Diabetes, Leg and Feet Swelling on Both Sides With Numbness

Cathy Asked :

I am a 52 year old female and recently I have been experiencing persistent swelling of both legs which were paining at first but now there is some numbness. I was diagnosed with diabetes around the age of 45 and over the past 3 years I have been on metformin.

I do not have any leg sores or anything of the sort but I noticed that the skin on my legs feel thick and smooth. My right leg does seem to be more affected but I assume that is because it is my dominant leg and  I put more weight on it. My feet are a big problem as well because I sometimes have difficulty putting on my shoes if it is very swollen.

I am a bit worried if this is related to the diabetes because initially it would just get swollen for a day or so and then settle down. Now the swelling is staying. The last time I experienced swelling like this was when I was pregnant at the age of 38. By the way, at that time I was diagnosed with pregnancy diabetes and was supposed to go for follow up diabetes tests after giving birth which I did not do.

My concern is that the diabetes may have been present for much longer than initially thought and this leg swelling may be the first sign of a diabetes complication. I will admit that until recently I was in denial about my diabetes and did not attempt to loose weight, exercise or maintain a healthy diet. Finally my doctor decided to put me on metformin after consecutive A1C tests revealed uncontrolled sugar levels.

I am not ignorant about the disease but I have behaved quite foolishly in the past and have now started to change my eating habits. Do you think that if this swelling is related to diabetes then it will go down once I get my glucose levels under control? Please can you give me some advice as to what I should start doing at this point to reverse any complications at this point.

This question was posted under the Swollen Leg and Swelling of the Feet article.

Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.

Dr. Chris Answered :

Your leg swelling may most likely be related to your diabetes but is important to first speak to your doctor and exclude other conditions like heart failure which needs immediate attention.

A major concern with uncontrolled diabetes and bilateral leg swelling is that it may be due to kidney related complications of diabetes (diabetic nephropathy). If you are experiencing water and salt retention due to kidney damage as a result of your diabetes, then this is of a serious nature. Once again, only your doctor can confirm or exclude this and you may need blood and urine tests which will indicate the presence of proteins in the urine or abnormal levels of urea and electrolytes in the blood.

If it is kidney related, then you will need specialist medical care to ensure that the condition does not progress to kidney failure. Depending on the extent of kidney damage, if present, your doctor may also have to consider dialysis treatments to ‘clean’ the blood.

The numbness of the legs is also of concern. It could be related to the swelling which is pressing on the nerves of your leg and will ease once the swelling goes down. However, it could also be diabetic neuropathy which is nerve damage as a result of uncontrolled diabetes. Refer to the article on Leg Numbness, Tingling Feet and Toes.

Hopefully none of the more serious and permanent diabetic complications have set in as yet. Your doctor will have to assess this and you will only know for sure once you bring your glucose levels under control.  A reassessment of your condition is important at this stage and your doctor may refer you to a specialist endocrinologist to decide if other medication or even insulin is necessary.

If you are serious about changing the status of your condition, you have to use your medication as prescribed and monitor your blood glucose levels on a regular basis, like 3 times a day. You will need a home glucose monitoring device for this and you should speak to your doctor about it. Refer to this article on Blood Glucose Levels so that you will have an idea of normal blood glucose values. You will also need to consult with a dietitian and develop your own individualized eating plan but in the meantime, you can find a low GI (glycemic index) diet on the internet which will assist you in the interim.

Exercise is essential but speak to your doctor about options and do not undertake any activity that is too strenuous initially. It is also wise to keep a food diary with corresponding glucose levels per meal. This will help your doctor assess your condition in conjunction with monitoring your A1c levels. Remember that apart from diet and exercise, losing weight is another key issue in improving your glucose tolerance.

In the meantime, speak to your doctor about measures which you could undertake to reduce the swelling. Elevate your legs as much as possible and change the type of shoes that you wearing so that there are no skin injuries which could complicate into ulcers at a later stage. There is no guarantee that any diabetic complications will reverse once you get your blood glucose levels under control but at least you will slow down the progression and possibly prevent other complications.

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  • Kimberly

    I am writing on behalf of my mother. She will be 60 this year and has had diabetes for over 20 years. I don’t have a long question, but an in-depth response would be appreciated. My mother’s feet and legs are swollen and have been for 2 weeks now. She is from GA and visiting me and the family in TX. She is on two high blood pressure meds, HCTZ 25 and Clonidine 0.1mg. Diabetic meds are Metformin and Actos. The swelling won’t go down and by her being so far from home, I’m concerned because she’s not near her Dr. Always concerned about her health, just that she’s so far away from her Dr. What could it be? Thank you in advance.

    • Dr. Chris

      Hi Kimberly

      I understand your concern but I hope that any response here will not detract from seeing a doctor in person. This platform is meant as a guide and at best, it’s not accurate for most cases because readers either do not give all the information, or are not aware of all aspects of their condition, and in the end, text can never replace the clinical evaluation by a doctor in person, coupled with all the necessary investigation and knowledge of the patient’s medical history. With that said, you really should not be seeking an answer online or take any answer as the final assessment if you are worried about your mother. She needs to see a doctor – IN PERSON. Here are some aspects to consider :

      The swelling could be due to many reasons – it may be related to the diabetes, her high blood pressure and underlying problems that both you and your mom may not be aware of. Being away from home can often lead to changes in the blood glucose and pressure of a diabetic/hypertensive patient. It is due to a number of factors – greater activity, change in regular diet, climatic differences, poor complicance with meds, etc – all of these common occurrences while holidaying away from home can affect the glucose and pressure levels and lead to swelling. However, given that your mom has had diabetes for such a long period of time, and the hypertension may have also been ongoing, there is a real risk that this may be due to kidney damage. This could be occurring independently or be associated with heart failure and would not have cropped up overnight. Rather it may only be showing the first signs (that you are aware of, your mom may have noticed signs earlier) now given the added strain/excitement/activity of being away from home and the factors mentioned above. I only mention the most common cause and the most serious cause. There could be many other possibilities in between that would be too exhaustive to delve into.

      Bottom line, your mom needs to see a doctor there. She may be more comfortable with her regular doctor but that is not an option. Apart from a physical examination, the doctor will also need to consider her medical history which he/she can acquire from her regular doctors. There may be more to the situation that you or your mom is aware of.

  • Raghu

    Hi Doctor,

    I am from India and i am writing on behalf of my mother, my mother is facing numbness and pain in left hand 3 fingers from past few months and also one of her leg also she says has pain along with some tingling when kept in water for some time. I dont know to which doctor i need to take her, can u kindly advise please.

    Thank you in advance

    • Dr. Chris

      Hi Raghu

      She needs to see a neurologist. If she is diabetic, it would also be advisable that she see an endocrinologist.