs and feet (enter foot complications). Peripheral neuropathy can cause loss of feeling, so one can injure their foot and not know it. This can lead to untreated injuries or infections. Diabetes causes poor circulation in general, and one of the areas most commonly affected by this is the feet. Blood vessels can narrow and harden, leading to a reduced ability to fight infection and heal, and chronic cold feet. This is why people living with diabetes are more likely to have lower limbs amputated than others.

Image result for massageMassage therapy is one of the best ways for diabetics to manage peripheral neuropathy. Massage of the lower extremities improves circulation in the legs and feet. Massage helps manage muscle and foot pain, improves and balances stress levels, which helps alleviate the mood swings that can result from changes in glucose levels.

Evidently massage has been recommended as a treatment for conditions related to diabetes for more than 100 years. A recent literature review on alternative therapies for diabetes was published in the Journal of Pharmacy & Bioallied Sciences. It touts the benefits of massage for people living with diabetes: Three published results of two trials and one unpublished preliminary study have examined the positive effect of massage on normalizing blood glucose. One trial also assessed the improvement in 56% of cases of diabetic neuropathy of the lower extremities by syncardial massage.

Massage has been demonstrated to reduce muscle tension in both subjective self-reports and objective electromyographic testing. Relaxation from massage has been demonstrated to be greater than that brought about from rest alone. Massage can reduce heart rate and blood pressure, two features of the relaxation response. The extreme stress-reducing benefits of massage have raised the possibility that massage may be of benefit to people with diabetes by including the relaxation response, thereby controlling the counter-regulatory stress hormones and permitting the body to use insulin more effectively.”

Massage therapy can truly help people living with diabetes manage their symptoms and live more comfortably with their disease, as a drug-free, noninvasive, and minimal-risk pain management option.