From the Guidelines
Tremors in diabetes are primarily associated with hypoglycemia, and immediate treatment with fast-acting carbohydrates is crucial to prevent severe complications. According to the most recent evidence 1, low blood glucose (hypoglycemia) is the most common immediate health problem for individuals with diabetes, and its symptoms include tremors, sweating, light-headedness, irritability, confusion, and drowsiness.
Causes and Symptoms of Hypoglycemia
The causes of hypoglycemia include too much insulin, too little food, delayed meals, or excessive exercise. It is essential to recognize the symptoms of hypoglycemia promptly and treat them with 15 grams of fast-acting carbohydrates, such as glucose tablets, 4 ounces of juice, or 1 tablespoon of honey.
Treatment and Prevention
After initial treatment, it is crucial to recheck blood sugar levels after 15 minutes and repeat treatment if levels remain low. For frequent hypoglycemic episodes causing tremors, consulting a healthcare provider about adjusting the medication regimen, particularly insulin doses or sulfonylureas, is necessary. Other causes of diabetic tremors include neuropathy and medication side effects.
Maintaining Blood Sugar Control
To prevent tremors, maintaining consistent carbohydrate intake, monitoring blood sugar regularly, carrying fast-acting glucose, and considering a continuous glucose monitor for early warnings are essential. If tremors persist despite normal blood sugar levels, seeking medical evaluation is necessary, as they could indicate diabetic neuropathy or an unrelated neurological condition requiring different treatment approaches. The evidence from 1 supports the importance of balancing food, medications, and activity levels to keep blood glucose levels as close to normal as possible, highlighting the need for careful management of diabetes to prevent complications such as tremors.
From the Research
Relationship between Tremors and Diabetes Mellitus (DM)
There are no direct research papers provided to assist in answering the question about the relationship between tremors and Diabetes Mellitus (DM). The studies provided focus on the treatment of painful diabetic peripheral neuropathy and the management of pain in diabetic patients, but do not mention tremors.
Treatment of Painful Diabetic Peripheral Neuropathy
- The studies suggest that duloxetine, pregabalin, and amitriptyline are effective in treating painful diabetic peripheral neuropathy 2, 3.
- These medications have been shown to reduce pain scores and improve quality of life for patients with diabetic neuropathy 2, 3.
- The US Food and Drug Administration (FDA) has approved several medications for the treatment of painful diabetic peripheral neuropathy, including duloxetine, pregabalin, and tapentadol extended release 4.
Management of Diabetic Neuropathy
- Tight glycemic control is the only strategy convincingly shown to prevent or delay the development of neuropathy in patients with type 1 diabetes and to slow the progression of neuropathy in some patients with type 2 diabetes 5.
- Early recognition of psychological problems is critical to the management of pain in diabetic patients, and physicians need to go beyond the management of pain per se if they are to achieve success 6.
- A variety of treatments are available for the management of pain in diabetic patients, including medications, lifestyle modifications, and intensive glucose control 4, 6.