Thursday, July 18, 2024

Diabetes Muscle Weakness And Fatigue

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How Is Diabetic Neuropathy Diagnosed

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Early diagnosis of diabetic neuropathy gives patients the best chance of effective treatment. But since not all foot or limb pain means diabetic neuropathy, accurate diagnosis is important to ensure appropriate treatment.

Diagnosis of diabetic neuropathies is based on history, clinical examination and supporting laboratory tests. Your doctor may:

  • Check muscle strength and reflexes.
  • Check muscle sensitivity to position, vibration, temperature and light touch.
  • Request additional tests, such as:
    • Ultrasound to determine how parts of the urinary tract are functioning.
    • Electromyography to determine how muscles respond to electrical impulses.
    • Nerve conduction studies to check flow of electrical current through a nerve.
    • Skin biopsies to evaluate cutaneous nerve innervation.
    • Nerve and muscle biopsies for histopathological evaluation.

A comprehensive evaluation including a review of blood pressure, cholesterol and blood glucose screenings combined with more advanced screening, helps the doctor rule out other causes and identify the core problem.

Various Approaches To Pain Management

People who have trouble moving due to muscle aches can explore various approaches to pain management, based on the advice of their health care team. Physical approaches may include applying heat or cold to the affected area, rest, exercise, and massage therapy. Neurological approaches that can help include meditation and relaxation exercise, such as hobbies or playing with a pet. It may also help to keep the mind busy with challenges such as playing Sudoku or completing crossword puzzles. Alternative therapies may also make a difference, such as the use of essential oils, such as clove, ginger or rosemary. Some people find antioxidants relieve pain, such as turmeric, chamomile or Echinacea. Laughter can also relieve pain. Watch a comedy show or try laughter yoga for some relief. Consider talk therapy from a professional if you need to.

Diabetes is often linked with neuropathy, muscle pain, and fatigue. Healthy lifestyle habits, losing weight, regular exercise, and maintaining proper blood glucose control can make a difference. Talk to your doctor about ways to relieve pain and move forward with your life more comfortably.

Can Neuropathy Be Reversed

If the underlying cause of the neuropathy can be treated and cured , its possible that the neuropathy can be reversed too. However, frequently by the time individuals are diagnosed with a neuropathy, there is some degree of permanent damage that can’t be fixed.

Even though this is the general belief of today, its not the hope of tomorrow. Nerve damage may be reversible someday. Researchers are already seeing positive results the regrowth of nerve fibers in a drug study in mice with diabetes. Ongoing research combined with living a healthy lifestyle so the body can repair itself will likely be needed. Stay tuned.

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Look Into Topical Treatments And Medications

Topical treatments can help relieve diabetic leg pain with few side effects or drug interactions. Consider using lidocaine patches and capsaicin cream to alleviate your pain.

Although opioids are not suggested for diabetic leg pain, over-the-counter pain relievers may provide relief when pain flares up. Other medications to treat this type of chronic pain may include tricyclic antidepressants.

What Is Diabetes Fatigue

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As it was mentioned above, diabetes fatigue is an extreme tiredness that individuals with diabetes can experience. It is a tiredness that disrupts a persons life and makes it difficult to function. It is very common, and studies have shown that 85% of those with diabetes experience fatigue.

Some signs of fatigue include:

  • Dizziness

Reactive hypoglycemia, a term used to define the crash that a person gets after eating a lot of sugar and carbs, can be an early sign of diabetes. In order for the body to use the sugars and carbs that are consumed for fuel, each molecule must be paired with insulin to get into the cell. If there isnt enough insulin available, then the sugar molecules stay in the bloodstream and cause high blood sugar.

What happens is that over time, eating a lot of sugar and carbs causes your body to have to produce a lot of insulin. Eventually, you develop insulin resistance and the insulin stops working as well which causes your body to make even more to keep the blood sugar under control. So after eating a large meal of sugar and carbs, the body starts producing a lot of insulin to try to use the food for energy. The problem is that after the food is digested, there is still insulin floating around and it causes the sugar to drop.

