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June 3, 2000


Question from California, USA:

My daughter is 17 and has had Type 1 diabetes since the age of 10. She is experiencing a general aching in both legs after exercise to the extent that she is unable to continue. One day she can run 6 miles and the next can't walk a block. Now is she experiencing a tightness in hands after walking a short distance like the moderate swelling/tight feeling that would be normal on long hikes in high altitudes. She is sturdy and exercises frequently and has hiked mountainous areas at diabetes camp for some 72+ miles in the summer without any of her current symptoms. These appear to be increasing in severity and frequency. It would seem that these are vascular symptoms, even though all of her check-ups have been entirely normal. Does this sound similar to complaints others have had?


As you yourself say this sounds like a vascular problem, a facet of Type 1 Diabetes that is partially reviewed in the February 2000 issue of Diabetes. It is a complex and so far poorly understood complication that is presumed to be autoimmune. It would be important to know how good control has been, whether cold in any way induced the limb pain and exactly what investigations had been carried out. One home remedy that might be tried would be to drink a glass of tonic water several hours before the exercise. This sounds suspiciously like alternative medicine and is presumably linked to the quinine; but it is a device that football coaches use for cramps that athletes get. A more serious remedy to talk to her doctor about might be a short trial of the drug nifedipine, which has been a mainstay of the treatment of Raynaud’s Phenomenon and which is occasionally associated with Type 1 diabetes; but is also linked to cold exposure.