Diabetes and Restless Leg Syndrome

Written by Ilene Raymond Rush

Restless legs syndrome (RLS) is a common sleep disorder characterized by the urge to move your legs. It is often accompanied by disturbing and uncomfortable leg sensations during nighttime and periods of inactivity.

RLS can make it hard to fall or stay asleep, and can lead to extreme tiredness during the day.

The condition affects 5 to 15 percent of Americans. But a higher percentage of people with diabetes may have RLS, which can be worsened by peripheral neuropathy or nerve damage caused by uncontrolled blood sugars.

In one controlled study, researchers found that out of 140 patients with diabetes, 28.6 percent had RLS, compared with only 7.1 percent in the control group.1

What Causes RLS?

Research suggests that the main cause of RLS is a faulty use of iron in the brain. The brain uses iron to make the chemical dopamine, which works in the part of the brain that controls movement and other brain activities.

Many conditions can affect how much iron is in the brain or how it is used. These include diabetes, kidney failure, Parkinson’s disease, rheumatoid arthritis, pregnancy, and iron deficiency. There is also a genetic component to the disease; people whose family members have RLS are more likely to develop the disorder.

Nerve damage in the legs or feet or sometimes in the arms or hands caused by diabetes can be associated with RLS.

Diagnosing RLS

So far there are no medical tests to diagnose RLS, but doctors may run blood tests or other exams to rule out other conditions. Diagnosis is based on a patient’s symptoms, medication use, the presence of other symptoms or medical conditions, and/or problems with daytime exhaustion.

Patients may be asked to keep a diary of their symptoms to aid in diagnosis.

Signs & Symptoms

For a diagnosis of RLS, four symptoms must be present. They include:

Patients with RLS often describe the unpleasant sensations in their limbs as creeping, crawling, pulling, itching, burning, aching, or electric shocks. Severe cases of RLS may cause painful aches, often in the lower calves. Aching and uncomfortable feelings can also occur in the legs, feet, or arms.

These sensations are experienced deep inside the limbs. Most often they occur in both legs, but can arise in a single leg, move from one leg to another, or impact one leg more than the other.

People with RLS may also experience periodic limb movements of sleep (PLMS), which can cause involuntary jerking or bending of the knees, ankles or hips during sleep.

Treatment of RLS

If RLS is connected to nerve damage caused by diabetes, improved control of blood sugars can often provide some relief.

In people with mild to moderate restless legs syndrome, lifestyle changes can help. This may include stress reduction, starting an exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of alcohol, caffeine, and tobacco.

Other nondrug treatments may include leg massages, soaking your legs in a hot bath, heating pads or ice packs applied to legs, and good sleep habits. Although people may find some relief with these measures, they rarely solve all of the symptoms.

Medications may be helpful for some people with RLS.  These can include Parkinson’s disease medications that increase dopamine in the brain; benzodiazepines, a class of sedative medications to help with sleep; narcotic pain relievers for severe pain; or anticonvulsants or anti-seizure drugs.

If you have an iron deficiency, a doctor may recommend taking a supplement.

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