Why are my muscles aching?

[Tim C]

I was diagnosed two months ago with type 1 and since coming out of the hospital and starting on insulin, I haven't felt better in a long time. But for about a week now, i've just had constant aching muscles, mainly arms, but in my legs too and its effecting my sleep. (I had a lot of problems sleeping before I was diagnosed, but then afterwards slept great up until recently) I have started feeling a little bit lacking in energy again too (but not quite like before) and for a about three days my heart rate increased up to about 100. its gone back down now to about 84 the last few days again, which has been my average, but sometimes it feels like it mildly quickley aches a little.

Over the last year I had lost a huge amount of weight and apparently my muscle fat was being eaten away for energy and I always felt weak, achy and fatigued. I don't think this aching feels the same, its a bit more acute, but I have been worried that this is happening again. I have not done any physical activity that could account for it. I've checked for ketones, and i'm getting negative results. I'm also on a low carb diet, if that has anything to do with it, because at the moment i'm just on a background insulin, (until january when I am being put on the Basal-bolus regimen). My levels have been okay, not great, averaging at about 11mmol (way better than a month ago) and staying quite steady with a few temporary highs and lows.

My muscles have definitely felt more solid than they did, which is good, and i've filled out a little bit, and back within my body mass index. Could the aches be to do with this? like my mucsles are growing back? I see the diabetic specialist again at the start of january, and i will mention it, but, blah, i just want this aching to stop.

Thank you in advance.

[Subby]

Hi. I don't know why your muscles are aching, but I can say that high blood sugars even not outrageously high ones, like hovering around 11 mmol/l, makes my body ache and makes me constantly fatigued. I think a first base is to get your control sorted out. It might not be the answer - but it might, and it's something that needs to happen for your general wellbeing anyway.

That's a bit hard when you don't have bolus insulin. My reaction to the idea of starting a T1 on basal only and resigning them to having to go low carb just to get middling to poor control is that it is cruel and unusual. I just cannot comprehend why this has happened this way for you.

Anyway, I understand we are often at the mercy of our doctors, but if there is any way you can accelerate this process it would be a good thing. Once you have bolus insulin you have at least the basic tools to provide control (with a lot of adjustment, likely), plus you can also up your carbs and test whether it's the low carb diet that your body does not like. I'm sure you've picked up that self education is key to success with diabetes, if you haven't picked up a good book such as Using Insulin by John Walsh I'd highly recommend it. Good luck and I hope the aching resolves soon.

[SCC]

Agree. Seems you are ready for a more full regime. Meantime, are you drinking plenty of water? Might be good in case you are slightly dehydrated. That's my two cents!

[jwags]

Muscle Aches can be from lots of things. It could be a vitamin or mineral deficiency, fibromyalgia or a reaction to a drug you are on. When I was on a Statin drug I had terrible muscle and joint aches. Talk to your doctor so they can run some tests. Are you overexercising? Sometimes after I lift weights, my muscles will be sore for just 24 hours and then be OK as they rebuild.

[Tim C]

Thanks for the replies, I appreciate it. I don't think i'm dehydrated, i drink a lot of tea, yes i'm British haha. Its not overexersise, because I just do steady, short bike rides for exercise, and well... its been very cold out :p Vitamin or mineral deficiency? possibly. Thank you for the suggestions.

Though, it is highly possible it is a mixture of higher glucose levels and the lack of carbohydrates. Obviously since being in the hospital I have been overwhelmed with information, and the first day I came out I bought 'Type 1 diabetes for dummies' not a bad book for starting out, it covers everything, but just the basics and seems to be more from the perspective of parents looking after children. So I do need to do much more research and educate myself, thanks for the recommendation Subby. The way I understand it is that my doctor and specialist believed that my body was still producing some incline, and so trying to work out a regime at this / that time would be pointless. Also there was the fear of it going too low, so i started out on 10 units of insulatard twice a day. My guess is, looking at my levels and responding to my body, I think over the last few weeks my pancreas has put out bursts of the last of it. (there has been a couple of times when it has been high and suddenly gone very low for no apparent reason and then high again). I've took it upon myself to keep moving my insulin up a couple of notches over time and I am currently on 20 units twice a day of bg.

This morning my muscles were still aching, and I ended up going back to bed for a few hours again, because it was just, blah. They gave me some deposable novarapid for 'sick days' and today i've been 'experimenting' (lol) a bit. I took 4 units before lunch, perhaps a little naively because I followed that with just some soup (but my levels before lunch were 11.8). About 4 hours later I had to pop out, still aching arms and legs, and while I was out I felt a hypo coming on. So I bought and ate a sugery chocolate bar. half an hour later it occurred to me that I didn't feel as achey anymore.

