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.