Diabetic Legs Swelling Causes and Remedies
Many people suffering from diabetes complain about swelling in legs and feet. Usually, this swelling is painless and due to retention of fluid. There can be numerous reasons leading to such retention, from very high and uncontrolled sugar levels (which is dangerous for various organs) to the secondary complications of diabetes. Usually, fluid retention indicates that either heart of a diabetic person has become weak. Thus there is a poor flow of fluids, or kidneys are not functioning properly. In some cases, it may be due to liver disease or some anti-diabetic medications. Other reasons of such swelling could be a disease of blood vessels, or deficit of certain micronutrients and electrolytes(“Swelling and Diabetes – Swollen Legs, Ankle & Feet, Peripheral Edema,” n.d.).
Let us look in detail at some leading causes of swelling of legs in diabetes.
Congestive heart failure
The major complication of diabetes is weakening of heart and blood vessels. Congestive Heart Failure (CHF) often coexists in diabetes(Nasir & Aguilar, 2012). In fact, a person suffering from diabetes is at much higher risk of heart failure(Nichols, Gullion, Koro, Ephross, & Brown, 2004). In CHF though the heart is functioning, but its pumping power is compromised, which means that it is not strong enough for blood to circulate properly in our body. Things are further made worse by stiffening of arteries(“Heart failure,” n.d.). All this leads to swelling and accumulation of fluids in the legs.
More than one-third people suffering from diabetes have chronic kidney disease(“Diabetes and Chronic Kidney Disease,” 2014). Diabetes is slowly emerging one of the leading causes of chronic kidney disease. Almost half of people going for dialysis, also have diabetes(Cavanaugh, 2007). In diabetes, due to ahigh level of sugar small blood vessels in the kidney are damaged, this leads to poor functioning of kidney. When the kidney is damaged, it cannot filter blood properly, resulting in retention of fluids(“Diabetes – A Major Risk Factor for Kidney Disease,” 2015), thus leading to the swelling of legs and ankles.
Peripheral vascular disease
Cells of blood vessels are injured in diabetes. It often results in narrowing of blood vessels or even in some cases even complete blockage of the blood vessels. Diabetics are at much higher risk of damage to blood vessels as compared to healthy people(“What is Peripheral Vascular Disease?” n.d.).Due to the damage of peripheral blood vessels, diabetic people often get swollen legs, dryness of skin. Chronic swelling and poor blood flow may often lead to the ulcers or infections of legs, foot or ankle(“Diabetic Foot Infections,” 2017).
Though in a small percent of cases, yet some of the antidiabetic medications may lead to the edema and swelling of legs. One such group of antidiabetic medicines known to cause swelling and edema are thiazolidinediones(Mudaliar, Chang, & Henry, 2003). In very rare cases insulin may also cause swelling of legs, it usually happens on the starting of insulin therapy, especially in a patient on high doses of insulin. Swelling caused due to insulin usually subsides spontaneously after some time(Baş et al., 2010).
Tips and remedies for reducing swelling in legs
Methods used to reduce swelling in legs depends on the causes. Tight sugar control is the key to avoiding complications with diabetes. Some types of swellings may indicate the serious conditions like heart or kidney failure and may require treatment with various drugs. The only specialist can decide on kind of medicines to prescribe for swelling. Usually specialist may give medicines to control blood pressure, increase urine flow (diuretics), and medicines to improve metabolism of various organs. Non-pharmaceutical methods may also help to relieve the swelling in legs. Some of the non-medicament methods that can be used are given below(“How Diabetes Causes Swollen Feet and 7 Ways to Help,” 2016, “Swelling and Diabetes – Swollen Legs, Ankle & Feet, Peripheral Edema,” n.d.; Rupavate, n.d.):
- Decrease body weight: If a person is obese decreasing a body weight can help to reduce the swelling in legs.
- Cut down on salt intake: Salt helps our body to retain fluids, by reducing the salt intake one may lessen the swelling of feet and legs.
