Hydrotherapy as an evidence-based nursing intervention for managing type 2 diabetes mellitus: An integrative review
DOI: https://doi.org/10.33024/minh.v9i2.2373
Evidence-Basedpractice Glycemic Control Hydrotherapy Type 2 Diabetes Mellitus
Abstract
Background: Type 2 diabetes mellitus (DM) is a major global health challenge. Effective management requires non pharmacological interventions in addition to medication. Hydrotherapy, a non invasive and affordable water-based therapy, shows promise in improving blood glucose, insulin sensitivity, and vascular function. This review identifies hydrotherapy interventions for type 2 DM and evaluates their clinical impact.
Purpose: To analyze how to improve adherence in type 2 diabetes mellitus patients in implementing the five pillars of diabetes mellitus management.
Method: This integrative reviews the size devidence on hydrotherapy for type 2 DM, guided by two questions: "what forms of hydrotherapy intervention are used in the management of type 2 diabetes mellitus?" and "What is the impact of hydrotherapy on clinical out comes for patients with type 2 diabetes mellitus?". The population, intervention, outcome (PIO) frame work was used. A systematic literature search was conducted across major electronic data bases (PubMed, Scopus, Web of Science, EBSCO host: Medline). Seventeen relevant studies were included after screening.
Results: Hydrotherapy interventions include hot water baths/immersions, aquaticexercise, hot/cold compression, and oral water consumption. Aquatic exercise can lower HbA1c, fasting glucose, and insulin levels. Hot baths may reduce poor glycemic control and decrease fasting plasma glucose. The tests revealed animmediate decrease in blood glucose. Oral hydrotherapy improved the ankle brachial index. Hydrotherapy also improved quality of life, physical health and reduced stress. The benefits extend to lipid profiles and obesity , as well as blood flow, vascular function, pain, and mobility.
Conclusion: Hydrotherapy is a potential complementary intervention for type 2 DM, offering benefits interms of glycemic control, vascular function, quality of life, and physical symptoms. Its non pharmacological, non invasive, afford able, and safe nature make sit a viable nursing option, especially in resource-limited are as. While nurses are crucial in its implementation, current studies have limitations interms of methodology, standardization, and long-term data. Further robust research is needed for widerad option.
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References
Abdul Basith Khan, M., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes—global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), 107-111.
Andriati, R., Pratiwi, R. D., Muthoinah, L., Yudiatma, M. F., & Poddar, S. (2025). Hydrotherapy on Reducing Blood Sugar Levels in Patients with Type II Diabetes Mellitus in Ciputat Village, South of Tangerang City. Window of Health: Jurnal Kesehatan, 40-48.
Åsa, C., Maria, S., Katharina, S. S., & Bert, A. (2012). Aquatic exercise is effective in improving exercise performance in patients with heart failure and type 2 diabetes mellitus. Evidence‐Based Complementary and Alternative Medicine, 2012(1), 349209.
Bakaliuk, T. G., Маkarchuk, N. R., & Stelmakh, H. O. (2022). Assessment of the Quality of Life of Patients with Diabetic Polyneuropathy Using Hydrogen Sulphide Baths. Acta Balneologica, 170(4).
Beever, R. (2010). The effects of repeated thermal therapy on quality of life in patients with type II diabetes mellitus. The Journal of Alternative and Complementary Medicine: Paradigm, Practice, and Policy Advancing Integrative Health, 16(6), 677-681.
Blahova, J., Martiniakova, M., Babikova, M., Kovacova, V., Mondockova, V., & Omelka, R. (2021). Pharmaceutical drugs and natural therapeutic products for the treatment of type 2 diabetes mellitus. Pharmaceuticals, 14(8), 806.
Bonab, S. B., & Dastah, S. (2023). Performing training in water improves glucose homeostasis and lipocalins in women with type 2 diabetes mellitus. Science & Sports, 38(1), 34-41.
Chidambaram, Y., Vijayakumar, V., Ravi, P., Boopalan, D., Anandhan, A., & Kuppusamy, M. (2024). Does hydrotherapy influence plasma glucose levels in type 2 diabetes?–A scoping review. Journal of Complementary and Integrative Medicine, 21(1), 14-18.
