DIABETES THERAPEUTIC MASSAGE AND TRADITIONAL CHINESE MEDICINE

           What is diabetes?

In western medicine diabetes is a disease in which your immune system attacks and destroys the cells in the pancreas that produce insulin. Without the proper amount of insulin blood glucose levels are elevated. Glucose is the bodies main source of energy provided by the food we consume. Somtimes our bodies pancreas cannot produce or use insulin effectively. When this happens the glucose remains in the body and the cells care deprived. Overtime an excess of glucose in the body causes numerous health problems.There is no known cure for diabetes but you can take steps to manage your diabetes. 

            Are there different types of diabetes?

Western medicine recognizes 3 main types of diabetes 

       * Type 1

Thought to be an autoimmune disorder that is closely corelated to your generics and environment. Diabetes mellitus results from the autoimmune destruction of the insulin producing beta cells in the pancreas.  The lack of insulin leads to increased blood and urine glucose. Type 1 usually presents in childhood,  but it could appear at any age. Type 1 diabetes requires daily insulin injections to stay alive. 

        * Type2

With type 2 diabetes the pancreas produces insulin but the body is unable to use the the insulin appropriately. Type 2 is closely linked to lifestyle choices, diet, exercise, as well as family history. Physical activity a clean balanced diet and close attention to blood glucose levels can greatly reduce symptoms of type 2 diabetes and help control blood sugar providing a better quality of life, with hard work type to diabetes can be cured. 

         * Gestational diabetes 

This type of diabetes develops during pregnancy and usually goes away after the birth of the child. If you have Gestational diabetes then you are more likely to get Type 2 later in life.

           How common is diabetes?

Approximately 1.5 million people are diagnosed  with diabetes each year. More Americans die each year from diabetes than AIDS and breast cancer combined. Almost 80,000 people each year die from diabetic complications.

           Symptoms of diabetes 

Frequent urination 

Excessive thirst

Extremely hunger

Slow healing cuts 

Extreme fatigue 

Numb limbs

Sweet taste and smell

Unexplained abnormal behavior 

            What are the treatments for diabetes?

Insulin is the main treatment for type 1 diabetes but there are many other things to do to help relieve symptoms. Massage therapy, healthy diet and exercise.  Testing blood sugar levels is very important in determining how much insulin to take. The invention of the insulin pump and CGM have greatly improved the life's of diabetics enabling  better control over blood glucose levels.

            How can massage benefit diabetes?

Massage is highly recommended for any type of diabetes. Some studies have shown it has great effect on lowering glucose levels and helping  neuropathy by bringing circulation to the affected area. Diabetic massage allows the muscles to relax and calms the mind. Reducing the physical and mental ailments associated with diabetes. Having diabetes is a life long condrion that takes an extreme routine lifestyle change and abundance of dedication to ones self. The client would benefit greatly from relaxation massage alone, because of the amount of care and mental stress that they deal with daily. Diabetics that often have hypoglycemia may experience a thickening of connective tissue. Massage can help loosen the muscle and tissue providing better circulation, range of motion and flexibility by relaxing the tendons, ligaments, and muscles. Foot massage is especially important because most diabetics eventually have restricted blood flow and circulation to the extremities causing neuropathy and can eventually lead to amputation. 

       What are the contraindications for massage?

There are not alot of Contraindications for diabetic massage, but it is very important to realize that a full body massage may drop blood glucose levels by 20-40 points and can result in hypoglycemia. It may be smart to keep orange or apple juice around in case of an emergency. Recognize the symptoms of a diabetic emergency:

         Excessive sweating 

         Trembling or shaking

         Pounding heart rate 

         Dizziness 

         Confusion 

         Personality change

         Unable to wake

         Non coherent communication

It is important that if your client is able to chew that you give them juice or something with a lot of sugar immediately. If they are not responding call 911 right away. You may also need to be aware of recent insulin injections sites and use universal precautions for any open wounds. Diabetics often have loss of pressure sensitivity so it is up to the therapist to judge how much pressure is appropriate.

           What does Traditional Chinese Medicine have to offer diabetics?

     Studies have shown that Thai chi can lower blood sugar, blood pressure, boost the immune system and even help with weight-loss. Western medicine says high blood glucose will damage the kidneys. Eastern medicine believes that both high blood sugar and the treatment affects the kidneys. Once the spleen and pancreas are showing problems the next major organ to be affected is the kidneys. Both schools of medicine agree that blood glucose is the main problem, but the treatments are very different. TCM uses herbs to strengthen the kidneys so they can better withstand the effects of high blood sugar. These same herbal remedies provide relief from many symptoms including frequent urination, cooling inflammation and adding nutrients to the digestive system, as well as tingling and numbness in extremities and blurred vision. With Type 2 diabetes the herbs will calm the intestines and stomach bringing the pancreas back to a normal state, resolving excessive thirst and hunger. Once the disharmony in the organs is addressed the blood sugar  should return to a normal level.

