Cramps are common in diabetics. This occurs in about 80% of people with type 2 diabetes and about 60% of people with type 1 diabetes. Cramps tend to be more common in the lower legs and at night. This cramping can be confused with hypocalcemia. So how to avoid cramps and how to get rid of cramps? The information below will help you to add to your knowledge about this phenomenon.
When you have leg pain and cramps related to diabetes, you have options in pain relief. Managing diabetic foot pain and cramps also helps prevent serious injury and improves your quality of life.
Leg cramps often occur as a result of a type of nerve damage called diabetic neuropathy. If you have leg pain and leg cramps related to diabetes, your doctor will teach you how to relieve the painful symptoms with medication, diet, exercise, etc.
1. Why do Diabetics often Get Cramps?
If diabetes damages the nerves in your arms or legs, it is called diabetic peripheral neuropathy. This complication may be a direct result of the long-term high blood sugar (hyperglycemia) of type 2 diabetes.
People with peripheral nerves often feel pain and tingling like ants when they have leg cramps. The disease can also lead to serious complications in the legs. Early detection of nerve damage is important in preventing this complication that can lead to amputation.
Diabetics often experience cramps that are explained by 3 main reasons:
1.1. Blood sugar is too high or too low
Sugar (glucose) is necessary for muscle contraction and regulation and also regulates the metabolism of electrolytes in muscle cells. Unstable blood sugar levels are the main cause of cramps in diabetics.
When blood sugar is too low, muscle cells are “hungry for glucose” so they are not able to stretch and flex, leading to cramps. If blood sugar is too high, the body has a mechanism to eliminate excess glucose by itself, pulling water and electrolytes that reduce electrolytes causing cramps.
Nutrients such as sodium, potassium, magnesium, … are not fully loaded, making the muscles weak and can cause cramps, this condition is often encountered in pregnant women when they are inserted. force the blood vessels in the lower extremities and feet to bear the weight of the body.
1.2. Due to complications of diabetic nerve damage
In patients with diabetes, blood sugar is often elevated and prolonged, causing certain damage to nerve cells. Damage can occur in any nerve cell in the body, but is most pronounced in the legs and arms.
At this time, the nerve cells are less sensitive, leading to the feeling of numbness in the limbs, cramps and tingling.
In addition, neurological complications may have accompanying manifestations such as burning pain, mild itching, loss of sensation, even calluses or decreased sweating.
1.3. Due to the use of drugs
Medications used to treat diabetes are also one of the causes of cramps in patients. Physicians think that it is the rapid and intense insulin regimens that control hyperglycemia in patients with a previous history of prolonged hyperglycemia that may lead to minor peripheral nerve fiber damage. However, this insulin neuroinflammation is uncommon in patients with diabetes.
In 1992, Duke University reported on cases of cramps in diabetic patients related to insulin injections. Subsequent studies have shown that insulin injections reduce serum potassium levels which in turn lead to potassium imbalance in muscle cells that causes cramps.
Some other drugs also have side effects that lead to cramps in patients such as: antihypertensive drugs, lipid (cholesterol) lowering drugs, Beta agonists …
2. Are Diabetic Cramps Dangerous? How Long Will It Happen?
Frequent cramps in diabetics may be a precursor to diabetic neuropathy. Therefore, if cramps occur daily and many times a day, absolutely not to be taken lightly, the patient should be checked by a doctor immediately.
Without timely remedial measures, cramps will continue to occur and do not go away on their own, affecting the patient’s quality of life.
However, if it is checked and cared for properly, this situation will diminish after about 2-4 weeks.
3. How to Treat Leg Cramps at Home?
Diabetic cramps are one of the warning signs of diabetic neuropathy. Therefore, patients need appropriate care to reduce the risk of neurological complications and other complications.
3.1. Feet and legs care
Every time you have a cramp, you should find ways to make it reduce or disappear, otherwise it will be very painful, very uncomfortable, even very dangerous. When cramp occurs in the calf muscles, straighten the leg and gently bend the toes back, pressing one hand firmly against the heel.
At the beginning of application, the pain may increase, but soon the pain will decrease because the muscles stop contracting and the blood circulation is restored. When the cramps are gone, gently massage the muscle that has just been spastic to allow blood to circulate again to avoid recurring cramps. At the place of cramps, if possible, you can rub oils to warm the skin and muscles or apply cold packs with ice packs or take a warm bath to improve blood circulation. Also try to get up and walk or wiggle your feet.
