The point of a spa visit is to immerse yourself in the relaxing experience and savor it, letting go of routine worries while you’re being pampered.
But, tell that to type 1 diabetes (T1D). Planning a spa experience with T1D on board can raise your angst, for sure.
There are the concerns… What if I go low during a treatment? Will I be able to keep my phone near me for CGM readings?
And there are the old wives’ tales and myths that seem to ring in your ears… Pedicures can be dangerous! Sugar scrubs elevate your blood sugars! Body wraps are bad for diabetes!
The good news for people with T1D is that a spa escape is totally doable for you, whether it’s an afternoon at the nail salon or a sleepover resort. With the right preparation, understanding, and factual knowledge, your spa visit can be just as fulfilling and relaxing as it is for the next person.
Dr. Stephen Brewer, medical director of the famed Canyon Ranch in California, Massachusetts, Nevada, and Arizona told DiabetesMine they welcome people with T1D regularly, and are always ready to make things go well — as any good spa should be.
Brewer says the first step is crucial: “Make sure you go to a reputable place.”
At Canyon Ranch and all reputable spots, “most practitioners have had training not just in treatments, but in medicine overall,” he said. That means you can expect most practitioners you interact with to have at least a basic knowledge of diabetes, one you can build on for any specific needs or adaptations you may require.
Cara Kilroy, a nurse practitioner at Joslin Diabetes Center in Boston, Massachusetts, who works closely with young adults and adults, said she advises clients regularly on how to spa well.
Her first piece of advice is simple: “You can do it,” she told DiabetesMine. “But let’s talk about reducing your risk. If you have a hint of hesitation, reach out (to your diabetes medical provider). It’s welcome by us and expected.”
Julia Blanchette, PhD, registered nurse and certified diabetes care and education specialist at the University of Utah College of Nursing, has had T1D since she was 7 years old and has been a spa treatment enthusiast for nearly just as long.
“There’s no reason not to embrace that fun,” she said of spa experiences. “Just know your own needs and be prepared.”
DiabetesMine turned to these experts to gather tips on how to do a spa experience well. We also broke down some of the common myths around spa visits and treatments with T1D.
Pedicures are absolutely fine, with a caveat
Blanchette gets pedicures regularly, both at destination spas as well as at locations near her home that she knows and trusts. Her advice: “If you’ve had a period of time with your blood sugars out of range, or have a slow-healing cut, you may want to consider just a polish change until your blood sugars are more in range or cuts heal.”
“If you have neuropathy, a skin rash, or any kind of circulation disorder, that’s more of a red flag,” she said, “But that does not mean it cannot be done.”
Rather, it’s important to discuss those issues with your medical advisor and then share any special treatment plans with your practitioner on spa day, she said.
Go all in for massages, but be prepared
Blanchette said she goes for massages often, particularly during more stressful work times, since stress reduction is good for people in general, and for blood sugars as well. Her first tip? Disclose your diabetes to the spa and your treatment provider.
Kilroy agrees that massages can be beneficial to people with diabetes.
“I don’t know if there is clinical evidence to support this, but we do hopefully become relaxed with massage, and I do think (reducing stress) can show a positive shift in blood sugars,” she said.
Have a device plan
If you wear an insulin pump or CGM, let the spa management or your practitioner know that you will need to keep your phone within reach for medical reasons. If you have the option, you can also bring along your non-phone CGM receiver or a basic glucose monitor.
You may also want to ask your massage practitioner to avoid rubbing around the areas of your body where your CGM sensor or insulin infusion set are placed — particularly if they are using creams and oils. You’ll also want to explain any alarms that may go off during a treatment, Blanchette said.
Have a blood glucose plan
You’ll want to time your eating, physical activity, and insulin dosing in a way that reduces your risk of running very high or very low blood sugars during a spa treatment.
Much of this comes with practice, Blanchette said. For her, going into a massage having just eaten and with a blood sugar over 120 mg/dL works well. Discuss a plan with your medical provider and then tweak it with experience, she said.
