Diabetes and Massage

Is Massage Useful in the Management of Diabetes? A Systematic Review

  1. Jeanette Ezzo, MsT, MPH, PhD,
  2. Thomas Donner, MD,
  3. Diane Nickols, BA, PA-Cand
  4. Mary Cox, MsT, BS


In Brief

Massage is among the fastest growing complementary therapies used in the United States. This article systematically reviews the available evidence on potential benefits and adverse effects of massage for people with diabetes. Massage at injection sites may increase insulin absorption. In addition, uncontrolled studies suggest that massage may have a positive effect on blood glucose levels and symptoms of diabetic neuropathy. However, randomized, placebo-controlled studies are needed to confirm any short- and long-term benefits of massage as a complementary treatment for diabetes and to further define an optimal massage treatment.

Massage has been recommended for diabetes for nearly 100 years.1 However, the usefulness of massage for people with diabetes remains unclear as evidenced by a recent exchange on an Internet diabetes message board. One writer posts the message, “Does anyone know if massage can help diabetes?” The only reply is another inquiry: “Hi! If you find out any information on massage therapy, please let me know. I just want to help my 16-year-old daughter, who has been diagnosed with diabetes. How do you think massage can help? Even type 2 diabetics, do you think?”2

If these writers were to surf the World Wide Web in search of answers to their questions, they would likely be left confused and frustrated. Internet information on this topic is fraught with unsubstantiated claims. One site actually suggests that diabetes can be prevented through self-massage.3 Another reports on an individual who allegedly had the bottoms of his feet massaged, eliminated large amounts of sugar in his urine during the second week of treatment, and then recovered from his disease.4 How, then, do consumers decide, or clinicians advise, about the usefulness of massage to people with diabetes?

This article aims to clarify what is and is not known about the usefulness of massage for people with diabetes by summarizing a systematic review of the scientific literature using Cochrane review methodology,5 a method specifically designed to maximize comprehensiveness and minimize bias. Through this method, all relevant studies that meet prespecified inclusion criteria are included in the review regardless of their results.

Using this method, we will address four frequently asked questions:


  1. Can massage improve insulin absorption, for example, by increasing serum insulin in type 1 diabetes or increasing tissue insulin sensitivity in type 2 diabetes?

  2. Can massage help normalize blood glucose levels?

  3. Can massage provide relief of symptoms associated with diabetic neuropathy?

  4. What are the known adverse effects, contraindications, or precautions related to massage for people with diabetes?

    This article copied from American Diabetes Assoc

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