Signs of reactive hypoglycemia are:

  • Difficulty concentration
  • Dizziness
  • Palpitations

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Controlling Blood Glucose Levels

Getting blood glucose levels under control cant reverse nerve damage but can prevent further damage from occurring. Your doctor will give you specific blood sugar goals. Managing these levels includes eating a healthy diet high in protein and low in carbs. When you eat carbs, try to choose food with a higher fiber content, avoiding chips and soda.

Regular exercise can help keep blood sugar levels manageable by increasing insulin sensitivity, meaning youll need to take less insulin each day. Getting enough sleep is also important, as we often crave high-carb foods when overly tired.

How Is Hypoglycemia Treated

The treatment of hypoglycemia depends upon its cause. If you’re otherwise healthy and you notice occasional hypoglycemia-like symptoms, try eating a diet that’s lower in simple sugars and/or try cutting down on your caffeine intake. If this doesn’t make the symptoms go away, be sure to talk with your doctor.

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Causes Of Peripheral Neuropathy

Neuropathy is one of the long-termcomplicationsof diabetes.

Over time, highblood glucose levelscan damage the small blood vessels that supply the nerves in your body. This stops essential nutrients reaching the nerves. As a result, the nerve fibres can become damaged, and they may disappear.

This can cause problems in many different parts of your body, depending on the type of nerve affected.

How Quickly Does Neuropathy Develop

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Some peripheral neuropathies develop slowly over months to years while others develop more rapidly and continue to get worse. There are over 100 types of neuropathies and each type can develop differently. The way your condition progresses and how quickly your symptoms start can vary greatly depending on the type of nerve or nerves damaged, and the underlying cause of the condition.

There are many causes of neuropathy. Diabetes is the number one cause in the United States. Other common causes include trauma, chemotherapy, alcoholism and autoimmune diseases.

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Rare Causes Of Muscle Weakness

Certain rare conditions can cause muscle weakness:

  • Dermatomyositis: Dermatomyositis is an inflammatory myopathy, or muscle disorder, that also causes skin irritation and rash. Due to the inflammation that develops with dermatomyositis, muscle tissue can break down, causing pain and weakness.
  • Rheumatoid arthritis : RA is an inflammatory, autoimmune form of arthritis that causes progressive joint inflammation and damage, leaving joints painful and stiff and causing muscle weakness around affected joints.
  • Sarcoidosis: Sarcoidosis is a systemic, inflammatory condition of unknown cause with symptoms like arthritis, joint pain, and sarcoid myopathy, which is characterized by muscle weakness, pain, and fatigue.
  • Secondary hyperparathyroidism: Secondary hyperparathyroidism, or excessive parathyroid hormones, is a common complication of kidney disease. Secondary hyperparathyroidism can cause joint pain and muscle weakness as increased parathyroid hormone levels contribute to muscle protein breakdown.
  • Systemic lupus erythematosus : SLE is a systemic, autoimmune condition that causes a skin rash and joint inflammation. It also causes myalgia and myositis , leading to muscle weakness.

How To Deal With Diabetes Fatigue

Its no secret that regular exercise is key in managing and preventing several health-related conditions including type 2 diabetes. In fact, the American Diabetes Association recommends physical activity to all people living with diabetes to manage glycemic control and overall health.

In particular, the ADA urges people living with diabetes to interrupt long periods of sitting with light activity by doing 3 minutes of light exercise every 30 minutes.

While this recommendation tops the list of ways to manage and treat diabetes, exercising when youre experiencing diabetes fatigue is often easier said than done.

Fatigue is common among people with diabetes, which can make it difficult to work up the motivation and energy to stay physically active, explains Dr. Emily Schroeder, an endocrinologist with Kaiser Permanente in Denver.

However, exercise is a crucial part of diabetes management. Schroeder says its vital that patients come up with ways to integrate exercise into their daily routines.

