Diabetes Client in Clinic

[Penn]

Okay, so I worked in my school's student clinic this weekend and one of my clients was new, never having had a massage before. She indicated: diabetes, c-section, and knee surgery. When asked: she takes insulin and had taken it that day, she indicated the location she used and I told her I would avoid the direct area but would be able to work around it; also, she had eaten earlier that morning. (I also discussed the two other concerns.)Okay. She's on the table supine and I've worked my way to her undraped left leg using light compressions (per client's post-requests). It was at this point that she indicated she needed either 'orange juice or candy' as she was experiencing low blood sugar. Her skin was now clammy and perspiring.Ended up giving her three small cups of cold water with sugar to bring her back to normalcy.Needless to say, I was thrown for about a second and then quickly started recalling what to do.I'm bringing this up now in this topic because it is a condition that is very prevalent (especially in the US) and I figure people will add to this topic as time goes on.What did I learn?Always be on the lookout for any client with a history of diabetes having a 'problem' on my table.Always have something to counteract a low blood sugar level.Do not panic.

 

[Jamie]

Diabetes Client in Clinic

Good job. Step One: Remain Calm is often the hardest.Thank you for reminding us to be aware and prepared.

 

[clade]

Diabetes Client in Clinic

If you have a client with diabetes, first find out which type they have.  The most prevalent is type II, or adult-onset diabetes.  This is the type which has seen a huge increase in the last 5 to 10 years and has been referred  to as "epidemic proportions".  Type II can be controlled with diet and exercise---basically getting one's weight under control and not taxing your system so much.  Type I diabetes is insulin-dependent and this is really the type you should have some concern with.  Because all insulin in-take from people with type I diabetes is external (we put it in ourselves either from an injection or from an insulin pump), the chances of becoming hypoglycemic are greatly increased.   Individuals with diabetes all pretty much react differently to low blood sugars, but there is point where things, during a reaction, go from bad to worse where a seizure is following close behind.  The problem is, during these reactions, the person is already not thinking clearly as the only substance we use to fuel our brain is glucose---shut that source off and you essentially lose all cognitive ability.  Orange juice is always a quick fix as it absorbs quickly through the tongue.  Hard candy will get in eventually, but it takes time and does not have the same, quick effect as orange juice.  The best remedy I've found is Hershey's syrup or even honey as they both absorb quickly through the tongue.  If you have a client with Type I diabetes, perhaps ask them what their last glucose reading was, and if they begin sweating or not responding then recommend some juice or something, but chances are they will be reluctant and in denial of what's going on because they really don't know what's going on.  It's tough from your point of view, but I've had hundreds of massages and have never had a reaction on the table.  But, the variance in people's individual control varies greatly and there really is no way of knowing for a first time client.  Hope this helps some.Jeff BaskettSombra Cosmetics Inc.

 

[Karamazov]

Diabetes Client in Clinic

Yes. Thanks for the info. I'm sure it will help others as well in the future.

 

[stupid people suck]

Another thing to be aware of with diabetes is that after a massage their blood sugars can drop.  It has not been proven scientifically because of all the variables (food, exercise, insulin protocol,etc) but it has been a noted phenomena in blood sugar readings before and after a massage.  My husband is Type 1 diabetic and I know it is always a precarious balance with food and insulin, when and how much and whatever else was going on physically and mentally.

 

[Pompal 09.]

good for you  ;Dit is comforting to your client that you were so calm and understanding of her situation.as a side note, i have felt slightly more at ease with diabetics who have the 'pager'-type insulin pump. it really is an incredible system and reduces the likelyhood of a negative reaction.

 

[Tanner]

Diabetes Client in Clinic

Here's a twist on this subject for you. I was diagnosed with type 2 diabetes 3 weeks ago. Kinda why I haven't been around lately (trying to deal with this) I had my practicum yesterday and between clients my teacher was talking to me and noticed I seemed a bit "slow on the uptake" I had a horrible headache and was a bit shaky. I go in and get next client on table when my teacher walks in with 3 different things he had bought out of vending machine and a bottle of water to wash it down with and hydrate me. He actually would not let me start on my client til I ate a small bit of somthing and downed some water first.I felt SO bad. Here my client (their first massage) is nekkidy under a sheet and has to wait 2 more minutes for me to woof down somthing so I don't crash during her massage.I was embarrassed. But I was also thinking "What a great teacher. He noticed I was not doing well and he cared enough to go get me some food. "I have to make sure as the therapist I have food handy for myself so my clients aren't suffering because I have a problem.

 

[#2 yankeesfan]

Diabetes Client in Clinic

More and more Type II diabetics are also taking insulin.