Das, S. V., Mooventhan, A., & Manjunath, N. K. (2018). A Study on Immediate Effect of Cold Abdominal Pack on Blood Glucose Level and Cardiovascular Functions in Patients with Type 2 Diabetes Mellitus. Journal of Clinical & Diagnostic Research, 12(3).
De Fronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., Hu, F. B., Kahn, C. R., Raz, I., Shulman, G. I., & Simonson, D.C. (2015). Type 2 diabetes mellitus. Nature reviews Disease primers, 1(1), 15019.
Dogaru, G., Ciubean, A. D., Marinescu, L., Pop, B. M., Pașca, G. S., & Ciumărnean, L. (2025). The effectiveness of balneotherapy on pain, walking, and function in patients with diabetic neuropathy: a prospective observational study. International Journal of Biometeorology, 69(2), 319-329.
Endang, S. P. N., Rizki, F., Ah, Y., Bisepta, P., & Ifa, H. (2024). Factors Associated with Positive Religious Coping in Diabetic Foot Ulcer Patients in Indonesia. Journal of Korean Academy of psychiatric and Mental Health Nursing, 33(3), 221-228.
Fioravanti, A., Adamczyk, P., Pascarelli, N. A., Giannitti, C., Urso, R., Tołodziecki, M., & Ponikowska, I. (2015). Clinical and biochemical effects of a 3-week program of diet combined with spa therapy in obese and diabetic patients: a pilot open study. International journal of biometeorology, 59(7), 783-789.
Forray, A. I., Coman, M. A., Simonescu-Colan, R., Mazga, A. I., Cherecheș, R. M., & Borzan, C. M. (2023). The global burden of type 2 diabetes attributable to dietary risks: insights from the global burden of disease study 2019. Nutrients, 15(21), 4613.
Huang, X., Wu, Y., Ni, Y., Xu, H., & He, Y. (2025). Global, regional, and national burden of type 2 diabetes mellitus caused by high BMI from 1990 to 2021, and forecasts to 2045: analysis from the global burden of disease study 2021. Frontiers in public health, 13, 1515797.
Kamioka, H., Mori, Y., Horiuchi, T., Hayashi, T., Ohmura, K., Yamaguchi, S., & Kato, M. (2020). Association of daily home-based hot water bathing and glycemic control in ambulatory Japanese patients with type 2 diabetes mellitus during the COVID-19 pandemic: A multicenter cross-sectional study. Diabetes, Metabolic Syndrome and Obesity, 5059-5069.
Leite, R. G. O. F., Banzato, L. R., Galendi, J. S. C., Mendes, A. L., Bolfi, F., Veroniki, A. A., Thabane, L, & Nunes-Nogueira, V. D. S. (2020). Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis. BMJ open, 10(1), e034481.
Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., Song, X., Ren, Y., & Shan, P. F. (2020). Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific reports, 10(1), 14790.
Młynarska, E., Czarnik, W., Dzieża, N., Jędraszak, W., Majchrowicz, G., Prusinowski, F., Stabrawa, M., Rysz, J., & Franczyk, B. (2025). Type 2 diabetes mellitus: new pathogenetic mechanisms, treatment and the most important complications. International journal of molecular sciences, 26(3), 1094.
Mooventhan, A., Chaudhari, S. S., & Venugopal, V. (2019). Effect of cold hip bath on blood glucose levels in patients with type 2 diabetes mellitus: A pilot study. Diabetes & Metabolism, 46(5), 411-412.
Mooventhan, A., Gowthami, R., Krishnamurthy, D., & Nivethitha, L. (2024). A narrative review on the role of naturopathy in the management of diabetes mellitus. Journal of Integrative Medicine and Research, 2(4), 229-234.
Mooventhan, A., Venugopal, V., & Chaudari, S. S. (2020). Twenty minutes of gastro-hepatic pack reduces blood glucose levels in patients with type 2 diabetes mellitus: A pilot single group pre-post study. Advances in Integrative Medicine, 7(3), 148-151.
Ohtsuka, Y., Yabunaka, N., Watanabe, I., Noro, H., & Agishi, Y. (1996). Balneotherapy and platelet glutathione metabolism in type II diabetic patients. International Journal of Biometeorology, 39(3), 156-159.