Once you establish a routine, you can gradually increase that activity up to 30 minutes a day or more as your body becomes accustomed to it.

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Research Design And Methods

Ninety-two diabetic patients who had participated in cross-sectional studies on motor function 68 years earlier were identified for follow-up . All patient files in the hospital were examined to identify any disorder that had developed since the first examination and that could interfere with motor performance apart from diabetic distal symmetric polyneuropathy. Such patients were excluded from follow-up. Furthermore, patients with neuropathies other than diabetic distal symmetric polyneuropathy, such as mononeuropathies, mononeuritis multiplex, and proximal diabetic neuropathy, were not included. The remaining patients and their individually matched control subjects were identified and invited to participate. Sixteen patients were excluded due to conditions possibly interfering with motor function, including stroke , intermittent claudication , renal dialysis , toe amputation , severe retinopathy , multiple sclerosis , prosthetic knee replacement , acute erysipelas , breast cancer , cervix cancer treated with radiotherapy , use of crutches for walking , and severe head injury . Three patients could not be located and 10 patients had died, leaving 63 patients for follow-up. All patients received a written invitation, and if no answer was returned a new invitation was sent. Twenty-three patients did not want to participate and 10 patients did not reply, leaving 30 patients for follow-up.

Diagnosis Of Diabetic Neuropathy

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Diabetic neuropathies are often diagnosed through a physical exam. Typically, the person with diabetes explains his or her symptoms to the doctor. The doctor checks the persons blood pressure, heart rate, and muscle strength. The patient will change positions, and the doctor will assess his or her reflexes and sensitivity. Other aspects that might be checked include touch, temperature, and vibration. Always have the doctor check your feet during routine exams. Other tests that might be done to diagnose neuropathy include electromyography or nerve conduction studies, ultrasounds, and a check of heart rate variability.

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What Are The Symptoms Of Neuropathy

Symptoms of neuropathy vary depending on the type and location of the nerves involved. Symptoms can appear suddenly, which is called acute neuropathy, or develop slowly over time, called chronic neuropathy.

Common signs and symptoms of neuropathy include:

  • Tingling or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
  • Sharp, burning, throbbing, stabbing or electric-like pain.
  • Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature or touch. Extreme sensitivity to touch.
  • Falling, loss of coordination.
  • Not being able to feel things in your feet and hands feeling like youre wearing socks or gloves when youre not.
  • Muscle weakness, difficulty walking or moving your arms or legs.
  • Weight loss .

Contribution Of Blood Glucose To Chronic And Acute Fatigue

For the substudy, the majority of patients was willing to participate. Twenty-one patients were excluded because of the presence of a comorbidity . A subset of 68 patients participated. From two patients, no data were obtained. Sixteen patients had incomplete 5-day data sets but were included in the analyses. Reasons for incomplete or absent data were premature sensor removal , technical problems with the CGM system or EFD . In this substudy, participants did not differ from patients not willing to participate regarding age, sex, fatigue severity, and HbA1c . The prevalence of chronic fatigue in the substudy was 37% compared with 40% in the total sample.

Chronically fatigued T1DM patients spent in proportion less time in hypoglycemia compared with nonchronically fatigued patients . There was no significant difference between the two groups in GLmean , Gvar and hyper .

None of the four blood glucose parameters were significantly associated with acute fatigue. Correlations between EFD scores and glucose parameters were GLmean , Gvar , hyper or hypo . GEEs showed no significant between- or within-subject effects of GLmean_hour and Gvar_hour on acute fatigue .

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When To See A Doctor

A person with diabetes should see their doctor regularly to monitor and manage their diabetes.

They may also wish to consult a doctor who specializes in treating new or worsening fatigue that interferes with daily life.

People should seek medical attention for fatigue that occurs alongside other symptoms, such as fever, chills, or malaise, as these could indicate an infection.

