Diabetes-Related Leg Cramps: How to Prevent and Treat

Being suddenly woken up by a painful knot in your calf—or frozen toes—isn't fun. Here's what diabetes has to do with it and what you do to stop the pain.


Painful Leg Cramps and DiabetesSome research suggests diabetes is linked to an increased frequency of painful leg cramps.

Perhaps you’ve been there—in the middle of a perfectly restful night of sleep you are abruptly woken up by an intense pain from a cramping muscle, typically in your foot or calf. 

Although the exact cause of muscle cramps is still up for debate, they are frequently linked to poor flexibility and muscle fatigue. A smaller body of research also suggests that diabetes can increase your risk of experiencing leg cramps, potentially due to swings in blood sugar levels, certain medications, and long-term complications such as diabetic neuropathy (nerve damage).1,2 With or without diabetes, these cramps are characterized by the sudden, involuntary, and painful tightening (contraction) of a muscle. They occur most frequently in the evenings in the following muscle groups:

  • Calf muscles (back of the lower leg)
  • Hamstrings (back of the thigh)
  • Quadriceps (front of the thigh)
  • Cramps can also occur in the hands, feet, arms, neck, and abdomen

What causes these painful cramps and how can I prevent them?

“Although the exact cause of muscle cramps remains unknown, they are not inevitable,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE. While cramps may seemingly come on without warning, knowing the factors and situations that can cause muscle cramps can help you understand them, prevent them, and treat them. Here, some reasons for cramps and what you can do to avoid them:

  • Uncontrolled blood sugar levels. Glucose is required for muscles to contract and relax, so if your blood sugar levels are too high or low, it impacts the body’s ability to regulate these activities properly.1 Controlling your blood sugar levels is important in preventing muscle issues. One study found that 75% of participants with type 2 diabetes reported experiencing leg cramps, compared to 39.5% in participants without diabetes.
  • Dehydration. If you don’t consume enough water, it can lead to an imbalance in your electrolyte levels, which can trigger muscle cramps. Remember to stay ahead of your thirst and drink water regularly to avoid dehydration.
  • Medications. Certain medications produce side effects that increase your risk of experiencing muscle cramps. Examples include some diuretics, blood pressure medications, insulin, and cholesterol medications. Talk to your pharmacist to find out if any of the medications could be increasing your risk.

  • Lack of nutrients. Low levels of potassium, calcium, and other vitamins and minerals can cause an imbalance that contributes to muscle cramping. Eating a well-balanced diet can help. Supplements are also an option, but check with your doctor before adding any to your health routine—some aren’t recommended with specific medications you might be taking for your diabetes or the associated complications.
  • Diabetic nephropathy. Kidney damage caused by diabetes, also known as diabetic nephropathy, has been associated with muscle cramps.
  • Diabetic neuropathy. Diabetic neuropathy is nerve damage caused by high blood sugar levels over time. Roughly 70% of people with diabetes experience some form of neuropathy.3 Symptoms include: numbness, tingling, or pain in the extremities.This nerve damage can contribute to muscle cramping. Talk to your doctor about ways to prevent or manage neuropathy.
  • Tight muscles. If you partake in more physical activity than usual and overwork a particular muscle group, you might experience some muscle tightness or cramping. Even if you’re not exercising more than usual, staying loose is important.

How can I stop the pain?

OnTrack Diabetes editorial board advisor Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE has two techniques you can try:

  • Stretch before bed. “Place your hands against a wall at shoulder height. Place the leg you want to stretch behind you, toes facing forward and heel on the floor. Lean forward, with the front leg bent and the back leg straight, until you feel a stretch in the calf. Hold the stretch for 30 seconds, without bouncing, and do one to two repetitions with each leg.”
  • Massage to stop the pain. If you do experience a cramp, try to “gently stretch and massage the cramping muscle, holding your joint in a stretched position until the cramp stops,” Hess-Fischl recommends. For example, if your calf muscle is cramping, try pulling your toes toward the top of your foot.

Home remedies abound all over the internet and include everything from taking a swig of dill pickle juice, placing a bare, cramping foot on a cold floor and even, pinching the skin under your nose very tightly! None of these techniques are based in science but you can certainly try them at your own risk. 

How serious are muscle cramps?

In many cases, muscle cramps are infrequent and relatively harmless, but it’s important to recognize that other complications and conditions can be confused with muscle cramps.

  • Frequent leg pain can signal worsening diabetic neuropathy. Research suggests that painful peripheral neuropathy occurs in 1 out of every 4 people living with diabetes.4
  • Leg pain can also be a sign of peripheral artery disease (PAD), characterized by a plaque buildup in the arteries, which prevents blood flow throughout the body.5
  • Severe cases of restless leg syndrome (RLS) may cause painful aches, often in the lower calves and other extremities. RLS is more common in those with diabetes than the general population.6

If you continue to experience frequent muscle cramps or pain, talk to your doctor. Either you’ll have peace of mind that it’s nothing serious, or you’ll be one step closer to figuring out what’s happening with your body and how to best address it.

Updated on: August 8, 2017
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