Massage therapy can have several relaxing effects on the body, some of which could be particularly useful for people with diabetes.

Studies have shown that massage therapy may help lower anxiety,

stress
and possibly blood pressure, all of which can increase your well-being.

Note that massage therapy should not replace any

medications
you are taking for these conditions.

If you are considering massage therapy for health reasons, it is advisable to consult your doctor first.

Types of massage therapy

Different types of massage therapy include:

• Swedish massage – also known as classic massage
• Thai massage – combines acupressure techniques with yoga poses
• Reflexology – involves applying pressure to the feet
• Shiatsu massage – massage is provided by specialist machines

These each work in different ways and will therefore have different benefits and precautions to consider.

Massage therapy benefits

Massage therapy is known to have benefits on lowering

anxiety
and stress and the effects are likely to extend to people with diabetes to some extent.

Stress is known to negatively affect

diabetes control
and therefore reductions in stress may result in improved blood glucose levels. However, there have been no well-run studies to show whether this applies in practice.


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Massage may also help

lower blood pressure, however, there is a lack of good quality studies to confirm this.


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There is some evidence that indicates that massage may improve glucose levels in children with

type 1 diabetes
but again more research is this needed in this area to confirm.


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Massage therapy and diabetic neuropathy

Whilst research into massage for neuropathy treatment is scarce, one study from 1973 showed potential for massage to relieve symptoms of

diabetic neuropathy

The study used a mechanical leg massage technique called syncardial massage. This involves wearing an inflatable cuff, similar to the cuffs used for taking blood pressure. The cuff was worn on the legs and delivers waves of pressure which is thought to aid blood flow.

The majority of participants noted improvement in symptoms, however, the trial was not randomly controlled and therefore researchers cannot rule out that the benefits may have been a placebo effect.

Precautions

A review from 2001, by Ezzo et al. noted that massage may present some risks if care is not taken by the masseuse (the practitioner giving the massage).

In people on insulin, massage may increase the risk of

hypoglycemia
(too low blood sugar).

In people with neuropathy, the masseuse should know the correct ways to apply pressure so as not to damage blood vessels and tissues.


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Relaxation therapy can take many forms. Learning how to manage stress and relax the body and mind can have benefits towards managing chronic diseases such as diabetes.

Guided imagery, sometimes called visualisatio, can profoundly affect the state of a patient’s mind. It is thought that those people who have an optimistic, bright outlook on life will also remain in

better health

Guided imagery teaches the patient the skill of creating a mental image. In the case of diabetes, this mental image may reflect the patient’s own perception of his or her diabetes.

The reactions to this image are then explored and discussed with a therapist who helps to change the image of the disease for the better.

Guided imagery can be used to treat a number of other conditions such as stress and depression

To date, there is lack of strong research available to help evaluate the benefits of guided imagery specifically for people with diabetes.

Research into guided imagery and diabetes

A research study published in 2015 investigated the effects of listening to a guided imagery recording on blood glucose control in children with type 1 diabetes.

13 children took part in the study. One group listened to the guided imagery recording along with background music twice a week for 12 weeks. Another group listened to the background music only.

The results showed that the guided imagery group achieved a significant reduction in HbA1c.

The study is small and further research would help to demonstrate how effective guided imagery is for lowering blood sugar across a larger population.


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Biofeedback uses electronic devices to help people control what are normally involuntary functions.

Biofeedback therapy supports people to gain awareness and control over body processes such has heart rate and other physiological processes that are normally not under conscious control.

Biofeedback can be used to treat a number of conditions which may result from diabetes including circulation, incontinence, and

blood pressure

How biofeedback works

Biofeedback can be used in a number of ways. This may include the patient wearing electrodes which will record some form of biological activity, for example; muscle contractions, skin temperature, breathing, pulse rate or sweating. This activity is then fed back to the patient by means of a sound or visual display.

The patient, becoming aware of how their body is reacting can learn to exert beneficial influence and effects. This could include for example having a calming affect on heart rate, and better control of

muscles

To date, most of the studies into the use of biofeedback in people with diabetes have been small and therefore it is hard to assess how useful the therapy is.

