Spontaneous Leg Cramps and “Restless Legs” Due to Diabetogenic Hyperinsulinism: Observations on 131 Patients*

The Role of Diabetogenic Hyperinsulinism in the Pathogenesis of Prostatic Hyperplasia and Malignancy*

“…The patient's detrusor activity subsided, only to return several minutes later; then he woke up, but was found to have only 150 ml of urine in the bladder. The suggestion that detrusor contractions rather than increases in urinary volume cause the patient to awaken at night to urinate is in accord with the cited severe spasm in other muscles resulting from nocturnal hypoglycemia (5, 67). An “irritable” bladder or a “neurologic” bladder was found in 29 of 50 unselected diabetic patients who were studied by cystomanometry (66d).…”

“…The writer has attended scores of patients with D.H. who were subject to spontaneous attacks of severe muscle spasm in various organs—leg cramps, angina pectoris, diarrhea and priapism. The cause of such spasms could be directly attributed to recurrent hypoglycemia on the basis of the following: 1) the prompt and sustained disappearance of the spasms after the institution of a corrective diet aimed at preventing severe reactive hypoglycemia day and night; and 2) their prompt recurrence after the ingestion of sugar (often in some unrecognized form) or failure to take the recommended snacks at night (5, 67). The occurrence of tumoriform focal muscular degeneration in male diabetics (66b) is also relevant.…”

“…These disorders included angina pectoris (especially when nocturnal), arrhythmias, “refractory” peptic ulcer, obesity, vascular headaches, spontaneous severe muscle cramps, pathologic drowsiness, and recurrent tremor. The interrelationships are considered elsewhere (5, 67), and are illustrated by the following abbreviated case reports:…”

Leg Cramps in Children

“…18 Other symptoms of hypoglycemia such as pallor, palLeg Cramps in Children pitation, tremulousness, headache, and perspiration are often present.…”

“…Other types of leg cramps may be unilateral or bilateral. 18,24 Precipitating factors: A leg cramp that follows vigorous physical exertion in a hot environment with profuse sweating suggests a heat cramp. A fasting or exerciseinduced cramp is suggestive of a metabolic myopathy.…”