I've been on a very low carb diet for months now. No potato, bread, pasta or anything like that, when I tried that stuff before, even just 1 slice of bread would send my levels straight up closer to 20mmol. I've been living off fish and beans and salad. For my evening meal, today, I decided to have sausage, mashed potato and mixed beans with onion and gravy, and even had a couple of small slices of brown bread (yes I enjoyed it!!!), and this time work out its carb content, which I estimated at around 50g. The whole insulin dose thing still confuses me, and I have no idea how sensitive I am to it. So i went for a 1 unit for 10g of carb ratio, although i moved that down a notch to be on the safer side and took 4 units rapid because I took 20 u of background (like usual) at the same time.

Before my meal my levels were 7.2mmol (and about an hour after a mars bar! so it must of gone low). I've just checked two hours after eating and its 10.8mmol. So it did work, because before I would of never of gotten away with eating what I did without suffering miserably. Though a few more units would probably have been needed, to account for the few extra carbs and to adjust the slightly too high level. The main point though here is that right now I don't feel very achey at all, maybe just a very slight ache in my arm muscles when I move them (previously it ached a lot even when I was perfectly still) so, we'll see how this goes.

I know this probably isn't that interesting to read, but I think writing it out helps me too, sort of therapeutic and helps me process stuff. Thanks everyone for your suggestions and advice.

[GrammaBear]

Tim,

It just occurred to me that maybe you've tried to reduce your blood glucose levels too quickly. I'm not encouraging you to return to your 'old' way of eating, but perhaps you've approached the low carb diet with a bit too much vigor. I know of other peeps who have felt like they've had the flu when they have drastically reduced their carb intake.

There is a website called Bloodsugar101.com that helps explain some of the other aspects of having diabetes. Also, there are several other books, one is "Think like a Pancreas" by Gary Scheiner and also "Using Insulin" by John Walsh. They are both good reads.

Do take care and let us know how you are getting on.

[BriOnH]

IMHO I would think that it's you building muscle back up. If you were lethargic for a long time you could have also experienced atrophy on top of ketones eating away at your muscle mass. Also as diabetics I think we are often extremely in tune, way more so then pre-diabetic, with what is going on with our bodies and notice everything more. That said, run it by your doctor; hopefully what you gather here you can ask him/her about.

My muscles ache as well when my BG is high as well. I get it mostly in my lower legs, and get a serious case of the jimmy legs lol. Stretching them out usually helps a lot though!

[Tim C]

Its just gone 6:30 am. I woke up in the night with aching and with tense muscles again and can't get back to sleep because I can't relax my body. After a while of trying, tossing and turning, i gave up and got up and made a cup of tea. I'm really really tierd right now, sat here at my computer and my muscles still feel achey and tense. I just want to sleep...

[Subby]

I'm not saying something else isn't going on, but that sounds so familiar to me with either hypos or highs causing muscle tension and an inability to relax the body. What was your blood sugar when you woke up in the night? Have you tested at points through the night recently, to see if you are having hypos? Unfortunately, hypos don't always wake us up, and our liver usually responds with a release of sugar, leading us to be if anything high afterwards and the cause of the trouble (the hypo) left undetected. So it can take a particular plan of waking and testing every few hours (or at least 2 -3 times through the night) for a night or so, to double check that lows and rebounds are not occurring.

The idea might seem odd if you are generally fighting against your blood sugars being high, as sounds the case: but a few things can conspire to mean that hypos can occur at night even when we think it is unlikely, such as the particular action of long acting, and the possibility of increased sensitivity to insulin for a period during the night. Only testing will tell.

[Tim C]

Thank you for your advice Subby, I really appreciate it. You may be on to something here. My muscles are aching a little right now, but not like they were this morning. I didn't think to check my levels when I woke up in the night, I waited a few hours until it was closer to the time that I usually do it. My levels had gone up to 14.1 mmol (from 10.6 before bed). Its quite common for my levels to be one or two point higher in the morning, only occasionally has it gone up by that much, so i'm not sure, but if I wake up in the early hours of the morning again i will check my levels straight away. I've only actually had one full on hypo, it wasn't pleasant lol, and i'm not sure I remember my muscles feeling this way and lasting this long. I've had about three more hypos, technically, but I recognized the early symptoms, caught it quick so it didn't drop any further. You could be right with this, and i'll play it by ear and then decide whats best to do. I thank you again for your help.