She also suggests having an easily accessible source of rapid-acting glucose on hand should you need it while on the table. This should be easy if you have your purse or bag nearby in the treatment room, but some spas encourage clients to put their belongings in lockers, so be sure to bring a small stash of fast-acting sugar that you can keep within reach.
Know that you can call a timeout
It can be aggravating to have to interrupt a spa treatment. You’re in the middle of relaxing, and even more, you’re paying a premium for those minutes. So the thought of losing some of that precious time can lead people to put off needing a restroom break or — in the case of T1D — thinking you may need to correct a high or low blood sugar.
But Brewer said practitioners really don’t mind pausing the clock for health emergencies.
“I don’t think there is a practitioner out there who isn’t going to stop and help you,” he said. “We care about [our clients].”
Body wraps do take some forethought
Kilroy says body wraps can be great for relaxation, but people with diabetes do need to discuss it with their medical provider ahead of time, particularly if they have any circulation or neuropathy challenges.
“Heat is something to be careful about in that situation,” she said. If your doctor says you are good to go for a wrap, she suggests before being wrapped, putting your hand on the wrap and seeing how hot it feels.
If it worries you, she said, ask to have it cooled a bit, or decline it.
In addition, it’s going to be difficult to reach for emergency glucose should you feel low during a body wrap. It’s very important to let your practitioner know about this risk and ask them to be ready to help in case you need that sugar pronto.
Plan carefully for any spa exercise program
Brewer suggests if a spa stay involves workouts, particularly if they are ones you’ve either never done or are more intense than you’ve done before, do some homework ahead of time to know what your body might need.
A good spa, he said, will discuss the workouts with you ahead of time so you can ease into them beforehand and a get a feel for where your blood sugars should be and any extra snacks you may need for them.
Take that information, he said, and talk to your medical provider at home ahead of time to come up with a plan, “Even if you have a CGM.”
Be your own advocate
Spas and providers cannot help you get the experience that best fits you unless you speak up. And far from being annoyed, they welcome the input, Brewer said.
Kilroy from Joslin agrees. “Advocating for yourself is really important,” she said. “Whether it is to carry a device or for the firmness of a treatment or just something that feels off, speak up. Don’t’ feel shy. The aftermath of an infection or something else is way more serious than feeling awkward saying something on the spot.”
“Phones are taboo in a spa”
There’s more flexibility here than you might think.
Brewer says that at Canyon Ranch, while they do not encourage chatting on the phone in spa areas, they do tend to see many people carrying their phones, since they use the Abbott Freestyle Libre as part of their spa visit program even for people without diabetes. “It’s not a problem here,” he said.
Most spas have similar approaches. While they have rules against talking and tapping away on your phone during your time there, they’re usually quite comfortable with clients carrying their phones for safety reasons.
“Sugar and other scrubs can elevate blood sugars”
It’s understandable to worry that sugar might be absorbed into your skin, but there’s no truth to it, Kilroy said. “You are not going to absorb any of it at a concentration that will impact blood sugars.”
“Botox interacts negatively with insulin”
Not true, said Blanchette, who has regular Botox treatments for medical reasons. Her tip: Get them from someone you know and trust who hopefully has some medical background.
She gets hers from her long-time dentist, who both knows her diabetes from years of treatment, and has a medical background.
“Acupuncture with diabetes may cause infection”
Not so. Brewer, who is an expert at acupuncture, said it is perfectly safe for people with diabetes — just as safe as for the general population. He does suggest letting your practitioner know about your T1D before they start. That way, they can take extra precautions like using more alcohol during treatment.
Overall, the key to a great spa visit, be it a quick or an extended one, is preparation.
A little work ahead of time can lock in the special experience you’ve hoping for, and avoid the disappointment of having your relaxation derailed by T1D, Brewer said.
“Setting things up, knowing [as much as you can] what to expect and what you need, instead of waiting to deal with things as they may arise is key,” he said.
Blanchette agreed, saying: “It can be frustrating to have to take extra steps ahead of time. But when you have T1D, you’re used to that. And if it brings you a wonderful spa experience? Totally worth it.”