According to the American Diabetes Association nearly 30 million people in the United States have been diagnosed with diabetes. Diabetes is found in two primary forms, type 1 and type 2. Type 1 diabetes is an autoimmune disorder usually diagnosed at a young age. Type 2 diabetes is a chronic condition often related to weight and lifestyle. It is more frequently diagnosed in individuals over the age of 45. Diabetes of both types can be treated and managed. Type 1 diabetes patients are reliant on insulin, which they can take as a pill or an injection. Type 2 diabetes patients may need to take medications, but lifestyle changes can also control the symptoms and effects of the disease. For diabetic leg pain, specifically, exercise, diet, and weight management changes can help with one of the major conditions associated with diabetes, diabetic peripheral neuropathy.
Diabetic leg pain caused by diabetic neuropathy
Diabetic neuropathy is a nerve disorder caused by diabetes. Over time, people with diabetes can develop nerve damage throughout the body. This nerve damage can happen in any part of the body. It is currently estimated that about 60-70% of people with diabetes experience neuropathy. Peripheral neuropathy specifically affects the limbs, especially the legs and feet. The condition is most common in individuals who have experienced difficulty controlling their blood sugar levels.
While diabetes, especially with uncontrolled blood sugar, is the most common cause of peripheral neuropathy there are other risk factors. These include:
- Vitamin deficiencies
- Infections such as Lyme disease or shingles
- Autoimmune diseases
- Repetitive motions
The condition can affect several nerves in the limbs including sensory nerves, motor nerves, and autonomic nerves. Sensory nerves are those that receive sensations like pain or touch. Motor nerves control movement. And autonomic nerves control functions like blood pressure.
Diabetic neuropathy typically begins gradually with numbness or tingling in feet or hands which will spread throughout the limbs. Burning and sharp pains are also common. There may be changes in the skin, hair, or nails. People often feel muscle weakness and diabetic leg pain. Paralysis can also occur if the motor nerves are affected. There may also be changes in blood pressure that cause dizziness or digestive problems depending on the nerves that are affected.
Frequently, diabetic neuropathy can be controlled if the underlying cause is managed and maintained. Medications can also be used to control symptoms such as over–the-counter pain relievers. Lidocaine patches or capsaicin cream can also be applied to alleviate pain. Patients are also urged to take care of their feet and avoid unhealthy activities, such as smoking. A few other lifestyle changes can also help relieve this condition, along with symptoms of diabetic leg pain.
You can learn more about this condition at the video below.
Managing diabetic leg pain
A few lifestyle strategies for managing the symptoms of diabetic leg pain include:
- Eating well and exercising
- Losing weight
- Continuously learning about your treatment options for diabetic leg pain
- Establishing the right healthcare team
- Managing blood sugar, blood pressure, and cholesterol
- Practicing relaxation strategies, like yoga and massage
In this article, we’ll be looking specifically at how diet, exercise, and weight loss can help you prevent and manage diabetes symptoms.
Can exercise help prevent or manage diabetic leg pain?
Rising rates of diabetes are fueled in part by the ongoing obesity epidemic. Being overweight and living a sedentary lifestyle are considered the biggest risk factors for developing type 2 diabetes. But can exercise actually prevent diabetes? Or improve blood glucose regulation and diabetic leg pain in people who already have it?
Benefits of exercise for diabetic leg pain patients
Despite the nuances that studies have recently uncovered with regards to exercise and its ability to help people stay healthy, physical activity remains one of the most basic lifestyle modifications recommended to patients with diabetes.
Physical activity helps cells develop greater sensitivity to insulin so the body can better process it. Exercise also activates a special cellular activity that involves absorbing blood glucose, according to the American Diabetes Association. Other benefits of physical exercise include:
- Weight loss
- Stress relief
- Reduced risk of heart attack and stroke
- Better circulation
These all improve health and reduce the likelihood of complications from diabetes, including diabetic leg pain.