Petrofsky, J. S., Lohman 3rd, E., Lee, S., De La Cuesta, Z., Labial, L., Iouciulescu, R., Moseley, B., Korson, R., & Al Malty, A. (2006). The influence of alterations in room temperature on skin blood flow during contrast baths in patients with diabetes. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 12(7), CR290-5.
Petrofsky, J., Lohman III, E., Lee, S., Cuesta, Z. D. L., Labial, L., Iouciulescu, R., Moseley, B., Korson, R., & Malty, A. A. (2007). Effects of contrast baths on skin blood flow on the dorsal and plantar foot in people with type 2 diabetes and age-matched controls. Physiotherapy Theory and Practice, 23(4), 189-197.
Qiu, Y., Zhu, Y., Jia, W., Chen, S., & Meng, Q. (2014). Spa adjuvant therapy improves diabetic lower extremity arterial disease. Complementary Therapies in Medicine, 22(4), 655-661.
Raveendran, A. V. (2018). Non-pharmacological Treatment Options in the Management of Diabetes Mellitus. European Endocrinology, 14(2), 31.
Rob, A., Hoque, A., Asaduzzaman, M. M., Khatoon, M. A. A., Khalil, R., Thomas, D., Ilyas, M., Mahmood, H., & Chowdhury, T. A. (2025). The global challenges of type 2 diabetes. Bangladesh Journal of Medicine, 36(2), 92-98.
Scheer, A. S., Naylor, L. H., Gan, S. K., Charlesworth, J., Benjanuvatra, N., Green, D. J., & Maiorana, A. J. (2020). The effects of water-based exercise training in people with type 2 diabetes. Medicine and science in sports and exercise, 52(2), 417-424.
Schenaarts, L., Hendriks, F. K., Fuchs, C. J., Sluijsmans, W. E., Snijders, T., & van Loon, L. J. (2024). A single sauna session does not improve postprandial blood glucose handling in individuals with type 2 diabetes mellitus: a cross-over, randomized, controlled trial. Experimental and Clinical Endocrinology & Diabetes, 132(11), 622-630.
Setiawan, A., & Pribadi, D. R. A. (2024). The Effect of Hydrotherapy on Reducing Blood Sugar Levels in Patients with Diabetes Mellitus. Journal of Health Sciences, 17(02), 100-106.
Sirait, H. S., Said, F. M., & Mohamad, N. A. (2025). Non-Pharmacology Therapy For Reducing Vascular Inflammation Among Type 2 Diabetes Mellitus Patient: A Literature Review. Holistic Nursing Plus, 3(1), 90-106.
Sunaryo, T., Lestari, S., & Khor, B. F. A. S. (2020). The effect of oral hydrotherapy on risk reduction of diabetic feet ulcer among people with type-2 diabetes mellitus. Enfermeria Clinica, 30, 192-195.
Vijay, A., Nivethitha, L., Mooventhan, A., & Manavalan, N. (2025). The impact of cold hydrotherapy applications on insulin resistance in patients with type 2 diabetes mellitus: A protocol for a single group pre post test study. Bangladesh Journal of Endocrinology and Metabolism, 4(2), 61-66.
Wang, X., Kang, J., Liu, Q., Tong, T., & Quan, H. (2020). Fighting diabetes mellitus: Pharmacological and non-pharmacological approaches. Current pharmaceutical design, 26(39), 4992-5001.
Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of advanced nursing, 52(5), 546-553.
Xu, S. T., Sun, M., & Xiang, Y. (2025). Global, regional, and national trends in type 2 diabetes mellitus burden among adolescents and young adults aged 10–24 years from 1990 to 2021: a trend analysis from the Global Burden of Disease Study 2021. World Journal of Pediatrics, 21(1), 73-89.
Ye, J., Wu, Y., Yang, S., Zhu, D., Chen, F., Chen, J., Ji, X., & Hou, K. (2023). The global, regional and national burden of type 2 diabetes mellitus in the past, present and future: a systematic analysis of the Global Burden of Disease Study 2019. Frontiers in endocrinology, 14, 1192629.
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature reviews endocrinology, 14(2), 88-98.
Zhou, Z., Sun, B., Yu, D., & Zhu, C. (2022). Gut microbiota: an important player in type 2 diabetes mellitus. Frontiers in cellular and infection microbiology, 12, 834485.
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