Therapeutic Massage and Diabetes

Hypoglycemia: What Massage Therapists and Diabetics Need to Know

  Hypoglycemia is the condition in which the individual experiences blood sugar levels below 70 mg/dl. Diabetics vary in their level of awareness and ability to recognize symptoms of hypoglycemia, which is a very serious and potentially life-threatening condition. Particularly for those using insulin, I recommend that blood glucose levels always be tested before receiving a massage. (Hyperglycemia is the term applied to high levels of glucose in the blood. This is the defining condition of diabetes. The keystone of treatment is management of sugar levels to keep them close to a normal range of 80-120 mg/dl. Many factors affect blood glucose levels, including insulin levels, food intake, level of activity, and stress hormones.)

In an informal study conducted in 1999-2000, several of my massage students offered one-hour massage sessions to diabetics. In more than 40 sessions recorded, clients monitored blood glucose before and after the session. In general, blood sugars tended to drop 20-40 points in the hour, which would be equivalent to the drop experienced with moderate activity. But the overall results, complicated by the variability of individual medication, diet and exercise regimens, were surprising to both the therapists and clients. We noted changes of as much as a 100-point decrease, as well as a 100-point increase. These changes were probably not attributable to the massage itself; rather they were the result of variability of insulin dosing prior to the massage, or the effects of exercise or food on blood-glucose levels.

What this investigation did confirm, however, was the wisdom of blood glucose testing before and after massage. When people with diabetes receive repeated sessions, they understand their response to massage and adjust insulin dosing accordingly. For example, I know that I tend to drop 30-40 points during a one-hour relaxing massage session, so if my blood sugar is less than 120 mg/dl, I will usually have a glass of juice handy to drink during the session. (Incidentally, as a massage therapist who is also diabetic, I apply this same rule, usually having juice available when I give a session.)

Due to the frequently unpredictable nature of the disease, it is important for the massage therapist to recognize the signs and symptoms of hypoglycemia:

  • Excessive sweating (skin may feel clammy)
  • Faintness or headache
  • Unable to awaken
  • Spaciness: the person may talk or move slowly, or not be able to speak coherently. (This may be confused with the more typical relaxed state that one experiences after a massage.)
  • Irritability
  • Change in personality
  • Rapid heartbeat

Addressing hypoglycemia

If the client shows any of the above signs, ask him or her, "How do you feel?" Note the coherence of their response. Be aware that blood-sugar level can drop quickly, so that treatment must be given immediately. If sugars are low, the diabetic needs sugar fast! This may be in the form of fruit juice, honey, a sugary drink or glucose tablets. (Many diabetics carry their own glucose tablets, or another source of quick-acting carbohydrates, such as juice or candy.) A cup of juice, or the equivalent of 15-20 grams of carbohydrates, will be sufficient to raise the blood glucose to a safe level. Changes will be noted in the person within minutes. Let them rest awhile, and then encourage the client to test their blood-glucose level again before leaving. They may need to eat something more.

Mary Kathleen Rose is a Type 1 diabetic, and founding member of the Boulder Valley Diabetics support group in Boulder County, Colorado. 



  Copyright Mary Kathleen Rose 2006