Massage therapy · Kitchener–WaterlooDiabetes

Type 1 diabetes can start at any age, but it usually begins in children and young adults (NHS, 2024). It is usually caused by a problem with your immune system (an autoimmune condition), and it means your body cannot make enough of the hormone insulin (NHS, 2025a). Insulin helps your body use glucose for energy; without it, the level of glucose in your blood becomes too high (NHS, 2025a). Type 1 diabetes cannot be prevented. You are more likely to get it if other people in your family have type 1 diabetes or another autoimmune condition (NHS, 2025a; NHS, 2024).

In type 2 diabetes, your body does not make enough insulin, or the insulin it makes does not work properly. This is called 'insulin resistance' (NHS, 2025a). It results in too much sugar building up in your blood - a problem called hyperglycaemia.

• being overweight and not very physically active
• having a condition that increases your risk, such as high blood pressure
• age: being over 40 if you are white, or over 25 if you are from a South Asian, Chinese, Black African or Black Caribbean background
• having a parent, brother or sister with type 2 diabetes

Gestational diabetes is high blood sugar that develops during pregnancy. It usually disappears after giving birth, but women who have had it are more likely to develop type 2 diabetes in the future (NHS, 2022).

For type 2 diabetes, lifestyle changes can sometimes lower blood glucose to a normal level and stop diabetes; this is called remission (NHS, 2025c). Type 1 diabetes cannot be prevented or cured, but it can be managed (NHS, 2025a). For all types, managing your blood glucose well can lower your chances of getting complications (NHS, 2025a).

(NHS, 2024; NHS, 2025b)

Ask for an urgent appointment with your family doctor or nurse practitioner if you think you or your child has symptoms of diabetes (NHS, 2025a). If you have diabetes, pain, tingling or numbness in your hands or feet can be a sign of nerve damage, so see your family doctor, nurse practitioner or diabetes nurse if you notice it (NHS, 2025d).

With all diabetes, there is no such thing as a 'diabetic' diet - a healthy balanced diet, including fresh vegetables and fruit, wholegrain foods and pulses, and limiting processed foods with lots of salt and sugar, is very powerful in managing your diabetes (NHS, 2025c). Do not change to a very strict, low-calorie diet without talking to a health professional first (NHS, 2025c). Changing your diet can be difficult, but there is plenty of advice out there - for example, the Diabetes Canada website www.diabetes.ca and your family doctor or nurse practitioner, who can point you in the right direction. The good news is that eating a healthy diet will also protect you from other conditions such as heart disease.

Exercise has so many benefits, both in prevention and management of diabetes. Physical activity helps to maintain a healthy weight, improve mood, improve circulation, reduce blood pressure and control blood sugar levels. The NHS suggests aiming for at least 2.5 hours a week of walking or another activity that leaves you out of breath (NHS, 2025c). For type 1, it is important to monitor your sugar level during prolonged exercise, as it may dip. Keeping hydrated is also particularly important for those with this condition.

Massage therapy does not treat diabetes itself, but I can support you alongside your diabetes team, with care adapted to your blood sugar, feet and skin, help with stress, and help getting more active. See the My Approach tab for how I work.

Options outside my scope

• Insulin: needed for life by people with type 1 diabetes, given by injection or a pump. It is sometimes also used for type 2 diabetes if other medicines do not help (NHS, 2025a; NHS, 2025c).
• Metformin and SGLT2 inhibitors: if you need medicine for type 2 diabetes and have no other serious health conditions, you will usually be offered metformin, which improves the way your body handles insulin, together with an SGLT2 inhibitor, which helps extra sugar pass out of your body in your pee (NHS, 2025c).
• GLP-1 agonists: an injected medicine that may also be offered to some people with type 2 diabetes, for example those with heart disease or those living with obesity (NHS, 2025c).
• Diabetes courses: courses are recommended for everyone with type 2 diabetes to build the skills and confidence to manage it (NHS, 2025c).

Do not stop taking your diabetes medicine unless your doctor or healthcare professional tells you to (NHS, 2025c).

(This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

How I can help (see the My Approach tab)

If you're confused, unusually drowsy or not yourself, I won't massage and you'll need medical care promptly. If someone becomes unresponsive, we call 911.