Diabetes and Muscle Cramps: Cause, Prevention, Relief

By Jacqueline Marshall, Jul 30, 2014

Muscle cramps, or spasms, are involuntary contractions (shortening) of our skeletal muscles.

Cramps can occur at any time but often wake people during the night. They can affect any muscle but usually show up in the calf, front and back thigh, feet, and arms.

Since having either high or low blood sugar contributes to spasms, many people with diabetes report having from mild to severely painful muscle cramping.

Causes of Cramping

Glucose and Electrolytes. The proper contraction and relaxation of our muscles requires a fuel source such as glucose, and a balanced exchange of electrolytes (e.g., sodium, potassium, calcium, magnesium) flowing through the cell membranes.

When blood sugar is low, the muscles can become starved for fuel. When blood sugar runs high our body excretes excess glucose via urine, causing dehydration, and a depletion of electrolytes.

These types of imbalances cause cramping in athletes engaged in extended strenuous exercise, those who are active without proper conditioning or hydration, and in active or sedentary people with fluctuating blood glucose.

Nerves and Circulation. Complications from diabetes can trigger muscle cramps as well. Since poor circulation and nerve damage may instigate spasms, people with peripheral vascular disease or peripheral neuropathy may be prone to cramps. In rare cases, muscle cramps are a symptom of kidney problems.

Medications and Others. Medications and substances that contribute to the incidence of muscle cramps include insulin, lipid (cholesterol) lowering drugs, antihypertensives, beta-agonists, antipsychotics, oral contraceptives, and alcohol.

Muscle cramps are also associated with thyroid disease, hemodialysis, fatigue, pregnancy, poor flexibility, spinal nerve compression, and sitting, standing, or lying in one position for long periods.

Preventing Cramps: Six Suggestions

Other than monitoring your glucose carefully, consider the following tips to prevent muscle cramps.

1. Before going to bed loosen your muscles with a hot bath or shower, by riding an exercise bike a few minutes, or doing some gentle stretching exercises.
2. Warm up your muscles well before exercising and stay hydrated.
3. Eat foods rich in calcium, potassium, and magnesium such as milk, broccoli, salmon, sardines, and bananas, and talk to your doctor about the advisability of taking nutritional supplements.
4. Wear supportive shoes, and if you stand a lot—stand on a rubber mat.
5. Consider practicing yoga to keep your muscles and joints flexible.
6. Avoid sitting still for long periods of time.

Calming the Cramps

Let your diabetes care team know if you are experiencing muscle cramps. They can run simple tests to pinpoint the exact cause, if necessary, and recommend individualized solutions.

The most common remedy for muscle cramps is to massage and stretch the affected muscle. For instance, if the calf muscle is cramping you can massage it and/or stretch out the leg, and gently pull the toes toward the top of the foot.

Some people find relief with warm or cold compresses. or rub an ice cube over the cramping muscle. Others use an anti-inflammatory such as ibuprofen or take prescribed muscle relaxers. There is some controversy about using quinine tablets or drinking tonic water for muscle cramps, so it is best to discuss this questionable option with your doctor.