Diabetes Risk Screening for RMTs: What to Ask Before Hands-On Work

When a client lives with diabetes, your intake can be the difference between a treatment that feels steady and supportive, and one that feels unpredictable. Diabetes risk screening for RMTs is not about diagnosing. It’s about noticing what might make hands-on work safer, more comfortable, and more respectful of what their body is managing that day.

If you’re practising in Toronto (or anywhere in Ontario), this fits beautifully inside what you already do well: clear consent, thoughtful assessment, and good documentation.

Why diabetes screening matters before you start

Diabetes can touch the nervous system, circulation, skin healing, and energy levels. Some clients feel completely stable and have no day-to-day limitations. Others may have:

• Reduced sensation (especially feet and lower legs)
• Skin that bruises or heals more slowly
• Greater sensitivity to pressure, heat, or cold
• Episodes of low blood sugar that can come on quickly

Your job is not to “solve” diabetes. Your job is to make sure the treatment in front of you matches the person in front of you.

The simple intake questions that cover most risks

You can keep this warm and conversational. Here’s a practical sequence that works well.

1) Basics: “What kind of diabetes, and how is it managed?”

• “Do you have Type 1, Type 2, or gestational diabetes history?”
• “Do you use insulin or blood sugar lowering medication?”
• “Do you use a CGM or do finger checks?”

Why it matters: clients using insulin or certain medications can be more vulnerable to hypoglycemia.

2) “How have your blood sugars been lately?”

• “Have you had any lows in the last week?”
• “Do you usually feel warning signs when you’re going low?”
• “Do you have a plan if you start to feel low during the session?”
• “Do you have glucose tablets, juice, or a snack with you?”

This one question alone can change how you pace pressure, breaks, and positioning.

3) Sensation and nerve changes: “How well do you feel pressure and temperature?”

• “Any numbness, tingling, burning, or pins-and-needles?”
• “Any reduced sensation in your feet, lower legs, or hands?”
• “Do you ever feel like you bruise easily or don’t notice pressure until later?”

If sensation is reduced, you may need lighter pressure, more frequent check-ins, and extra caution with feet.

4) Skin and circulation: “Anything I should know about your feet or skin right now?”

• “Any current wounds, blisters, ulcers, or skin infections?”
• “Any swelling, unusual redness, or changes in skin colour?”
• “Any history of circulation issues in the legs or feet?”

If there’s broken skin, active infection, or a concerning change in colour or temperature, it’s often a “pause and reassess” moment.

5) Timing and nourishment: “Did you eat recently?”

• “When did you last eat?”
• “Did you take your usual medication today?”
• “Do you tend to get lightheaded if you lie face down or get up quickly?”

This helps you decide treatment pacing and transitions off the table.

What to watch for during the session (and how to respond calmly)

Most of the time, things go smoothly. Still, it helps to know the “quiet tells”:

Possible low blood sugar signs can include sweating, shakiness, sudden fatigue, confusion, irritability, dizziness, or a spaced-out feeling.

If you notice any of this:

1. Stop hands-on work.
2. Check in gently: “How are you feeling right now?”
3. Help them follow their own plan (snack, glucose tablets, juice).
4. Do not rush them off the table. Let them settle.
5. If symptoms are severe (confusion worsening, fainting, seizure), call emergency services and follow your local emergency procedures.

You’re aiming for calm, steady support. No drama. Just care.

Treatment considerations that keep things safe and comfortable

These are simple adjustments that often help:

• Use more frequent pressure check-ins (especially if neuropathy is present).
• Be conservative with deep, sustained pressure on areas with reduced sensation.
• Be cautious with feet if they have any skin breakdown history.
• Plan slower transitions (supine to sit, sit to stand).
• Keep the room comfortably warm and avoid extremes of heat or cold if sensitivity is altered.
• Document what you asked and what they reported, plus any modifications you made.

Documentation, consent, and scope in Ontario

In Ontario, your standards and record-keeping expectations matter. A clean note answers:

• What you asked (screening questions)
• What they reported (meds, recent lows, sensation changes, skin concerns)
• What you did (treatment plan and modifications)
• How they responded (tolerance, check-ins, outcomes)
• Any referral recommendations if something felt outside your scope

Good charting is not just protective. It’s also a quiet form of respect.

A gentle invitation to book (for clients in Toronto)

If you’re reading this as someone living with diabetes and you want massage that feels unhurried, safe, and well-communicated, you’re welcome here. If you’re in Toronto, you can book a session with Aurelia RMT and we’ll tailor the pace and pressure to your body, exactly as it is today.