Confirming If You Have A Neuropathy

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Some people may need to see a neurologist in hospital for further tests such as:

  • a nerve conduction test where small metal wires called electrodes are placed on your skin which release tiny electric shocks that stimulate your nerves the speed and strength of the nerve signal is measured
  • electromyography where a small needle is inserted through your skin into your muscle and used to measure the electrical activity of your muscles

NCS and EMG are usually carried out at the same time.

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Fatigue Feeling Faint Muscle Weakness And Shaking

Reviewed on 7/13/2021

Muscle weakness and shaking can be features of neurologic conditions including Parkinson disease. Fatigue is a nonspecific symptoms that can accompany many different illnesses. Feeling faint can be a sign of dehydration or other illnesses as well. Be sure to seek the advice of a healthcare provider if you are concerned about these or any other symptoms.

While the list below can be considered as a guide to educate yourself about these conditions, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms and signs. Here are a number of those from MedicineNet:

What Causes Nerve Damage

Nerve damage is the result of high levels of blood glucose over long periods of time. It isnt entirely clear why high glucose levels damage nerves.

A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the Mayo Clinic.

Other factors include high blood pressure and cholesterol levels and nerve inflammation.

Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later.

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Complications Of Peripheral Neuropathy

The outlook for peripheral neuropathy varies, depending on the underlying cause and which nerves have been damaged.

Some cases may improve with time if the underlying cause is treated, whereas in some people the damage may be permanent or may get gradually worse with time.

If the underlying cause of peripheral neuropathy isn’t treated, you may be at risk of developing potentially serious complications, such as a foot ulcer that becomes infected. This can lead to gangrene if untreated, and in severe cases may mean the affected foot has to be amputated.

Peripheral neuropathy may affect the nerves controlling the automatic functions of the heart and circulation system . You may need treatment to increase your blood pressure or, in rare cases, a pacemaker.

Symptoms vary according to the type of peripheral neuropathy and may develop quickly or slowly.

The main types of peripheral neuropathy include:

  • sensory neuropathy damage to the nerves that carry messages of touch, temperature, pain and other sensations to the brain
  • motor neuropathy damage to the nerves that control movement
  • autonomic neuropathy damage to the nerves that control involuntary bodily processes, such as digestion, bladder function and control of blood pressure
  • mononeuropathy damage to a single nerve outside of the central nervous system

In many cases, someone with peripheral neuropathy may have more than one of these types at the same time.

Why Does Having Diabetes Cause Fatigue

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Having diabetes changes your blood. Imagine someone without diabetes having blood that flows like water. Now imagine someone with diabetes having blood that flows like maple syrup. When the blood flows much thicker and slower, like syrup, it is harder for cells to flow through the bloodstream to provide energy and oxygen to parts of the body, including the brain.

Diabetes also causes inflammation, which sends messages to the brain that the body needs to take a rest in order to heal. When this happens, fatigue is going to be a problem.

One of the biggest reasons that diabetes causes fatigue is because of its complications. Organs such as the kidneys, eyes, heart, and the nerves can all be damaged because of diabetes. End stage renal disease, which is when the kidneys fail, can lead to low red blood cells. Low red blood cells, which is also known as anemia, can lead to fatigue. Studies have shown that people with diabetic complications such as nerve damage, heart disease, and kidney problems have increased levels of fatigue. The next section of this article discussed more things that can cause fatigue.

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Modify Your Diet Before Calling Your Doctor

Bergamo says if youre having some of these subtle symptoms try a low-carb diet of protein and green leafy vegetables. Avoid sugary drinks and drink at least 2 liters of water for a few days to see if these symptoms get better.

Subtle symptoms could be just that youre eating too many carbs and your body cant handle it, Bergamo says. It doesnt necessarily mean you have diabetes, but its a wake-up call that maybe youre headed that way.

If you have any symptoms that are frightening such as sudden numbness, weakness or chest pains, call your doctor immediately.

Are you concerned about diabetes? Talk to your doctor about having your blood glucose levels tested. Need a doctor? Find one near you.

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