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So I just gave a one hour deep tissue/medical massage to a new client that is type 1 Diabetic. After the session she had a few dizzy spells and collapsed. She blacked out one of the times and I had to catch her! :/ After drinking a soda she felt better, but I am shooken up! I am a fairly new therapist and have not experienced this yet. I researched a bit and I Know it can drop glucose levels. From what I found out it's good to have juice/snacks on hand and for them to take their insulin an hour or less before the massage. She had taken her insulin 2 hrs before. She also is experiencing numbness/tingling in her feet which could be peripheral neuropathy. I didn't massage her legs or feet though. Am I safe to give her deep tissue and should I avoid her legs altogether? Any and all advice, experiences, and facts would be greatly appreciated! Thank you!

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Having snacks on hand to help with blood sugar is smart...and check in with your client right before the massage. I always have protein bars in my office and have been known to give a client some if they were super empty.

If someone has peripheral neuropathy there could be an issue with deep tissue. If the pain response is interrupted because of nerve pathology then deep tissue is contraindicated. Good luck!

Hi Trina,

I'm Novlette, a massage practitioner, a reflexology teacher and practitioner. I'm also type 2 Diabetic...

Diabetic Peripheral Neuropathy (DPN) is a nerve disorder that occurs when the nerves of the Peripheral Nervous System (PNS) are damaged. These nerves run from the brain and spinal cord to the PNS, which reaches all areas of the body, including the arms, hands, legs and feet.

DPN affects (1) the Motor Nerves (ie., nerves that control how your muscles move and function);

(2) the Sensory Nerves (ie., nerves that receive sensations such as touch, heat, pain);

(3) Autonomic Nerves (ie., nerves that control autonomic functions such as blood pressure, heart rate, digestion and bladder function).

Treatment for DPN:

Once your body has developed neuropathy, the nerve disorder may never be completely heal, but the discomfort can be alleviated. However, it's best to first consult the client's health care provider about whether massage is good for him/her.

Best regards.

Lucianna~ thank you for your input. I definitely keep snacks on hand now. She came in a second time and said her numbers were high right before. She had a little dizzy spell after still, but not near as bad as last time. Our game plan now is to give her something to eat halfway thru the session so that there's hopefully no dizziness after.

Novlette~ thank you for explaining DPN in more detail. I don't believe this client has it. She just has lack of circulation and gets numb feet from time to time. If she did have DPN though or when her feet are numb is it contrindicated for me to massage the numb area, or atleast deep tissue in the area?

Hi Trina,

I believe Swedish massage would suffice, but still consult with your client's health care provider to be on the safe side. Knowing her numbers is an excellent idea.

Keep up the good work.

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