Leg Pains From Diabetes

QUESTION: My doctor says leg pains come from my diabetes. What's he talking
about? What should I do?
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ANSWER: This is an important issue, for peripheral arterial disease is a
frequent problem amongst diabetics and a major health problem in the United
States. It is caused by diminishing blood flow to the legs and feet due to
the narrowing or constriction of an artery in the lower abdomen or legs. In
the diabetic patient, where circulation in secondary or smaller blood vessels
is particularly poor, vessel complication can become quite serious. The
arteries of diabetics frequently contain high levels of calcium which cause
the arteries to harden, carrying less blood to the muscles. Since blood is
the key supplier of nutrients and oxygen to our vessels, these conditions are
responsible for the pain felt in the lower extremities.
The most severe symptom of arterial disease is intermittent claudication,
a condition that brings on pain in the muscle after brief exercise, which
disappears after a few moments' rest. Fortunately, 60 to 90 percent of
patients can be managed medically. Initial treatment should involve an active
walking program for at least 30 to 60 minutes a day, or until painful symptoms
occur. Walking develops and increases circulation and can significantly
increase a patient's mobility.
Smoking greatly increases risk factors, and diabetics are urged not to
use tobacco in any form. If they are overweight, diet and exercise are
encouraged. Normalizing blood sugar levels are vital to diabetic management,
as well, especially since research confirms that blood sugar control can
prevent or delay vascular complications.
Exposure to extreme heat or cold should also be avoided. Thus, hot foot
or leg soaks, heating pads, and hot water bottles should never be used for
relief. Loose-fitting clothes and comfortable shoes are advised, since
circulation can be affected by anything constricting the body.
Vasodilating drugs are unsuccessful in treating peripheral arterial
disease since they lower systemic pressure and decrease circulation.
Propranolol and other beta-blockers have the same effect, so if you take any
medications of this kind, they may have to be discontinued so improvement can
be measured. Fortunately, there is a new drug called pentoxifylline which has
been successful in alleviating intermittent claudication. It works by making
red blood cells more flexible and allows them to pass through smaller vessels,
thus bringing oxygen and nutrients to areas suffering from arterial blockage.
Its important to check with your doctor about these prescription medications.
Plenty of bed rest is advised and it may be a good idea to raise the head
of your bed in an effort to increase circulation to your lower body. If your
feet swell for any reason, they should be elevated as well. It is also
advisable to avoid activities such as carrying heavy items which strain the
legs.
Your doctor certainly seems to be on the right track, and it is important
that you continue your care. You can help him and yourself by providing him
with valuable information about your condition. Note what you feel and keep a
record that you can bring along when you talk to your doctor. He will be
better able to advise you and obtain any special tests that may become
necessary.