Massage & Bodywork

January/February 2012

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EDUCATION SOMATIC RESEARCH Diabetes and Massage: Diabetes, a group of diseases marked by high levels of blood glucose, affects 25.8 million people in the United States, or 8.3 percent of the population. One in four over the age of 65 and one in seven people between the ages of 45–65 have been diagnosed with the disease,1 diabetes.2 and 79 million people have pre- Chances of seeing a diabetic client in your massage and bodywork practice are almost certain. For somatic therapists, it is helpful to understand the disease and its complications, to be prepared for the symptoms that might present with a diabetic client, and to address the symptoms that prevent people from being active or making healthy choices. According to the literature, the potential for delaying the onset of diabetes and its associated conditions is great.3 For optimal success, clients and their health-care team must work together to develop a treatment plan and self-care regimen. As one study says, "CAM encounters may provide opportunities to coordinate health promotion and prevention messages with patients and primary care providers."4 BACKGROUND Diabetes is a condition resulting from defects either in the production of insulin or in the action of insulin, or both. Type 1, previously known as juvenile onset or insulin- dependent diabetes, is an autoimmune disease where the body's immune system destroys insulin-producing pancreatic beta cells. People with type 1 diabetes must take synthetic insulin by injection or pump. There are no known ways to prevent or cure type 1 diabetes, but much can be done to prevent or minimize the complications Translating the Evidence By Diana L. Thompson of the disease. Fortunately, only 5–10 percent of the diabetic population has this form of the disease.5 Previously called adult-onset diabetes, type 2 diabetes accounts for 90–95 percent of all diagnosed cases. Type 2 usually begins as insulin resistance, a disorder where the cells do not use the insulin properly, and the pancreas gradually loses its ability to produce insulin. Type 2 has the most potential for prevention or delay through lifestyle modifications that decrease the demand for insulin by limiting the glucose burden and lowering blood glucose levels, such as diet and exercise, oral medication, or injections. Other forms of diabetes, such as gestational diabetes, account for the remaining 1–5 percent of diabetics.6 COMPLICATIONS OF DIABETES The risk of death for people with diabetes is about twice that of people of similar age without diabetes. Medical expenses for people with diabetes are more than two times higher than those without the disease, accounting for $116 billion in direct medical expenses, and $58 billion in indirect expenses such as disability, loss of work, and premature death.7 About 67 percent of people with diabetes have heart disease or high blood pressure. The risk for stroke is 2–4 times higher, depending on age. Diabetes is the leading cause of kidney failure and new cases of blindness among adults. About 60–70 percent of people with diabetes have mild to severe forms of nervous system damage, and about 30 percent have severe periodontal disease. Poorly controlled diabetes before conception and during the first trimester of pregnancy among women with type 1 diabetes can cause major birth defects in 5–10 percent of pregnancies and spontaneous abortions in 15–20 percent of pregnancies.8 People with diabetes are more likely to die from influenza or pneumonia and twice as likely to have depression, and their activity levels are less than those of similar age without diabetes. 50 massage & bodywork january/february 2012

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