For cramps, the patient should relax the muscles, combine with gentle massage of the painful area to relax and then slowly move. Home remedies for foot and hand care also help reduce cramps for diabetics relatively effectively and safely, such as massage, physical therapy.
With physical therapy, you can learn exercises that target pain relief in your legs. Other treatments include electrical nerve stimulation and light therapy, which can be used in physical therapy. Acupuncture is a potential treatment being studied in diabetes clinical trials.
In addition, people with diabetes can also take home measures such as walking, cycling, soaking feet in warm water to reduce cramps and numbness in the limbs.
3.2. Building a scientific diet
A diabetic diet is very important for general health as well as reducing leg cramps. However, dietary supplements do not cure foot pain and are still being studied for safety and effectiveness. Furthermore, not all patients need these supplements because they get equivalent nutrients from food on a daily basis. It’s important to discuss supplements with your doctor before using them to treat diabetic leg cramps, especially if you take any medications.
In addition, people with diabetes need to supplement the following substances to treat and prevent neurological complications:
- Alpha-lipoic acid (ALA): ALA intravenously or taken orally improves blood sugar levels and relieves symptoms of numbness in the limbs. Patients also need to be supplemented with ALA in daily foods such as: red meat (beef, pork, …), probiotics, animal organs (kidney, liver), broccoli, spinach, .
- Acetyl-L-carnitine: Acetyl-L-carnitine is believed to have the ability to promote the production of nerve cells. At the same time, this substance also helps to significantly reduce blood sugar by increasing the activity of enzymes that increase the use of sugar by muscle cells. Therefore, Acetyl-L-carnitine supplementation reduces the risk of diabetic neuropathy. Some foods rich in Acetyl-L-carnitine are: beef, pork, fish, chicken, milk, etc.
- Vitamin B12: Vitamin B12 helps support red blood cell function, regulate nerve cell activity, and prevent damage. Vitamin B12 deficiency also increases the risk of diabetic neuropathy. Vitamin B12 can be supplemented from foods: animal liver, beef, cereals, salmon, clams, milk, eggs, etc.
- Vitamin D: This is a vitamin that plays an important role in controlling blood calcium levels, helping the contraction and relaxation of muscles to be flexibly regulated. Since then, vitamin D contributes to reducing numbness and tingling of the limbs. In addition, many studies show that vitamin D improves the body’s sensitivity to insulin, effectively lowering blood sugar. Foods rich in vitamin D need to be supplemented for people with diabetes: mushrooms, egg yolks, shrimp, cod liver oil, salmon, oysters, etc.
- Magnesium: This supplementation for diabetics with cramps is extremely necessary. Among the essential minerals for the body, calcium and magnesium directly cause cramps. Muscle contraction when calcium and magnesium when they fully dilated. When the body lacks the micronutrients of magnesium and calcium for muscles, it leads to an imbalance in muscle contraction and relaxation, causing frequent cramps.
When working hard, sweating a lot, it is necessary to add water mixed with salt (preferably oresol solution). Need to drink enough water in a day/night (about 1.5-2l).
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3.3. Using painkillers
In case diabetics have severe cramps and have been diagnosed with neurological complications, patients need to use pain relievers to treat symptoms, soothe pain, and muscle paralysis. Two commonly used pain relievers are Paracetamol and Ibuprofen.
In addition, if the pain is too severe, you can use some other opioid pain relievers such as codeine, tramadol, tapentadol, sprays and topical applications.
4. Control the Pain of Cramps
It’s important to tell your doctor about leg cramps pain, even if the symptoms don’t interfere with daily activities. If leg cramps are frequent or the pain is sharp, it could be a sign of worsening diabetic neuropathy. Please report the common symptoms to your doctor immediately.
Even mild leg pain and cramps should take note. Even if you don’t have neuropathy, these symptoms could be signs of peripheral artery disease (PAD). Diabetes puts you at a higher risk of developing PAD, which is a serious condition characterized by blockage of blood vessels in the legs. PAD also increases the risk of heart attack and stroke. The National Institute of Heart, Lung, and Hematology estimates that one in three adults with diabetes over age 50 has PAD. Most people don’t realize they have PAD because the warning signs of the disease are so subtle.
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