Exercise for maintaining blood sugar levels
Although few doctors would advise diabetes patients against exercise, studies show conflicting evidence about the impact that exercise has for maintaining healthy blood sugar levels. For example a study conducted by the Endocrine Society, found that 20% of Type 2 diabetes patients saw no improvement in blood sugar levels or insulin sensitivity after exercising. Researchers aren’t sure why some people respond well to exercise and others do not.
Study author Dr. Lauren Marie Sparks says:
“Genetic and epigenetic patterns could hold the key to differentiating between the two groups. With that information in hand, we can target specific interventions and treatments to the individuals who will benefit the most and identify novel treatment approaches to help those who do not respond exercise.”
Another study completed at the University of Kansas discovered information that could offer insight into the Endocrine Society results. The researchers discovered that physical activity and healthy diet, although helpful for reducing diabetes among college graduates, surprisingly don’t work as well for people who did not graduate college. Researchers discovered that physically active college graduates were 6% less likely than those without bachelor’s degrees to have elevated blood glucose levels or symptoms related to pre-diabetes. For those with less education, exercise bestowed only a 1% reduced risk of pre-diabetes symptoms.
Researchers said that the findings corroborate other research showing people who earn degrees after high school have access to healthier lifestyles that include memberships to gyms or walking-oriented neighborhoods. Study author Kyle Chapman says:
“Education has been shown to affect people’s behavior on multiple levels. Not only does it give you the capacity to think critically, but once you’re in a different education level, there’s a different culture around people you associate with…There are different standards of doing things and things are encouraged or discouraged.”
Researchers said the results are important because they show that people with less education need more help to stay healthy than those with higher levels of education.
Diet or exercise, or both?
Researchers find diet and exercise bestow separate benefits on diabetes’ patients health.
Researchers at Saint Louis University decided to dig into the ubiquitous “lifestyle modifications” to answer the question few have asked: which more profoundly improves a diabetic person’s health, diet or exercise?
They found that each offers different benefits that accentuate the other. Patients who participated in both diet changes and weight loss experienced the most significant health benefits, with a doubled improvement in insulin sensitivity.
Researchers have already proven that exercise alone can help the body process glucose. However they discovered in the course of research that exercise alone was not superior to dietary changes when it came to regulating glucose. Study author Dr. Edward Weiss says:
“The study says you can be healthier if you exercise and eat the right amount of food. There is more to be gained by including both approaches in your life.”
Diet benefits for different populations
Researchers at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital also showed that a healthy diet reduces the risk of developing type 2 diabetes in minority women, one of the highest risk groups for diabetes. They adjusted for lifestyle factors like activity level and smoking as well as age, family history, and hormone levels. These women filled out questionnaires every four years, and some were followed for as long as 28 years.
While a healthy diet reduces risk in every population, because minority women have a higher likelihood of developing type 2 diabetes, the number of avoidable deaths prevented with a healthy diet was much higher than in other non-white populations. Healthy diets are associated with a decrease in body-mass index, which is also associated with less obesity, a major risk factor in developing type 2 diabetes, as we’ll discuss shortly.
Lead author Jinnie Rhee extrapolated these results to their worldwide importance, saying:
“This study suggests that a healthy overall diet can play a vital role in preventing type 2 diabetes, particularly in minority women who have elevated risks of the disease. As the incidence of type 2 diabetes continues to increase at an alarming rate worldwide, these findings can have global importance for what may be the largest public health threat of this century.”
Losing weight to manage diabetic leg pain
Related to lifestyle changes that include diet and exercise, are steps taken to lose weight. Losing weight is an important step for reducing any types of leg pain, but especially diabetic leg pain. Lower weight reduces the amount of pressure on the legs. But now it is also widely known that obesity is a risk factor for developing type 2 diabetes. Once a person is diagnosed with type 2 diabetes, though, weight loss can also play an important part of managing diabetes symptoms.
