Question from the USA:

I’ve have had diabetes for 22 years, and my hemoglobin A1cs have averaged 6% consistently for the last three years only. Before that, they averaged about 8.5 or 9%, with the occasional 10% here and there. Also, have had three DKA [diabetic ketoacidosis] episodes, the first being eight or nine years ago, and the last one was four years ago. Adding to the typical DKA symptoms, I experienced red-hot burning pain from deep within the muscles of my neck, shoulders and upper arms, down to my elbows. It was such a deep-rooted pain it felt as if it originated deep in my bones and radiated outward. On a pain scale, I’d put it as worse than either childbirth or my two broken legs! Up until about a year ago, those DKA episodes were the only times I’d felt that unspeakable pain.

A year ago, I started having bone-deep, hot, burning pain in shoulders and upper arms just about every time my blood sugar gets the least bit high (even at 180 mg/dl [10 mmol/L]). The current pain is nowhere as intense as the DKA variety was, but it’s of the same type, makes me cry, and is the worst pain I experience now. I check my sugar often and, if it’s high, it’s been high for only a matter of hours. So, the painful burning ache is not the result of a several days worth of high blood sugars, headed-toward-DKA binge, it develops in mere hours. The unspeakable muscle pain is my first warning that my blood is high. I check it, take however much Humalog I need, and, When my blood sugar lowers, the pain goes away. This takes about an hour from start to finish.

I’ve never heard of this pain being a symptom of DKA, let alone of a merely slightly high blood glucose that’s been elevated for only a few hours at most. What can you tell me about muscle pain as a symptom of DKA? Do you know why I’m now reacting in such a painfully dramatic way to moderately high blood sugars?