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Suggest Treatment For Swelling And Pain In The Legs
Question: I am a 63 yr old type II diabetic. Have had for 15 years, have managed it fairly well,, but fluctuated. Developed Charcot foot about 5 yrs ago, (got to keep my foot :) )), now have early stage diabetic retinapathy, and have fairly serious neuropathy in feet. 4 - 5 mos. ago I started developing swelling in bottom of legs (calf area). When sedentary for awhile, then get up, feels like lead has been poured in to me. Now, bubbles or swollen bumps (small) developing just above my ankle. Lastly, I also had a biopsy 4 yrs ago that showed very beginning of non-alcohol cirrhosis of liver. Is this symptomatic of kidney failure?
( YYYY@YYYY )
( YYYY@YYYY )
Brief Answer:
Possible but need tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Swelling of this type can be due to kidney, liver or thyroid problems or due to a clot in the leg veins, to name only a few possibilities.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid) 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Ultrasound exam of the calves
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Possible but need tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Swelling of this type can be due to kidney, liver or thyroid problems or due to a clot in the leg veins, to name only a few possibilities.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid) 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Ultrasound exam of the calves
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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