Hba1c reduction

A 2005 study by the Medical University of Ohio found that 3-month usage of biofeedback and relaxation therapy resulted in lower

HbA1c levels
than the control group. The study was small and included 30 participants who completed the therapy.


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Increasing blood flow

A study in 1984 of 20 participants, 10 of which had diabetes, underwent temperature biofeedback therapy and the results showed that skin temperature of the hand increased more in the group with diabetes.

The researchers noted that this may indicate that the therapy increases blood flow in extremities for people with diabetes. This could indicate benefits for people with conditions such as

peripheral vascular disease
but larger studies would be needed to confirm this.


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Healing of foot ulcers

A 2001 study showed that use of biofeedback therapy was associated with a greater success rate in the healing of

foot ulcers
14 out of 16 participants receiving biofeedback relaxation therapy experiencing healing of ulcers compared with seven out of 16 in the control group.


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Improving fecal continence

Fecal incontinence, an impaired ability to control bowel movements, is a possible long-term complication of people with diabetes.

Biofeedback is used to assist people to have improved control of their bowel. A study from 2009, of 108 patients with average age of 60 years old, showed that biofeedback had significant success in reducing the severity of fecal incontinence.

Whilst the study did not directly recruit people with diabetes, the way the therapy works may have potential for helping people with diabetes.


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Aromatherapy is the practice of using essential oils (extracted from plants and concentrated) to improve the condition of the mind or body.

Whilst aromatherapy has shown evidence of reducing anxiety, stress and

depression, controlled studies indicate that the benefits are likely a placebo effect.


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Whilst there is little hard evidence that aromatherapy is an effective clinical therapy, it may help you relax and improve your general well-being.

What is aromatherapy?

Aromatherapy has a long history dating back to the Greeks and the Egyptians, but its renaissance occurred in France in the 1940s, when French chemist Rene-Maurice Gattefosse used lavender to help cure a burn he had suffered.

Essentials oils can be used with massage, compresses, in baths or by inhaling.

Aromatherapy has been used clinically to reduce anxiety in areas of palliative care, rehabilitation after major

heart disease
events and in mental health.

It’s use in clinical settings is somewhat controversial as its effectiveness is yet to be established by well-run research.


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Benefits of using aromatherapy to treat diabetes

The main clinical use of aromatherapy is in reducing

anxiety
Research studies has shown effectiveness in reducing anxiety. However, typically when placebo controlled trials have been undertake, no significant differences have been observed.

There is therefore a case to be made that if either aromatherapy or a placebo is effectively used, then this may benefit some people in clinical settings.

Depression

Whilst there are research studies that demonstrate benefits of aromatherapy in improving symptoms of depression, there is currently a lack of well-run controlled studies in this area.


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Wound healing

Another purported benefit of aromatherapy is wound healing. Whilst some oils, such as tea tree oil, have antibacterial properties, research into wound healing properties have been inconclusive.

Foot wounds
in particular present a high risk of danger for people with diabetes and it is therefore important that any foot wound is treated by a healthcare professional.

It is not recommended to rely on aromatherapy as this method has not been proved to be effective in people with diabetes.


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Side effects

Side effects may exist depending on which type of oil is used for which purpose.

Some people may experience allergic reactions to contact with certain essentials oils. Essential oils may also interact with some

drugs

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Ayurvedic medicine is one of the world’s oldest medical systems. It has been practiced in India for thousands of years and is deeply rooted in spiritual ideology.

Some Ayurveda practitioners believe that it has applications in the

treatment of diabetes, but research into the effects of Ayurvedic medicine on people with diabetes is mostly inconclusive.

Ayerveda should not be used to replace conventional care or your existing treatment plan. You should consult your healthcare provider before taking Ayurvedic medicine.

What is Ayurveda?

Ayurveda promotes the use of compounds, special diets and other unique health practices not widely studied as part of conventional Western medicine.

Treatment is directed towards establishing and maintaining an internal balance in the body, rather than singling out individual symptoms for treatment.

How can Ayurveda treat diabetes?

In Ayurveda, diabetes is recognised for its multifactoral nature. These include the differences between

type 1 diabetes
and

type 2 diabetes

Ayurveda teaches that there are three mind-body constitutions, known as doshas, and imbalances in the metabolism lead to imbalances in these doshas (Kapha, Pitta and Vata).


