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Diabetes and Massage

November 2017 Issue 6

This blog provides a brief introduction to diabetes and the benefit of massage. It marks Tuesday 14 November – World Diabetes Day.

There are two types of diabetes:

Type 1 Insulin dependent diabetes Mellitus – where the pancreas produces little or no insulin. Despite there being a general genetic predisposition, onset can occur after a physical or emotional stressful episode. Diabetics with type 1 diabetes need to take regular injections of insulin and comprise around 15% of those with diabetes.

Type 2 Non-insulin dependent diabetes mellitus – where the bodies cells develop resistance to insulin despite the pancreas producing the hormone. The resistance to insulin means that cells are unable to transfer glucose from the bloodstream, blood sugars become elevated – the lack of energy in cells leading to fatigue. Type 2 diabetics comprise around 85% of those with diabetes.

Signs and Symptoms

Hyperglycemia – abnormally high blood glucose with symptoms of excessive thirst, hunger and urination. Onset can be gradual.

Hypoglycemia – abnormally low blood sugar with symptoms of irritability, sudden changes of mood, personality or behaviour, slow speech, confusion and poor attention. Low blood sugar can result from an increase in insulin, exercise and delayed meals. Onset is usually sudden and can become an emergency and be fatal if untreated.

Complications

High blood glucose for Type 1 can lead to complications due to the burning of fat tissues for energy producing an accumulation of ketones leading to more acidic blood with resultant symptoms of headache, nausea and fatigue. In Type 2 high blood glucose can result from stress caused by an infection resulting in fluid imbalance with dehydration, confusion and lack of consciousness.

Diabetes can also lead to serious chronic conditions such as cardiovascular plaque, nerve damage to the hands and feet, skin issues such as poor healing of wounds, infection and ultimately gangrene, impaired kidney function, thickening of connective tissue and poor immunity to infection.

Management

Diabetic management includes long term aspects such as diet and exercise to maintain blood sugars within a normal range. Type 2 can be reversed with suitable diet and exercise. Type 1 requires regular injections of insulin.

Massage and diabetes

A massage therapist needs to conduct a very thorough preliminary consultation for those with diabetes as the range of severity can be very diverse. This ranges from well managed blood sugar levels with no complications, advanced complications (say, in terms of peripheral neuropathy) and/or poor blood sugar stability with the potential for an acute episode. It is important that current health, possible contraindications and ability to tolerate massage are clearly established. In general, the more advanced the diabetes the more contraindications there will be.

Should a low blood sugar episode occur during or immediately after massage then if it important to ensure that sweets or glucose are consumed; if little recovery after 10 minutes more sweets should be consumed; if no recovery after that then emergency medical help should be sought.

Massaging a local insulin injection site should be avoided within 1 hour of injection. Massage improves blood circulation and therefore the transport of blood sugar around the body – but unlike exercise it does not increase the utilisation of blood sugar.

A major potential complication is cardiovascular disease – heart disease, thinning of the coronary arteries and/or angina. Massage pressure should be adjusted accordingly particularly around the carotid arteries.

One complication of diabetes is potential loss of feeling – particularly in the hands and feet. This is often combined with poor blood circulation in the hands and feet. Massage pressure should be conservative with light pressure.

Another complication is thickening of connective tissue – massage, and myofascial release in particular, can greatly aid elasticity of the muscle tissues and connective tissues and improve the range of mobility.

Depression can arise from the stresses of constant management of diabetes. One study indicates that around 20% of diabetics can have clinical depression. Massage is a major help with relaxation – the release of endorphins calming the nervous system and therefore combating stress. The reduction in stress can assist in achieving control of blood sugar levels. Regular massage can help to alleviate the symptoms of depression.

Careful aftercare is essential for diabetic clients and it is important that a client should be encouraged to rest for a while following massage in the therapists premises to ensure that serious low blood sugar levels do not emerge.

Do you have diabetes? Massage can provide significant benefits to augment your existing diabetes management. Book a massage today on 07504 554936

Sources:

Huang Y et al (2013) “Collaborative care for patients with depression and diabetes mellitus: a systemic review and meta analysis” BMC Psychiatry, 13:260 [Accessed 13 November 2017 https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-13-260]

Rose, Mary Kathleen (2003) “Diabetes” in Massagetherapy.com [Accessed 6 November 2017 http://www.massagetherapy.com/articles/index.php/article_id/96/Diabetes]

Walton, Tracy (2011) “Medical Conditions and Massage Therapy: A Decision Tree Approach” Lippincott Williams & Wilkins

 

The impact of diabetes can be serious – consult your doctor if you experience extreme, acute or prolonged symptoms.

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Stress

Blog – Stress

November 2017 Issue 5

This blog provides a brief introduction to stress and its physical and emotional impacts. Stress is the bodies response to physical and emotional demands and pressures placed on it. There is short term stress (acute stress) and long term stress (chronic stress).

Immediate, short term stressor usually result in a normal ‘flight or fight’ response. This is where the sympathetic nervous system trigger the adrenal glands to produce adrenaline and cortisol. These hormones impact on our body systems to produce a heightened state of alertness to help us cope with the immediate stressor. Impacts include faster heart rate, dilated pupils, release of glucose into the bloodstream to provide immediate energy and blood is diverted from the digestive system to the muscles. Once the stressor has gone the sympathetic nervous system triggers the release of endorphins to calm the body back to its normal state.

Chronic or long term stress, however, is a situation where the heightened state remains in the ‘on’ position and the ‘off’ switch to restore a normal state does not appear to function. The constant impact of the adrenaline and cortisol has an adverse effect on the heart, digestive system and immune system.

Long term stress can be triggered by ongoing situations including problems in the workplace, family and financial difficulties to name a few.

The UK Labour Force Survey states that around 1.5% of workers had work related stress in 2015/16 resulting in 11.7 million lost working days – 45% of all working days lost due to ill health.

 

Self help ideas

Have a clear sense of purpose – this provides meaning whether it is spirituality, family, help others or work.

Work/life balance – prioritise time and energy based on what is important

Sleep – insufficient sleep impacts on many body systems including the digestive system and impacts on the ability to focus and concentrate

Healthy eating – eating the right types of food in the right quantities. A Mediterranean diet generally is rich in protein and vegetables and lower in carbohydrates compared to the average UK diet.

Support – getting support from family, friends and work colleagues can help reduce stress.

Exercise – regular exercise such as walking, sports or the gym has a key impact on how the body deals with hormones in terms of eliminating stress hormones such as adrenalin and cortisol or promoting hormones such as endorphins that provide that feel good factor.

 

Massage and stress reduction

There are now many research studies showing the dramatic impact massage can have on reducing stress in a number of different contexts – whether work-related or health condition specific.

Massage not only reduces the levels of cortisol but also releases endorphins that calms the nervous system and also releases the ‘happy’ hormones serotonin and dopamine.

Regular massage helps the body to maintain normal hormonal function in relation to stress hormones and endorphins.

When was your last massage to reduce stress and lift your mood? Book a massage today on 07504 554936

 

The impact of chronic stress can be serious – consult your doctor if you experience constant stress for a prolonged period.

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