Preventing type 2 diabetes with weight loss
Research from St. Louis University found that all traditional routes to weight loss offered both singular and cumulative benefits. Researchers enrolled inactive, overweight men and women and placed them in three groups: just exercise, just calorie restriction, and calorie restriction combined with exercise. They measured levels of insulin sensitivity, a low level of which may predict the development of type 2 diabetes.
The results were surprising. While calorie restriction alone and exercise alone resulted in weight loss, the group that combined both not only lost weight but also showed improvement in insulin sensitivity. In other words, they may have actually reduced their chances of developing type 2 diabetes.
Associate professor of nutrition and dietetics Edward Weiss, Ph.D believes that these findings go beyond using exercise to maintain what appears to be a healthy weight. He points out that simply maintaining a healthy BMI just doesn’t provide the benefit:
“The exercise group was, in a way, our control group. It was already known that exercise can improve glucoregulation, both through weight loss and through mechanisms that are independent of weight loss. This means that even if you don’t lose weight, exercise helps. On the other hand, it often has been assumed that calorie restriction improves glucoregulation simply because it leads to weight loss. On the surface it may seem obvious, and yet there are a lot of people who believe that if they maintain a healthy weight, it doesn’t matter what they eat. And others have an appropriate food intake but don’t exercise.”
Weight loss for type 2 diabetes patients
Weight loss can be a struggle for anyone, but for those with type 2 diabetes it can be especially challenging. Research continues to show that people with type 2 diabetes often struggle to lose weight and then struggle again to maintain a healthy weight.
A study in the Journal of the American Medical Association looked at the ability of a daily insulin injection to help those with diabetes lose weight. They found that when combined with exercise and diet, study participants taking liraglutide achieved greater weight loss over 56 weeks than those who had a placebo. While simply changing the type of insulin a diabetes patient receives may have some weight loss benefit, there really is no quick fix when it comes to losing weight and maintaining a healthy body-mass index (BMI).
Preventing diabetic leg pain
All of this research should show one thing: preventing and managing diabetes (and the diabetic leg pain that often comes with it) isn’t a simple process. By combining exercise, a healthier diet, and weight loss, however, you have the most chance of reducing your symptoms or preventing them entirely.
Just as research has uncovered that not everybody experiences the same benefit from physical activity, scientists have also recently discovered that not everybody with pre-diabetes is equal when it comes to trying to stop them from developing the full-fledged illness. Study author Dr. Jeremy Sussman says:
“We need to go beyond single risk factors and look holistically at who are the people in whom a particular approach works best.”
The team developed a model and analyzed data from 3,000 people. All participants had high body mass indexes and abnormal blood sugar levels. The researchers wanted to see which type of patients experienced the most benefit from a variety of risk reducing activities like prevention drugs or lifestyle modifications.
The patients who were least likely to develop diabetes over the next three years scored lowest in seven key measurements including fasting blood sugar levels, waist-to-hip ratio, waist measurement, height, and family history of high blood sugar.
Researchers wanted to learn which subset of people would gain the most from preventative efforts like medicine or lifestyle changes. While losing weight and exercise helped everyone, the drug metformin helped only those with the highest risk profile. The drug was effective, reducing the risk for that set of patients by 21%. However, even for the highest-risk patients, diet and exercise proved most beneficial, reducing risk by 28%. Lower risk patients still saw a benefit from lifestyle modifications, but the reduction was less dramatic, at 5%.
Researchers said that many patients receive excessive treatments, and that many of those treatments aren’t even effective. They wanted to clarify which types of treatments would work for which types of patients in hopes of making health care more effective and efficient while reducing patient overwhelm and possible side effects.
The World Health Organization predicts that diabetes will become the seventh leading cause of death worldwide by 2030. At current rates, the number of people with diabetes in the U.S. is set to double or triple by 2050.
Making these lifestyle changes is one of the safest and most effective resources we have to combat this epidemic. As always, it’s best to talk to your doctor. They can help you identify the best treatment and prevention strategies for your specific condition. They can also provide guidance on how to incorporate exercise and diet strategies into your lifestyle.
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