      TCM practitioners believe diabetes is a result of eating too much fatty, sugary, rich foods. They see poor diet as one of the four contributing factors pertaining to the root cause of diabetes. This is believed to be a depletion of the yin energy - a cool dark and earthy energy combined with excessive asthenic fire in body. It is recommended to avoid greasy, sweet food and alcohol, they exhaust the spleen and create  damp heat. Also an unstable emotional life disrupts the flow of Qi and causes stagnation leading to an excess of internal fire. One more note is that excessive sexual intercourse depletes the kidney essence imparing the ability to provide yin to the body.

     TCM divides treatments into three main sections the upper, middle,  lower wasting:

     Upper wasting: characterized by excessive thirst,  dry mouth and irritability. Red tongue with a thin yellow coating, and rapid pulse. Having lung heat with depletion Syndrome. Rise in internal heat in lungs and a deficancy in body fluids(yin jin). Treatment includes a concoction of coptis chinesis, ophiopogon japonica and radix Rehman.

     Middle wasting : Shows as excessive hunger, bad breath, weight-loss, constipation, dry stool, oral ulcers, excessive thirst and urine output. Also tongue will show red with a yellow coating and pulse is rapid. Stomach fire syndrome is resolved using a remedy known as Jade maiden decoction made with gypsum fibrosum, rhizome anemarrhenae and gardenia jasminoides.

     Lower wasting:  Can be described as excessive turbid urination, lower lumbar pain, knee weakness, fatigue, dizziness, tinnitus, dry lips and dry itchy skin. Tongue diagnosis shows a red tongue with little to no coating. The pulse is thin and rapid. Treatmentment consists of six-flavor rehmannia pills made with schisandra, Chinese yam and wolf berry or gogi berry.

        Acupressure Protocols      

SP Qi Deficiency  alone, with dampness or damp heat

LV Stagnation  alone, or with fire

☝ Upper Wasting - LU Heat

Symptoms: 

Dry throat and mouth 

Excessive thirst 

Frequent urination 

Tongue: Red with dry yellow coat

Pulse: Rapid 

Treatment points 

👉 St. John treatment points (modified)

👉 SP6 Tonify yin

👉 ST36 Tonify Qi

👉 LU 5 Clear lung heat

👉 UB13 LU Shu

✌ Middle Wasting - ST Dryness

symptoms:

Excessive hunger 

Epigastric pain

Constipation 

Tongue: yellow dry coat

Pulse: Rapid 

Treatment points 

👉 St. John treatment points 

👉 SP6 tonify ST/SP

👉 ST36 Tonify Qi 

👉 ST44 Clear ST Heat and dryness

👉 KD3 Tonify KD

👉 UB20 SP Shu

👉 UB21 ST Shu

👌 Lower Wasting - KD Yin and Jing

Symptoms: 

Sore back

Knee pain

Weak lower body

Dizziness 

Blurry vision 

frequent urination 

Dry mouth

Tongue: Red no coat

Pulse:fine, rapid

Treatment points 

👉 St. John treatment points  ( modified) 

👉 KD 6 Tonify yin

👉 KD3 Tonify KD

👉 CV4 Tonify Yin 

👉 SP6 Tonify ST/ SP Yin

👉 GV20 Raise the yang

👉 UB23 KD Shu

Spleen Qi Deficiency 

Symptoms: 

Fatigue 

Weakness

Poor appetite 

Loose stools

May generate dampness combined with heat

Tongue: pale with teeth marks coated dampness 

Pulse: empty, slippery with dampness 

Treatment points 

👉 St. John treatment points ( modified) 

👉 SP3 Tonify SP

👉 SP6 Tonify SP yin

👉 ST36 Tonify Qi 

👉 CV12 ST Mu

👉 UB21 ST shu

👉 in damp SP9

👉 if damp effecting head ST8

👉 if damp heat LI 11

LV Qi Stagnation 

Symptoms: 

Depression 

Anger

Belching 

Gas

PMS

Menstrual cycle irregularities 

Tongue: normal pale, purple ( red with yellow coat with liver fire)

Pulse: wiry (rapid with LV fire)

Treatment points 

👉 St. John's points(with modifications)

👉 LV3 with LI4 four gates TX harmonize  LV

👉 LV14 LV MU

👉 PC6 open the chest calm the spirit

👉 UB18 LV Shu

👉 if LV fire LV2

There are many more treatments out there but I hope that someone can use this information!

NS 2021

References:

 

https://www.humantouch.com/blog/all-things-considered-what-are-the-effects-of-massage-for-people-with-diabetes.html

https://www.massagetherapyreference.com/diabetes-massage-contraindications/

https://www.euyansang.com/en_US/home

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes

https://www.diabetes.co.uk/diabetes-history.html

http://www.diabete.qc.ca/en/understand-diabetes/all-about-diabetes/history-of-diabetes/treating-diabetes-1921-to-the-present-day/

Mayo Clinic

https://www.integrativehealthcare.org/mt/massage-therapy-and-diabetes

https://www.nwpc.com/

Yinyanghouse.com