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Ayurvedic theory notes that type 2 diabetes develops from an excess of the Kapha dosha and treatment is largely steered towards

diet
modification.

Some studies have linked Avurvedic medicine and diabetes in a positive light, but scientific evidence for its effectiveness is limited.


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Panchakarma

Some Avurvedic practitioners will look to treat diabetes with a cleansing program known as panchakarma. The treatment intends to help regulate blood sugar levels, but there isn’t sufficient evidence to confirm this.

Panchakarma includes massages, herbal therapy, saunas and fasting. This will sometimes be followed by a herbal purge and yoga and breathing exercises. Herbs and a strict diet make up the basis of the treatment.

Yoga therapy
is another part of the Panchakarma treatment system, and is common throughout the UK.

Traditional Chinese Medicine (TCM) is an ancient form of treatment that aims to maintain harmony and balance within the body.

A number of therapeutic methods may be combined to produce a holistic effect.

Whilst some aspects of TCM may result in benefits, there is little in the way of scientific proof to show that the theory behind TCM is valid.

How does Chinese medicine work?

Chinese medicine works to benefit the mind and body overall.

Techniques used in Chinese medicine include:

• Chinese herbal medicine
• Acupuncture
• Diet therapy
• Mind body exercises such as qigong and t’ai chi
• Chinese
  
  massage
  (tui na)

Chinese herbal medicine

Chinese herbal medicine is centred on the use of plants, but also some minerals and animal products. These herbs are often combined in formulas and administered as capsules, powders or teas.

Different herbs are chosen based on the person’s symptoms. These may be single herbs or a combination, with the different herbs playing different roles.


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Acupuncture

Acupuncture is the practise of inserting needles (4-25mm long) into specific areas of the body to stimulate sensory

nerves.

The stimulation of nerves can result in the release of chemicals in the body including endorphins.

Research studies have demonstrated that acupuncture therapy may benefit peripheral

diabetic neuropathy
and reduce

nerve pain.


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Evidence showing a positive effect of acupuncture on blood glucose levels are limited to animal studies.

Diet therapy

Diet therapy in Chinese medicine is based around eating natural whole foods. Chinese

diet
therapy puts forward the idea that diabetes is down to excess internal heat.

The remedy is to have cooling foods. Many

fruits
and vegetables, tofun, certain grains and certain seafood are defined as being cooling foods.


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Whilst eating natural, whole foods is a good step, care should be taken about choice of foods as Chinese diet therapy lacks a strong scientific basis.

Note that grains and most fruits are relatively high in carbohydrate. Too much carbohydrate in the diet is linked with high blood glucose levels and poor blood glucose control.

Qigong and t’ai chi

T’ai chi and Qigong are martial arts that have evolved into different forms including low impact exercise. In this form, they are characterised by controlled breathing, stretching, balance and slow, flowing movements.

T’ai chi and Qigong are recognised as being particularly useful for some

elderly people
as research suggests that they may improve psychological wellbeing and balance to prevent falls.


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Tui na massage therapy

Tui na is a form of massage therapy that uses techniques such as kneading, pull and pushing of the flesh at acupressure points.

Whilst research has found positive results for tui na in a number of areas of health, such as lower back pain and

high blood pressure, however, stronger and more reliable research is needed to qualify the benefits.


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Colour, music and art are sensory or creative therapies. A number of studies have been run to test the benefit of these therapies on different aspects of diabetes.

There is some evidence that art and music therapy can have some benefits for certain people but the

research
to date is limited to small studies, therefore the reliability of the findings is not guaranteed.

In this guide, we review which studies have been run and what they can tell us.

Art therapy

Art therapy can help someone with diabetes regain a sense of control and maintain a feeling of independence.

The therapy could help people move towards gaining acceptance of diabetes which is an important hurdle to cross. Accepting diabetes can lead people towards taking ownership of their diabetes which in turn can lead to improvement in

diabetes management

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A 2013 study into art therapy for children with uncontrolled

type 1 diabetes
showed evidence of benefits for diabetes management.

