Massage for Type I Diabetes – Part 2: Contraindications

Although massage therapy has many benefits for Type I diabetic patients, there are contraindications that must be respected and performed to avoid complications and/or patient harm. This information can be used in objective, action, and assessment areas of charting. Some information, such as “I have high blood sugar” statements can be used in subjective areas of the patient’s chart when the comments have not yet been confirmed with records request. Asking the patient to sign a records request to validate information helps ensure better patient outcomes.

Contraindications:

  1. Record areas of hyper- and hypo- sensitivity and update regularly. Review these prior to massaging at each appointment.
  2. Keep lubricant a hand-width away from injection sites, pump tubing, or unhealed lesions and ulcers to avoid infection.
  3. Residual insulin can accumulate at fibrotic injection sites. Do not touch these sites! Avoid all direct pressure on them or a release of accumulated insulin could result, endangering the patient with unintended hypoglycemia.
  4. Symptoms of hypoglycemia require immediate medical attention. Stop the massage and dial 911 if the patient develops a pallor, sweating, extreme irritability, muscle weakness, nausea, vomiting, confusion, seizure or LOC (loss of consciousness) and/or coma.
  5. Avoid long-duration massages that may produce systemic responses such as blood pressure and glucose changes.
  6. Avoid excessive turning or repositioning that challenges mobility.
  7. Protect any prosthesis from lubricant contamination.
  8. Get approval before massaging any amputation site.

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