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Diabetes is a health condition characterised by abnormally high levels of glucose or sugar in the blood. It affects millions of people worldwide and is steadily increasing. Diabetic patients may experience a feeling of shakiness in their hands, limbs, head, or voice that they cannot control. This is known as a tremor. Tremors can be caused by low blood sugar or hypoglycaemia, which is common in people with diabetes, especially those who take insulin to manage their condition. Taking too much insulin or injecting it into the muscle instead of fat tissue can lead to hypoglycaemia. Hand tremors are a significant symptom of hypoglycaemia, as nerves and muscles are powered by blood sugar.
| Characteristics | Values |
|---|---|
| Can insulin cause muscle tremors? | Insulin can cause muscle tremors indirectly by causing hypoglycemia or low blood sugar.. |
| How does insulin cause muscle tremors? | Insulin can cause muscle tremors by causing hypoglycemia. Excess insulin can lead to low blood sugar, which causes tremors as the brain doesn't have enough sugar to control the body. |
| What are the other symptoms of low blood sugar? | Other symptoms of low blood sugar include shakiness, faster heartbeat, seizures, comas, and brain damage. |
| What are the causes of low blood sugar in diabetics? | Low blood sugar in diabetics can be caused by taking too much insulin, incorrect insulin, injecting it into the muscle, not timing insulin and carb intake, increased physical activity, alcohol consumption, irregular meals, and unbalanced meals. |
| How common is low blood sugar in diabetics? | Low blood sugar is common in people with diabetes, especially those who take insulin. One study found that 4 in 5 people with Type 1 diabetes and nearly half of people with Type 2 diabetes who take insulin experienced low blood sugar in a four-week period. |
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What You'll Learn
Insulin and diabetes
Insulin is a naturally occurring hormone produced by the pancreas that helps the body turn food into energy and manages blood sugar levels. It does this by moving glucose from the blood into cells all over the body, which use it as their main source of energy.
Diabetes is a chronic and potentially life-threatening condition where the body loses its ability to produce insulin or becomes resistant to insulin, resulting in high blood glucose levels (hyperglycaemia). There are several types of diabetes, but the main types are type 1, type 2, and gestational diabetes. Type 1 diabetes develops when the pancreas stops producing insulin, often due to the body's immune system attacking the pancreas' beta cells. Type 1 diabetes is usually diagnosed in children and young people but can occur at any age. It is treated with insulin injections, which are often required multiple times a day. Type 2 diabetes occurs when the pancreas does not make enough insulin, and the body's cells become resistant to insulin. Type 2 diabetes is often manageable with a healthy diet and increased physical activity, at least initially, and may eventually require diabetes tablets or insulin injections. Gestational diabetes occurs in some pregnant women and usually goes away after childbirth, although it increases the risk of developing type 2 diabetes later on. Other types of diabetes include type 3c diabetes, which is caused by pancreas damage affecting insulin production, and latent autoimmune diabetes in adults (LADA), which is similar to type 1 diabetes but develops more slowly.
In summary, insulin and diabetes are closely related: diabetes occurs when the body does not produce or properly use insulin, leading to high blood sugar levels. Insulin is the key that allows glucose to enter cells and be used for energy, so a lack of insulin or insulin resistance results in diabetes.
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Hypoglycaemia and tremors
Hypoglycaemia, or low blood sugar, is common in people with diabetes, especially Type 1 diabetes. It occurs when the level of sugar (glucose) in the blood drops below the healthy range. Insulin is a hormone produced by the pancreas that is the most significant contributor to maintaining healthy blood sugar levels.
Low blood sugar can be caused by an excess of insulin, either naturally produced by the body or injected as synthetic insulin. Other hormonal and metabolic issues can also lead to low blood sugar. Hypoglycaemia can be life-threatening and requires immediate treatment, usually by consuming sugar or carbohydrates. The brain needs a continuous supply of glucose to function properly, and without it, the body experiences symptoms such as shakiness, tremors, and an increased heartbeat.
Hand tremors are a significant symptom of hypoglycaemia, as nerves and muscles are powered by blood sugar. One study found that 71% of older adults with diabetes reported experiencing trembling. Tremors caused by hypoglycaemia may be similar to those experienced in the early stages of Parkinson's disease. In some cases, diabetes-related tremors may be caused by peripheral neuropathies, or nerve damage to the extremities.
Machine learning has been used to develop tools to detect hypoglycaemia through hand tremors, with the aim of creating a proactive, non-intrusive alert mechanism for hypoglycaemic events. However, there are currently no validated tools or algorithms to monitor and detect hypoglycaemic events via hand tremors.
