In purely scientific terms, the benefits of massage therapy on
diabetes have not been adequately investigated by medical research to
reach any definitive conclusions. Some preliminary studies have shown
that massage/touch therapy can reduce glucose levels in children,
however insufficient research has been conducted to back these studies
and these studies are generally not accepted by the medical community
at this time.
While there is very little *direct* research to demonstrate the
benefits of massage for people with diabetes, there is secondary
evidence that indicates that massage therapy could indeed be helpful
for some people with diabetes, particularly those who are not
insulin-dependent.
Diabetes occurs when the body is no longer able to maintain blood
sugar, or glucose, in the proper amounts because the body does not
produce or properly use insulin. Some people with diabetes are able to
maintain their blood sugar at the proper levels with diet and weight
loss. This is known as Type 2 diabetes. Others are required to take
insulin injections to maintain proper glucose levels, otherwise death
will occur. This is known as Type 1 diabetes. Approximately 17 million
people in the United States have diabetes.
The key argument for the benefit of therapeutic massage in glucose
management is stress reduction. It has long been known that blood
sugar levels can be drastically altered by stress. When the human body
encounters stress, it prepares itself for "fight or flight" by raising
glucose levels in the blood stream in an attempt to give the body
extra energy for whatever danger lies ahead. However, extra glucose in
the bloodstream is exactly what most diabetics want to avoid.
Therefore, managing stress is an important way that many diabetic
patients can manage their glucose levels. A study by Duke Medical
University demonstrated this fact; 32 percent of Type 2 diabetic
patients who underwent stress management had HbA1c levels that were
lower by 1 percent or more after one year, versus only 12 percent of
the control subjects. Because massage is considered relaxing and an
excellent way to de-stress for many people, in theory massage should
have the same positive benefits on glucose levels as other stress
management techniques.
While massage therapy may have some benefits, you should also be aware
that there are some potential dangers that must be considered with
massage therapy and diabetes. In particular, massage has been shown to
increase insulin absorption rates due to increased circulation when
applied near an injection area. Another important consideration is
diabetic neuropathy, a common complication of diabetes. Persons
suffering from neuropathy frequently have dulled sensations, and may
not be able to provide adequate feedback about the amount of pressure
applied during a massage therapy session. Furthermore, since many
diabetics suffer from thinning skin as well as reduced blood flow to
the extremities, there can be increased odds of bruising or injury if
care is not taken. Caution should be taken to ensure that diabetics
are not exposed to infection. Finally, the most obvious consideration
is that if massage does effect blood sugar levels, diabetic clients
should be sure to monitor their glucose in case changes to their diet
or insulin dosage need to be made. A diabetic person should always
consult with their doctor before beginning a massage regimen.
From my reading it seems that--except in the cases where a diabetic
patient has a number of secondary complications--the medical community
is less concerned that the diabetic patient will be harmed by massage
therapy than they are concerned that the patient will mistakenly see
massage as a "replacement for" instead of an "adjunct to" traditional
therapy. Physicians fear these patients will make dangerous decisions
about their health--such as discontinuing insulin injections--that
could have dire consequences. An important consideration that you may
want to explore in your paper are the ways that massage therapists can
increase awareness and open lines of communication with the medical
community. In many ways, I personally believe that most of these fears
come from the way that many people view holistic treatment and Western
medicine as an "us or them" decision, which it really shouldn't be.
Patients should feel comfortable combining any of the various
treatments that are shown safe and work right for them. Open, honest
two-way communication between holistic practitioners and the medical
community is one of the major barriers not only to acceptance of
alternative treatments, but even proper research of their value.
Ultimately, promoting trust between holistic therapy practitioners and
traditional physicians benefits both groups, but most of all it
benefits the person who needs it most: the patient.
Good luck with your paper, and if you need any further clarification,
do not hesitate to ask.
Have a nice day,
-Spot
"Implications for physical therapy in the treatment of patients with
diabetes mellitus", Akemi Tanemura
School of Occupational Therapy and Physical Therapy, University of
Puget Sound
http://otpt.ups.edu/Gerontological_Resources/Gerontology_Manual/Diabetes_Tanemura.html
Diabetes Complications
http://www.niddk.nih.gov/health/diabetes/pubs/niddm/compl.htm
Absorption kinetics and biologic effects of subcutaneously injected
insulin preparations.
http://www.uptodate.com/patient_info/topicpages/abstrcts/Abstrx22/1106982.htm
Field, T., Hernandez-Reif, M., LaGreca A., Shaw, K., Schanberg, S.,
and Kuhn, C.
Massage therapy lowers blood glucose levels in children with Diabetes
Mellitus.
Diabetes Spectrum ,10, 237-239. 1997.
Basic Diabetes Information
http://www.diabetes.org:80/main/application/commercewf?origin=*.jsp&event=link(B)
Stress Management Can Help Control Glucose in Type 2 Diabetes
http://dukemednews.duke.edu/news/article.php?id=5182
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