The Surprising Ways Spa Time Affects Your Blood Sugar
By: Alicia Downs RN, MSN, CDCES, BC-ADM, Director of Patient Care and Education
I was recently gifted with a “spa day” by my amazing partner who knows that loving as a person with T1D can be extra stressful. As I proceeded to the massaged into a boneless mass and moisturized into dermatologic bliss I had time to reflect on how a spa day can impact blood sugar and I realized that the day (or days like it) had the potential to be decidedly LESS than relaxing for insulin users if we were not prepared. So here are some things to consider before you arrive to be pampered (or pummeled, to each their own) with self-care.
From saunas, hotsprings and hot massage oil to heated blankets, hot yoga and volcano salt rooms, heat seems to be a staple of the spa experience. (I think I lost a pound of sweat laying on the heated massage and facial tables not moving an inch!) For a lot of us heat will have a few impacts to think about!
Heat increases capillary circulation, which can lead to insulin absorbing more rapidly than usual.
This can cause sudden unexpected drops in blood sugar. Even long-acting insulin can get a sudden boost in blood sugar lowering, and then not last as long as usual.
The heat itself can also cause blood glucose to drop in some people.
We want to keep this in mind and reduce bolus doses, set temp targets, and keep fast-acting carbs on hand throughout services. When on long-acting insulin we should also be prepared to add correction boluses, or back up the timing of our next long acting injection, if possible, to cover a possible gap in coverage.
Insulin worn in pumps (particularly patch pumps) can also be cooked by heat of hot tubs, hydro therapy, and even heated wraps and blankets.
Avoid submerging these or keep a close eye following heated services for unexpected high blood sugars that signal compromised insulin.
But, diabetes is never quite so simple!
Heat can cause a stress response for some people, which can elevate blood sugars!
If it’s your first time at the spa I recommend to plan for low blood sugars, but check in and be ready to reverse course and treat a high bg.
Another thing that can impact blood sugars is massage!
Massaging an area where you recently bolused can speed absorption too, so either ask your masseuse to avoid that small area, or once again be ready to treat a possible drop in bg.
Just the thought of stripping down and having a stranger touch us can be unnerving!
The anticipation could cause blood sugars to rise!
Once again, our individual responses can go either way, so check in with yourself. For me, I find that the deep relaxation of a spa day reduces my typical workday/motherhood stress level and I run a bit lower. I have found that I need a basal reduction for relaxation! (A powerful reminder of the amazing impact of stress reduction on our blood sugar management)
Services themselves impacting blood sugars directly is rare since most do not include eating or drinking. But if a cleansing tea or other item is part of the experience you’ll need to think through the impacts of carbs, and herbal ingredients. A good rule of thumb is that if it gives you energy it will raise blood sugar.
One quick word on two special areas of concern that are less than glamorous.
- First is infection avoidance, particularly with pedicures. We all know our feet are at higher risk of infection than those without diabetes. We should avoid having callouses removed with sharp tools by anyone but a podiatrist.
And never do pedicures in foot baths that use jets where you have not seen the system flushed out with sanitizing fluid between uses. The crevices and valves of jets are ideal places for bacteria and fungi to grow. Particularly if you have ingrown toenails or a sore on your foot; ask for an individual basin of water to be used and just enjoy the pampering with more peace of mind.
Never allow your toenails to be cut closely. Files only! And keep them no shorter than the end of your toe; too short increases the risk of ingrown toenails. If you have neuropathy in your feet, this is even more important to avoid injury or infection You should be extra attentive in checking your feet for 3-5 days following a pedicure to be sure there are no issues.
- And colonics… if you’re not sure what that is, I can say with confidence you’ve never had one. And if you want to know, you’re going to have to look it up, I’m not going to describe it here! But suffice to say, they can greatly speed intestinal movement for a period of hours to days. This can reduce carb absorption until things normalize. So be prepared to reduce boluses by about 30% following this one!
With all spa services, be sure to check with your primary care provider for clearance first, especially if you have high or low blood pressure, respiratory issues, skin issues, are pregnant, undergoing cancer treatments, or any other chronic or serious health concerns.
Now that all these considerations have taken the enjoyment all but out of a spa day, remember that the purpose of the day is to relax! So think through your needs well in advance, set reminders and communicate with staff so that on the day you can enjoy self-care without Diabetes getting in the way.
3 Responses
Hi there,
Thank you for the amazing spa. Hope I can have it. This is amazing and really every diabetic person needs it.
Have a wonderful weekend!
Best wishes,
Fifi Ebrahimi
Thank you for helpful, useful advice. One question: Do you mean “podiatrist” rather than “pediatrist” in the sentence below?
We should avoid having callouses removed with sharp tools by anyone but a pediatrist.
thanks for catching the typo that spellcheck missed Cathy.