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Parkinsonian Tremors
Tremors are the most common type of involuntary movement. They can be classified into physiological, essential, dystonic, Parkinsonian, and psychogenic types. Parkinsonian tremors are a typical symptom of Parkinson's disease (PD) and are characterised by slow, rhythmic movements that occur when the body is at rest, known as a "resting tremor". This is different from most other types of tremors. The tremors usually start in one hand, foot, or leg and can eventually spread to both sides of the body. They can also occur in the jaw, chin, mouth, or tongue, and some people experience internal tremors, which are not visible to others.
The tremors associated with Parkinson's disease can interfere with daily activities such as shaving, dressing, and writing, which require fine motor coordination. They are often described as a "pill-rolling" motion, where the individual continuously rolls a pill between their thumb and forefinger. Alternatively, they can exhibit "supination and pronation", where the palm faces up and down.
The onset of Parkinsonian tremors is often gradual, and they tend to worsen with fatigue, stress, or intense emotions. While they can be annoying, they are not typically disabling. However, they can attract unwanted attention, causing individuals to feel self-conscious. It is worth noting that tremors are not the primary issue for most people with Parkinson's disease.
In terms of treatment, doctors may prescribe medication such as Levodopa/carbidopa combination medicines (Duopa, Inbrija, Parcopa, Rytary, Sinemet, and Stalevo), which are dopamine agonists and typically the first line of treatment. Other medications include Bromocriptine, pramipexole, ropinirole, rotigotine, and injectable apomorphine.
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Peripheral neuropathy
Diabetes can lead to peripheral neuropathy, which is nerve damage to the extremities. Peripheral neuropathy is an umbrella term for nerve diseases that affect a specific subdivision of the nervous system. It can affect nerves anywhere in the body, disrupting the body's control of automatic processes, the sense of touch, and muscle control. The peripheral nervous system carries motor signals, which are commands sent from the brain to the muscles, allowing movement.
There are many different symptoms of peripheral neuropathy, and they depend on the type of nerve signals affected. Symptoms can include muscle weakness and paralysis, as nerve deterioration weakens the connected muscles. This can cause difficulty moving the toes, foot drop, and hand weakness, and weakness can also affect the thighs and arms. Loss of nerve connection can also cause muscles to shrink in size, especially in the feet, lower legs, and hands, and sometimes there are deformities of the feet and hands due to muscle loss. Uncontrolled muscle movements can occur when nerves that lose their connection to the brain become hyperactive, causing cramps. Tingling is another symptom, occurring when there is a problem with nerves that carry signals to the brain.
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Non-invasive detection methods
While insulin is not directly mentioned as a cause of muscle tremors, diabetes is a health condition associated with abnormally high levels of glucose in the blood, and diabetes can cause tremors.
Tremors are an impairing symptom associated with several neurological diseases, some of which are neurodegenerative. The gold standard for the analysis and diagnosis of tremors is electromyography (EMG). However, this technique is invasive and costly, and generally unsuitable for continuous monitoring.
Recent developments in mobile devices have led to the creation of several portable and wearable solutions for health monitoring and disease diagnosis. These devices are often based on inertial sensors (accelerometers and gyroscopes) or a combination of inertial and electrophysiological information.
One such device is a wearable watch-like tool equipped with two EMG acquisition plates (one for each muscle) and a wireless connection to a smartphone and mobile app for real-time processing and fully automated evaluation. The system can characterise rest tremor phase patterns in under a minute and discriminate between PD and non-PD on an individual basis.
Other non-invasive techniques for detecting muscle fatigue include mechanomyography, near-infrared spectroscopy, and ultrasound for both isometric and non-isometric contractions.
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Frequently asked questions
Insulin can cause muscle tremors indirectly by lowering blood sugar levels, which can lead to hypoglycaemia. Hypoglycaemia is a condition where the body does not have enough glucose (blood sugar) to function properly, and it is common in people with diabetes, especially those who take insulin. Tremors are a significant symptom of hypoglycaemia, as the nerves and muscles rely on blood sugar to function.
Symptoms of hypoglycaemia include shakiness, an increased heartbeat, seizures, and in extreme cases, comas and brain damage.
Hypoglycaemia in diabetics can be caused by taking too much insulin, incorrect timing of insulin and carb intake, increased physical activity, alcohol consumption, and incorrect dosages of oral diabetes medications.
Hypoglycaemia is usually detected through invasive methods or intrusive devices, which are not always accessible to diabetic patients. However, research has shown that machine learning models and wearable physiological sensors can be used to predict hypoglycemic events through hand tremors, providing a proactive and non-intrusive alert mechanism. Consuming carbohydrates may help alleviate symptoms more quickly.
