Get in the hot tub; soak down that blood sugar
A good hot soak can do wonders for the mind and spirit, and now a Colorado researcher has found that soaking in a hot tub can bring about significant reduction in blood sugars as well.
In a letter to the editor published in the Journal of the American Medical Association, Philip L. Hooper, MD, an endocrinologist affiliated with the University of Colorado Health Sciences Center in Loveland, reported reductions in weight, fasting plasma glucose levels, and HbA1cs for eight patients involved in the study.
The Type 2 diabetic patients were submerged up to their shoulders for 30 minutes daily, six days a week, for three weeks. They were instructed not to make any other changes in their diabetes regimen during that time.
Even though the study was small, Hooper says his results warrant further investigation:
• Mean fasting plasma glucose dropped from 182 +/- 37 mg/dL to 159 +/- 42 mg/dL.
• Mean HbA1c dropped a full percentage point, from 11.3 +/- 3.1% to 10.3 +/- 2.6%.
• Weight decreased by a mean of 1.7 kg.
Hooper reported that one patient reduced his insulin dosage by 18% after 10 days of hot tub therapy. Patients also reported improved sleep and an increased general sense of well-being.
He theorizes that the hot water simulates exercise by increasing the blood flow to skeletal muscles, thereby reducing insulin resistance. He notes that the benefits dropped sharply six weeks after his study when patients had discontinued the therapy.
Clinicians may be asked about hot tub therapy since the study was reported in the popular press. He says the results probably could be duplicated if the patient can submerge up to the shoulders in a hot bathtub. "I’d recommend it in particular for patients who cannot ambulate. This might really help people who are unable to exercise for a variety of reasons, including gross obesity and osteo-arthritic back pain."
Two patients in Hooper’s study were morbidly obese. One weighed 440 pounds, and the other weighed 380 pounds.
In general, soaking in hot water has not been recommended for diabetics. Hooper theorizes this is because hot water can cause a temporary drop in blood pressure. Patients in his study were assisted by an attendant when they exited the hot tub and seated until they could walk safely.
Soaking in hot water may not be advisable for patients with peripheral neuropathy since they might be unable to detect the temperature of the water. Hooper used temperatures between 37 and 41 degrees Centigrade. He also says Type 1 diabetics using a hot tub might find a drop in blood sugar in the hours following a soak, so they may need to adjust meals and medications accordingly.
While hot tub therapy is far from becoming standard practice, it’s an "intriguing" idea, says Alain Baron, MD, chairman of the department of endocrinology at Indiana University Medical School in Indianapolis, who has written about the benefits to diabetics when skeletal muscles are profused with blood.
"This is highly controversial," he says. "In theory, there is reason to believe if the skeletal muscle is profused by putting people into a tub, it might work. But this needs more study."
Baron says it is unclear whether the hot water actually increases blood flow to the muscles or if it simply increases blood flow to the skin and theorizes that the benefits reported may be a simple product of the increased attention received by patients. "The more you start paying attention to the patient, the more good things start to happen. If you just spend time with a patient, he’ll usually get better."
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