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Recall of metformin extended release
In May 2020, the
Food and Drug Administration (FDA)recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.
Diabetes can lead to a variety of complications. Leg pain and cramps often occur as a result of nerve damage called diabetic neuropathy. If diabetes damages nerves in your arms or legs, it’s called diabetic peripheral neuropathy. This condition can be a direct result of long-term high blood sugar levels (hyperglycemia) in those who have diabetes.
Pain, burning, tingling, and numbness are common symptoms. Peripheral neuropathy can also result in serious foot and leg conditions. Catching nerve damage early is important in preventing symptoms. This can help prevent lower leg amputations.
You have options for alleviating leg pain and cramps due to diabetic neuropathy. Managing leg pain and cramps may also help prevent the condition from progressing and improve your quality of life.
Diabetic neuropathy is most common in the legs and feet. Without treatment and management, it can become debilitating. The most important thing you can do to lower your risk of all complications, including diabetic neuropathy, is to keep your blood sugar level within the target range.
If you have neuropathy, controlling blood sugar is still very important. But there are some other steps you can take to help control this condition.
One of the first courses of action is pain management through medication. Over-the-counter medications, such as acetaminophen and ibuprofen, may help alleviate mild to moderate pain. Two medications are currently approved by the U.S. Food and Drug Administration (FDA) for treating diabetic peripheral neuropathy:
- duloxetine (Cymbalta)
- pregabalin (Lyrica)
Other medications and treatment options include the use of opioid medications, such as tramadol and tapentadol, and topical remedies and sprays.
Certain dietary supplements may also help ease pain, including leg discomfort associated with diabetes. Some nutrients can possibly play a role in repairing nerve tissues and even protect from future damage. Scientists are studying the following supplements for diabetic neuropathy treatment:
ALA is an antioxidant that has garnered a lot of attention in home remedies for diabetes. While found in some foods like broccoli and carrots, ALA is also available as an oral supplement. People with diabetes take ALA to help alleviate pain and possibly prevent further nerve damage. Some, but not all, studies support the use of oral ALA.
Acetyl-L-carnitine mimics natural chemicals found in the body. It’s thought to help produce healthy nerve cells. This supplement has a risk of side effects, such as vomiting, and can interact with blood thinning medications. One study did find acetyl-L-carnitine beneficial in reducing pain in those with diabetic peripheral neuropathy.
Vitamin B-12 is present in meats and fish and helps support red blood cells. This vitamin may also potentially promote healthy nerve function to prevent damage. Metformin is a common medication used with type 2 diabetes. It’s known to lower the body’s vitamin B-12 level. Talk to your doctor about making sure you are not deficient. A B-12 deficiency can lead to neurological damage and mimic diabetic neuropathy. Vitamin D can also help support healthy nerve functions and decrease swelling that can lead to pain.
In diabetes, a healthy diet is critical for overall health and leg pain relief. Dietary supplements do not cure leg pain, and they are still being studied for safety and efficacy. Also, not all patients need these supplements because they get adequate nutrients from the foods they eat.
It’s important to discuss supplements with your doctor before taking them for diabetic leg pain — especially if you take any medications.
Managing diabetes leg pain and cramps may require more than taking medications or supplements. While these methods may reduce inflammation and pain, they can take time to work. Additionally, it may be dangerous to take certain medications, such as opioids, for extended periods of time.
With physical therapy, you may learn exercises that target and ease leg discomfort. Other potential treatments include electric nerve stimulation and light therapy that may be used during physical therapy. Acupuncture is another potential treatment being studied in diabetes clinical trials.
You can also take actions to ease your leg pain that include:
- going for short, frequent walks
- using a stationary bike to increase blood flow
- soaking your legs in a warm bath
- using a bed cradle at night to protect your legs from discomfort caused by bedding
It’s important to address any form of leg pain with your doctor, even if the symptoms don’t interfere with daily activities. Frequent cramps or shooting pain can indicate worsening diabetic neuropathy. Report frequent symptoms to your doctor right away.
Even mild leg pain and cramps should be discussed with your healthcare team. Even if you do not have neuropathy, these can be symptoms of peripheral arterial disease (PAD).
Diabetes puts you at a greater risk for PAD. This is a serious condition characterized by blocked blood vessels in the legs. PAD also increases your risk for heart attack and stroke. The
As a general rule, call your doctor if something just doesn’t seem right — it may potentially save your life.