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November 2, 2005

Aches and Pains, Exercise and Sports

Question from Federal Way, Washington, USA:

My 14 year old son occasionally gets severe hamstring cramps at the end of the day after soccer, running, or basketball. His A1c is 7.6 and, generally, his blood sugars are well controlled. We assume the cramps are possibly from poor hydration or overuse, but could it be at all related to his type 1 diabetes? Are they related to not enough glycogen stores after a week of heavy exercise/play? These cramps are terrible, but don't occur very often.


Well controlled athletes with type 1 diabetes have the same risk factors for muscle cramps as someone who does not have diabetes. It is still somewhat of a mystery what causes muscles cramps but there are a few theories. A popular one is dehydration. The easiest way to determine if someone is dehydrated is to check the color and quantity of the urine. A dark colored urine may indicate metabolic wastes and lack of water in the body. An exception to this is someone taking a vitamin supplement which may darken the urine. In this case, going with volume is a better indicator. How much sweat or water is lost during a workout can be determined by weighing in before and after the activity. For every pound lost, replace with about 16 ounces of water. Athletes who lose more than 2% of their body weight (150 pound person = three pounds) during exercise will most likely have their performance suffer.

Another theory is lack of sodium in the body. This situation is most likely to happen to athletes with low sodium in their diets. Someone who eats a lot of salads can disrupt the balance of sodium in their diet. This may contribute to muscle cramps. Eating salty foods (i.e., pretzels) is a good way to replace the sodium lost during exercise. Low calcium and potassium are two other electrolytes that may contribute to muscles cramps. There is usually enough calcium stored in the bones to counteract any depletion of calcium through exercise. Potassium can easily be accounted for by eating fruits (i.e., bananas) and vegetables.

Prevention is the main key for muscles cramps, but massage, stretching, and ice are excellent ways to relieve the severe pain when cramps become debilitating. Athletes are more prone in hot weather and in the beginning of the season when conditioning may be poor. Participating in sports with a high blood sugar can also lead to dehydration due to an increase in urine output.