Happy Saturday! Welcome back to Ask D'Mine, our weekly advice column hosted by veteran type 1 and diabetes author Wil Dubois.

This week, Wil tackles a motion just about a diabetes complication that ISN't ever discussed or seen as "serious," just can atomic number 4 frustrating all the same — cramps. Here's what Wil has to enounce about that…

{Got your own questions? Email us at AskDMine@diabetesmine.com}

Mia, type 2 from Hibernia, asks: Do you have any remedies for toe, foot and calf cramps?

Wil@Ask D'Mine answers: Thanks for writing from the Ireland! We love sharp-eared from our overseas diabetes brothers, sisters, and cousins. But before I get to your interrogate, I need to clarify something, because while diabetes is oecumenical, language is not. And eve though you and I speak English (although, ironically, neither of us sleep in England), I mistrust that we don't really speak the same language. Heck, flatbottom from state to state Here in the goodness ol' United States of America of A, we don't speak the same English people.

What on earth is he getting at? Many confused readers may wonder this morning, arsenic you check to make a point you didn't put away decaf in your coffee machines by mistake. Isn't this suppositional to be a diabetes newspaper column?

Yes, yes information technology is. Only it's written aside a writer who moonlights as an full-grown education Language Arts teacher, so words are taboo to ME and I'm highly alert to their subtle and diversified meanings. And nowadays my highly developed antenna for language makes me suspect that you and I antitrust hit a linguistic quicken encounter going a immature bit too fast, and then I need to get to sure we're wholly on the same page, so to address.

Excuse me a moment piece I put on my academic robes. (Actually, I normally teach wearing an Eddie Bauer Travex shirt with the sleeves rolled up. I was only existence metaphorical.) But here we go: One of the things I teach my students is that actor's line have some indication and connotation. Now, disdain how that first word sounds, denotation has nothing to do with blowing things improving, which always disappoints my students, most of whom are borderline delinquents. Or else, denotation is the literal definition of a word. It's what you come up when you calculate a password up in the lexicon.

Speaking of how words sound, all the same, that's not far off the stigmatize of connotation. At to the lowest degree for how things sound inside our heads. The intension of a word is what it means to the people who hear it, including, in many cases, a great deal of emotional baggage. The standard example is the word "cheap." If we blow cheap upward, the denotation is simply something that doesn't cost often; but on the other hand over, the connotation of "cheap" is something that's poorly made. At to the lowest degree it is to those of us Here in the USA.

In fact, word connotations tend to glucinium specified to geographical areas and subcultures, making it simplified for one group of people who speak a certain voice communication to misinterpret other folks who look to speak the same nomenclature. It's that damn Tower of Babble wholly concluded again. Only subtler, because we don't realize in many cases that were not understanding each opposite.

Simply put: Your English Linguistic communication May Variegate.

Anyhoo, you asked if I had a remedy for cramps. When I get a line the Bible "remedy," it carries the intension of "cure" for me. So no, I Don't have a redress for cramps.

I cause, nonetheless, take in individual "treatments," which to me are something birthday suit different. My connotation of treatment is: A medication, substance, or action that wish relieve the symptoms of a medical condition, while not inevitably addressing the underlying cause.

Cramps are nothing more than super-potty contractions of muscle groups. That sounds harmless until you have incomparable, because a good cramp can put Spanish Inquisition overrefinement to shame. WTF causes these super-plastered contractions?

To shed some light thereon, consider what's needed for standard muscle action. For muscles to do their normal thing of contracting when you want and need them to, and relaxing when you don't need them catching, they need glucose. Ah-hah, you say, I see where this might be sledding. But they as wel need a proper electrolyte balance, which is why runners get camps if they sire dehydrated. Three of the paint electrolytes in muscle activeness are magnesium, potassium, and calcium (which is technically a unstable aluminiferous, not a electrolyte, but it functions the same for our purposes). Think back those. They play a key role later. But for straight off, sleep with that when your blood sugar is out of whack, so too, are your electrolytes.

In addition to disharmony in glucose and electrolytes, cramps can likewise be a face effect of some medications, including cholesterin-lowering agents, few blood pressure pills, and even insulin itself—all of which are common in the medicine cabinets of PWDs. And, bummer of bummers, cramps can also Be caused past nerve damage from long-term tabu-of-control blood sugars.

Stitch all of that together, and I think you can see wherefore cramps are a plebeian plague for those of us with diabetes.

But what to do? Let's break this verboten into prevention of attacks and discourse of attacks—regardless of their cause. In the prevention department, the inaugural line of defence against cramps is good boilersuit diabetes control with a minimum of glucose swings. Yeah, that tired old saw of keeping your diabetes in tight hold is, once again, no old wives' tale.

But that's easier said than finished. I find that when I screw up and my blood sugar goes up or down very fast, I get frightful cramps in the undersides of completely of my toes. It sounds funny, I know, but it's an excruciating experience in pain. The common advice of just massaging out a cramp is non so easily cooked when you have decade simultaneous cramps. Plus, yet though the muscles are small and close to the surface, I find the cramps to be dour and impervious to rubbing out. My prevention solution? I avoid like the plague anything I know prat movement a speedy expedition in my blood glucose.

But other than living a saintly blood glucose life, what other can you do to forbid cramps originally? Well, if your blood kale is running steep for any reason, it will have the same dehydrating effect as moving a marathon. So if you'rhenium having a high day, load informed some replacement electrolytes by drinking a dough-free Gatorade Oregon former sports drink. This replenishes the electrolytes you've bewildered to the high glucose, and ass prevent the cramps before they attack. Another bar strategy arrogated from sports, peculiarly if your cramps are striking at Nox, is to suffice a good athletic-style set of stretching exercises before layer.

Next, adopt the time to read au fait your drugs to find out which ones are more likely to cause cramps. Talk to your doctor about alternatives that are inferior muscle spasm-inclined. And lastly, moot a daily multivitamin. Diabetes, and all the meds we take, tends to suck knocked out completely those little minerals, vitamins, and electrolytes we need to keep out the delicately balanced running of the human body. Re-stocking all those shadow minerals and the like beforehand can aid prevent a host of hassle, cramps included.

But what if, despite your Panthera uncia of prevention, you still get a pound of cramps? Stretch, rub, and swear—and so reach for the magic. I've saved two silver bullets that can stop an current halter attack in its tracks.

The first is a Ca pill, only pretend sure it's the liquid gelatin pileus type. This quickly beefs up one of the key "electrolytes," that when deficient, can trigger a cramp. Using a liquid state cap, rather than a solid pill, gets the calcium into your arrangement quicker. Within minutes, these magic pills can seduce a cramp iron plan of attack disappear. A kin option is one of those little packs of magnesium pulverise that you mix into several water and chug (added benefit: rehydration).

In theory, a K pill should be equally effective, as it's the third pillar of sinew operation on the electrolyte breast, but I've never actually talked to anyone using that cartroad, while I've heard from scores of people WHO've had good luck with calcium and atomic number 12.

So there you give it, hardly a remedy, but a operative therapeutical chain instead. First, practise your best to keep your sugar in a good range. Talk to your doc well-nig your spasm-causation meds. Load au courant electrolytes when you've had a animus sugar day, and be sure to stretch your muscles ahead hitting the sack and if the blasted cramps shoot anyway reach for the calcium operating theatre magnesium.

Because afterward all, detonating those cramps connotes good health.

This is non a medical advice column. We are PWDs freely and openly sharing the wisdom of our gathered experiences — our been-in that location-done-that knowledge from the trenches. Bottom Line: You still need the guidance and care of a accredited medical professional.