[Subby]

No problem, it's well worth looking at these possibilities. It's worth stressing that if you have unexpected high numbers in the morning, it may well be from a low in the night and the subsequent rebound. The liver, not knowing the pancreas is unable to deliver insulin as required to mop up later, can release an excessive amount of glucose into the system as an emergency response to a low blood sugar. The result can be in a seeming paradox some hours later, significant highs. If you want to look more into it, a phrase was coined for the phenomenon, the Somogyi effect. It is different to dawn phenomenon, which can also cause highs in the morning, but generally manifests in a pretty consistent way.

[Tim C]

If there is one major thing that I have learnt about diabetes in my two months of being diagnosed, its that the more you dig into it, the deeper the rabbit hole seems to go. Its like waking up out of the matrix, oh why oh why didn't I take the blue pill? ha ha. Just kidding, but i'm sure you know what I mean. I do want to learn as much as I can, and in a year, i'm expecting to become a diabetes guru expert lol, but for now, i appreciate all suggestions, knowledge and avenues to explore I can get. I will take a look into that now. Thinking about it a little deeper, it may make some sense, because I'm not exactly on a proper insulin regiem. I take 20 u of insulatard when I get up and before my evening mean (around 5-6pm) I seem to be able to eat more in the evening, which actually may potentially be the morning shot effecting me more early evening. Therefore it would stand to reason that my evening background shot may actually peak in the middle of the night / early hours of the morning. hmmmm.... some testing is required. Thank you.

[WendyL10]

Hi Tim,

I've had the same problems..muscles just ache and cramp..sometimes everywhere, hard to lift even my arms. it's the fluctuation of blood sugars, recovering from DKA, if you were there. I just get really bad muscle cramps when my blood sugars go high, if they fall too fast, etc...I asked my Endo about this last week, he said nearly every one of his diabetic patients has muscle cramping, especially when newly diagnosed. It was bad for me too, after DKA and diagnosis and starting insulin. As my Endo said, "the excessive sugars in our body need somewhere to go"..it attacks or nerves, cells, muscles, everything when our blood sugars are off. If you had really high numbers when diagnosed, the pain can be from everything readjusting, getting rehydrated, nourished again, your muscles and nerves refiring...etc..my endo told me when first diagnosed, "it will get worse before it gets better and you get more stable."

hang in there..it will get better. i do still get these muscle pains when my blood sugars are off.

[Tim C]

Hi Wendy, I'm sorry that you got the muscle ache too, but at the same time, i'm glad someone else has too. Yes, i went through the whole ketoacidosis thing, thats what I was rushed to the hospital for and must of put up with it for about a year, and my levels must of been constantly extremely high all of the time. Symptoms actually started mildly almost two years before I was diagnosed, which means my muscles must of been slowly wasting away the whole time. I did become very skinny and did notice that I my muscles had shrunk, but I still must of had a bit of a distorted perspective of myself, because I didn't realize just how much. Although i've looked into different possibilities, I keep going back to that, basically, my muscles are regrowing, actuating getting nutrients and energy instead of being burnt away. It makes sense and when I first noticed the ache I also noticed that it actually feels like I have some muscles now and they are more solid. Its not an acute muscle pain, its more like my entire body just aches like the next day after moving house and carrying heavy furniture all day. Cramps is also a good description. ouch, yes! lol. Its just that I felt pretty good for two months after leaving the hospital, and then suddenly, bam! .....pain. lol. But I guess, like you say, everything needs time to readjust. Thanks

[WendyL10]

yeah...i hear ya. i look back maybe even 5 years prior to my Dx and noticed things were off with my body, being a woman I thought it was all 'hormones"...well it was (insulin) but not the ones I was thinkin'..ha! I actually kept going to an allergist, thinking i was allergic to something, i must be allergic to foods...i was peeing a lot too, just a host of weird stuff, not feeling well, sores on my feet, tired, then...like you, it just got so bad, couldn't breath, the peeing, weight loss (was skinny in the first place), blurred vision...so weak. Well, you know the story. Yeah, it's like an all over body ache, like the flu sometimes..but, when my sugars are stable and good and I'm not bouncing all over the place, it goes away..it will go away for you too. I also kept going into my doc thinking my potassium was off again - it was that type of cramping and aching (I was put on Rx potassium for a while after DKA), but my potassium was fine...it was again just everything trying to get stable. Diabetes is indeed a beast, effects everything, ya know. Take care.