Therapeutic Outcomes of Using Complementary Hand-based Treatment in Diabetes

Therapeutic Outcomes of Using Complementary Hand-based Treatment in Diabetes (TOUCH-D): A Pilot Single-group Feasibility Study Evaluating Biological and Psychological Effects of Swedish Massage in Adults With Type 1 Diabetes.

This pilot study evaluates potential biological and psychological effects of Swedish massage in adults with type 1 diabetes. Massage may influence stress-related mechanisms, such as hypothalamic-pituitary-adrenal (HPA) axis activity and inflammation, which are linked to impaired insulin sensitivity and glycemic control. Twenty participants with type 1 diabetes will receive weekly 45-60-minute Swedish massage sessions for five weeks. Biological outcomes include HbA1c, fasting glucose, copeptin, hs-CRP, IL-6, and TNF-α. Glycemic variability will be assessed using continuous glucose monitoring (CGM). Psychological outcomes include perceived stress (PSS-10) and anxiety (GAD-7). The study aims to explore feasibility, acceptability, and preliminary within-group effects on stress regulation and glycemic balance

Inclusion Criteria:

• Adults (≥18 years) with type 1 diabetes ≥ 1 year
• Able to attend two assessment visits at Vrinnevi Hospital
• Uses CGM or equivalent system
• Able to communicate in Swedish and provide consent

Exclusion Criteria:

• Severe diabetes complications (e.g., advanced neuropathy)
• Acute psychiatric disorder requiring treatment
• Contraindications to massage (e.g., thrombosis, fever, infection, recent surgery)