The children chosen to take part had been struggling with self-management. Needle phobia and difficulty adhering to a good diet and taking injections were some of the main issues encountered by the

children.
Art therapy was maintained for an average of about 9 months in the intervention group of children.

The study showed that those taking part in art therapy improved their

HbA1c
by 9 mmol/mol (0.8%) on average compared with the control group.


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Music therapy

Most of us find music can be useful for relaxing and motivation. Research has also tested music therapy and shown that it may have some short-term benefits in certain areas.

A 2013 study found evidence that music therapy could help lower systolic blood pressure of patients with diabetes and

high blood pressure

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Listening to pleasant music could help reduce feelings of pain, according to a study from 2008. This effect could, for example, have short-term benefits for people with a degree of

neuropathy pain

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Colour therapy

Colour therapy, also known as chromotherapy, is based on the idea that different colours can help with physical and

mental health

However, there is little evidence to demonstrate that the therapy has treatment potential in diabetes.

Homeopathy treatment is based on the use of highly diluted substances. Scientific research has shown homeopathic medicine to have no evidence of benefit beyond a placebo effect.

Homeopathy should not be used to treat any

type of diabetes
or diabetes related complications. It must not replace any prescription medication you are currently taking.

What is homeopathy?

Homeopathy was developed in Germany and has been used for more than 200 years.

A homeopath will select the most appropriate medicines for you based on your symptoms, then heavily dilute and shake these substances in water.

Whilst practitioners claim these substances can be used to treat a wide variety of illnesses, research shows no scientific evidence that the treatments are any better than using a placebo.

A placebo effect is when people experience a benefit that is psychological and not brought on by any therapeutic effect of the medication.

Does homeopathy work?

There is no evidence to support the use of homeopathy for treating medical conditions.

In the UK, the House of Commons’ Science and Technology Committee called for the

NHS
to withdraw funding of homeopathy; concluding that there was no evidence that homeopathy works beyond a placebo effect.

The British Medical Association supports the view that homeopathy is not supported by evidence and therefore should not be funded on the NHS.


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It is not only the UK that has found no scientific basis for homeopathy. The Australian Government’s National Health and Medical Research Council states in a 2015 review:

“Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective.

“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay

treatments
for which there is good evidence for safety and effectiveness.”


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Availability

Despite the lack of evidence for the effectiveness of homeopathy, many health shops and pharmacies sell homeopathic tablets or other remedies.

There is no legal regulation of homeopathic practitioners in the UK, and no qualifications or experience is needed to practice homeopathy.

If you are considering homeopathy for your diabetes, you should first consult your healthcare team. Do not stop taking any

diabetes medication
as this can put you in danger.

Some people with diabetes might benefit from additional treatments, referred to as complementary and alternative medicine (CAM), that are not part of standard medical care.

Additional treatments can help people with diabetes who have problems such as nerve pain, which can develop from

diabetic neuropathy
Some therapies can also help with relaxation and relieving stress.

However, it is important to understand how each individual therapy could affect your diabetes and your health. You should consult

your diabetes health care team
and your doctor before receiving any alternative therapies.

Alternative treatment guides

Some therapies will work for some individuals, others simply will not.

Please click on the links below for more information:

• 
  Chinese Medicine and Acupuncture
• 
  Ayurverdic Medicine
• 
  Dietary Supplements
• 
  Aromatherapy
• 
  Relaxation Therapy and Guided Imagery
• 
  Massage Therapy and Reflexology
• 
  Biofeedback
• 
  Colour, Music and Art Therapy

Diabetes and other complementary alternative medicines

Some people with diabetes might be able to obtain benefits from alternative treatments to complement the treatments from their doctor.

However, bear in mind that some treatments may interact with your standard

treatment
or have side effects. For this reason, it’s important to discuss with your doctor which alternative therapies you are considering before you undertake them.

Alternative treatments tend not to be the subject of vast scientific research. In many instances, success stories from alternative treatments are anecdotal, and people often have varying experiences of the same treatment.

Crucially, alternative treatments should not be used in place of your existing

diabetes medication
If you have concerns about how an additional treatment might affect your medication, you should see your doctor.