Inspiration And Expert Advice: Expert Columns
Help! My Feet and Legs are Swollen
By Joy Pape RN BSN CDE WOCN CFCN
I receive a lot of questions from people concerned about swelling of their feet and legs. I wish I had a simple answer for each you, but I don’t because it’s not always so simple.
The medical term used for the word swelling is edema. Edema is the abnormal accumulation of fluid in various body tissues, which causes swelling. This swelling can occur at different places on your body, such as your feet, ankles, legs, hands, abdomen, and even your eyelids.
Edema has many causes. Just having an elevated blood glucose level is not usually the cause for edema, although some people do notice both at the same time. It’s one of those, “what came first, the chicken or the egg?” questions. Elevated blood glucose can affect other parts of your body, and if other parts of your body aren’t working right, this can cause your blood glucose to rise as well as cause edema in certain parts of your body. Many times it is noted in your feet and legs.
Edema can be caused by but not limited to the following problems which are closely related to diabetes:
- Cardiovascular problems. Diabetes is closely related to heart and vessel disease. Conditions such as congestive heart failure and peripheral vascular disease are common in people who have diabetes and can cause edema of your lower extremities.
- Nerve problems. Nerves work closely with your vessels and muscles. It is not unusual for people who have peripheral neuropathy to have edema.
- Inflammation. The cardinal signs of inflammation are redness, swelling, heat, and pain. Different diseases are considered inflammatory diseases. For example, arthritis is considered an inflammatory disease. Swelling can occur when your arthritis is acting up.
- Infection. Inflammation is associated with infection, so you will usually see swelling if there is infection brewing in your feet or legs.
- Thyroid Problems. A lot of people who have diabetes have thyroid problems. Thyroid problems can cause swelling.
- Kidney Problems. If your kidneys are not functioning properly, you won’t be able to remove the waste products and extra water. One of the first symptoms associated with kidney problems is edema.
- Medications. Certain medications have a side effect of edema. A class of diabetes medications, Thiazolidinediones (TZDs), has this side effect for some people. The two TZDs that are available at this time are Actos (pioglitazone), and Avandia (rosiglitazone). There are also medications that treat high blood pressure that can cause edema.
When you have a question, we like to give you an answer. As you now see, there’s no one answer that fits all. I hope the information given above helps you to understand that to treat edema, you need to address and treat the problem. If you notice you or a loved one has edema, you will want to discuss this with your healthcare team. They will most likely first do lab work and other tests to diagnose what is actually causing the edema. They will also look at your medications to see if any of those are the culprit. Then, once they know, they will work with you to treat the underlying cause as well as relieve your edema.
Stay tuned for next month. I’ll discuss some practical tips to help your edema once you know the cause.
EnJOY!
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*Joy Pape values each question asked by the dLife community. However, due to the large volume of questions that she receives, Joy cannot answer every question received nor promise a timely response. Should your question be selected for answering in her column, dLife will contact you at that time.