In diabetes, leg circulation problems can cause cramps, but they can also cause “cramps that are not quite cramps,” which can be mistaken for restless legs disorder.
If you are diabetic, do any of these symptoms apply to you?
- Difficult-to-describe but uncomfortable sensations build up in the calves of one or both legs. (In some people, these sensations can also occur on the backs of the arms.) The only way to stop the sensation is to move the body.
- Movement of the legs, arms, or torso stops the sensation.
- The sensation occurs at any time of day but increases during the evening.
- The need to move the body to stop the unpleasant sensation interferes with sleep.
What Is Periodic Limb Movement Disorder?
There is also a very similar condition called periodic limb movement disorder. Periodic limb movement disorder occurs during sleep rather than before sleep. In this condition:
- The legs twitch or jerk periodically during sleep.
- The motion may be barely noticeable or strong enough to knock sheets or blanket off the bed.
- The movements may occur only once or twice a night, or every 30 to 90 seconds throughout the night.
If you go to the doctor and recite these symptoms, chance are you will be sent home with a sedative.
Doctors often prescribe the same medications for these disorders as they do for Parkinson’s disease. The oldest drug used for all three disorders is Sinemet, which is the trade name for a drug known as L-dopa.
This drug provides the brain with the neurotransmitter dopamine, which increases the ability of “control neurons” to communicate during the night and stop twitches. Newer drugs such as Mirapex (primapexole) and Requip (ropinirole) stop the brain from breaking down dopamine.
Medications and “Common Sense” Solutions Just Make the Problem Worse
There are two problems with these drugs, even if you need them. One is that they make nighttime leg twitches better, but they make early morning leg twitches worse. The other is that users tend to need more and more of them, and they get more and more nausea, constipation, and hypersexuality as higher doses lead to more side effects.
Many people who use these drugs are not warned that a greatly stimulated sex drive, sometimes with uncontrollable erections in men, can result at higher doses taken over a period of years.
Of course, many diabetics just are not willing to suffer the side effects of the drugs they are likely to get. They try avoiding their symptoms it by staying up later and later in an attempt to get so tired and sleepy that maybe the twitches and kicks just won’t happen. Unfortunately, this strategy seldom works, either, and the result is ever increasing fatigue. But there is a better way.
A Better Way to Deal with “Cramps that Are Not Quite Cramps”
In type 2 diabetes, simple leg circulation problems often mimic restless legs syndrome and nighttime period limb movement disorder. Sometimes what is needed is not heavy medication, but lighten and gentle massage of the lower legs, for about half an hour, before going to bed.
Gentle massage on the legs stimulates blood flow right down to your toes. Oddly enough, the big toe on your right foot will get stimulation before the other toes on your right foot, and the middle toes on your left foot will get stimulation on your left foot before the big toe and little toe. You probably will feel different sensation in your left foot and your right foot, and then in your left leg and your right leg.
But the increased circulation to your legs helps the nerves in your legs get enough oxygen to stay still all night. It’s really wonderful if you can hire a professional massage therapist to come to your home every night to massage your legs to health.