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Dr. Bernstein Objects to "Hot Tub Therapy"/ Articles
Article: "Hot Tub Therapy" Helps Diabetics, Reuters Health, September 15, 1999

Sitting in a hot tub helped improve blood sugar readings, sleep, and general well being in a group of patients with Type 2 diabetes, reports a Colorado researcher.
 
But a diabetes expert cautions that "hot-tub therapy" can be dangerous for diabetics who have lost feeling in their feet, and increase their risk of skin injuries.
 
The new study, in a letter published Thursday in The New England Journal of Medicine, looked at a group of 8 people with Type 2, or adult-onset, diabetes. Such patients are often told to engage in regular exercise to control their condition, but not all are able to exercise. The researchers conducted the study to see if sitting in a hot tub offered an effect similar to the beneficial effects of exercise for these patients.
 
The research team, led by Dr. Philip L. Hooper from the McKee Medical Center in Loveland, Colorado, found that sitting in a hot tub for 30 minutes a day, 6 days a week for three weeks improved the patients' condition, helping them lose weight and lower their blood sugar or glucose levels.
 
"As the study progressed, they reported improved sleep and an increased general sense of well-being," Hooper writes.
 
After 10 days of such hot-tub therapy, one study participant reduced his daily dose of insulin by 18%, the researchers report.
 
"Our results suggest that hot-tub therapy should be further evaluated as a therapy for patients with Type 2 diabetes," Hooper concludes, suggesting that the benefits "could result from increased blood flow to skeletal muscles."
 
But one diabetes expert, Dr. Richard Bernstein, director of the New York Diabetes Center in Mamaroneck, New York, warns people with Type 2 diabetes to think twice before jumping into the hot tub.
 
"The heat will help dilate blood vessels, which improves blood flow and helps the body use insulin better, but hot tubs can be dangerous for people with diabetes," Bernstein told Reuters Health.
 
"For one thing, people with the condition often have nerve damage in their feet which means they can't feel their feet, so they are likely to get burned in hot baths yet feel no pain at the time," he explained.
 
In addition, soaking in water can harm the skin and make it more susceptible to injury. "For diabetics, sitting in the hot tub is just asking for trouble," he adds. "There are much better ways to lower insulin resistance. Exercise is fabulous, weight loss is great, and several medications are also helpful," he adds.
 
Type 2 diabetes afflicts about 15 million Americans; most of whom are older than age 45 and overweight. People with this type of diabetes do not make enough insulin or do not use insulin properly. Without enough insulin, sugar builds up in the bloodstream. Type 2 diabetes is typically controlled by eating a healthy, low-fat diet, maintaining a normal body weight, and engaging in regular exercise. Sometimes medication is necessary to help the body use insulin. (Source: The New England Journal of Medicine, 1999; 341:924-925.)