- Regular exercise: It has many health benefits, it makes your heart and blood vessels strong. Improves the blood flow to various organs, at the same time it helps to bring down the blood glucose levels.
- Keeping legs elevated: By keeping the feet at the higher level for some minutes at regular intervals would help to drain the excess of liquid in the legs. If your work involves sitting in one place for an extended period to time, you should find a way to elevate legs from time to time.
- Compression bandages and stockings: They help to fight the accumulation of fluid in legs by applying pressure on the lower legs and feet. In some countries special diabetic socks and stockings are available for such purpose,else person may use the elastic bandage instead.
- Wear right kind of shoes: Diabetics should avoid wearing very tight shoes so that on swelling there is no reduction of blood flow in the lower extremities.
- Foot massage: It improves the circulation in feet and helps to remove the extra fluid that has accumulated and causing swelling. Just a few minutes of foot massage, few times a day may make a big difference in many cases.
- Good posture: Maintaining healthy postural habits is very important for diabetics. A person suffering from diabetes should avoid either sitting or standing at one place for avery long time. While sitting, never cross your legs, as they limit the circulation in legs.
- Baş, V. N., Çetinkaya, S., Yılmaz Ağladıoğlu, S., PeltekKendirici, H. N., Bilgili, H., Yıldırım, N., &Aycan, Z. (2010). Insulin Oedema in Newly Diagnosed Type 1 Diabetes Mellitus. Journal of Clinical Research in Pediatric Endocrinology, 2(1), 46–48. https://doi.org/10.4274/jcrpe.v2i1.46
- Cavanaugh, K. L. (2007). Diabetes Management Issues for Patients with Chronic Kidney Disease. Clinical Diabetes, 25(3), 90–97. https://doi.org/10.2337/diaclin.25.3.90
- Diabetes – A Major Risk Factor for Kidney Disease. (2015, December 24). Retrieved May 27, 2017, from https://www.kidney.org/atoz/content/diabetes
- Diabetes and Chronic Kidney Disease. (2014, August 12). Retrieved May 27, 2017, from https://www.kidney.org/news/newsroom/factsheets/Diabetes-And-CKD
- Diabetic Foot Infections: Practice Essentials, Background, Pathophysiology. (2017). Retrieved from http://emedicine.medscape.com/article/237378-overview
- Heart failure. (n.d.). Retrieved May 27, 2017, from http://mayoclinic.org
- How Diabetes Causes Swollen Feet and 7 Ways to Help. (2016, August 24). Retrieved May 27, 2017, from http://www.md-health.com/Diabetes-Swollen-Feet.html
- Mudaliar, S., Chang, A. R., & Henry, R. R. (2003). Thiazolidinediones, peripheral edema, and type 2 diabetes: incidence, pathophysiology, and clinical implications. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 9(5), 406–416. https://doi.org/10.4158/EP.9.5.406
- Nasir, S., & Aguilar, D. (2012). Congestive Heart Failure and Diabetes: Balancing Glycemic Control with Heart Failure Improvement. The American Journal of Cardiology, 110(9 Suppl), 50B–57B. https://doi.org/10.1016/j.amjcard.2012.08.031
- Nichols, G. A., Gullion, C. M., Koro, C. E., Ephross, S. A., & Brown, J. B. (2004). The Incidence of Congestive Heart Failure in Type 2 Diabetes. Diabetes Care, 27(8), 1879–1884. https://doi.org/10.2337/diacare.27.8.1879
- Rupavate, S. (n.d.). 7 tips for diabetics to reduce swelling in the feet. Retrieved May 27, 2017, from http://www.thehealthsite.com/diseases-conditions/7-tips-for-diabetics-to-reducing-swelling-in-the-feet-sh314/
- Swelling and Diabetes – Swollen Legs, Ankle & Feet, Peripheral Edema. (n.d.). Retrieved May 27, 2017, from http://www.diabetes.co.uk/diabetes-complications/edema-and-diabetes.html
- What is Peripheral Vascular Disease? (n.d.). Retrieved May 27, 2017, from http://www.hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/peripheral_vascular_disease_85,P00236/