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What Causes Swelling In Ankle And Calf Of A Diabetic Patient?

Posted on Tue, 7 Jun 2016

Question: Hi, I am a 63 year old female, over-weight all of my life, and I have Type2 diabetes. My ankles and calves are very swollen, more so than usual, and red. My skin is actually shiny because they are so tight. I have my compression socks on, but that's not helping much. I have been very busy and active this past week as my husband has broken his foot and will be going into surgery on Monday. I'm taking care of him, and getting the house clean, mowing the grass, doing the laundry, getting the wood in (we heat with a wood stove), and getting my garden ready to plant, plus cooking meals, etc. I know I've been on my feet a lot, but this is really bothering me that the swelling isn't going down, even after putting my feet up and after sleeping all night. They are sore and tender. My BP is 160/79, HR 62, and gluecous level is 141. My husband thinks I should go to the urgent care unit or ER (because it's Sunday). I don't think it's an emergency, but I know that I won't be able to get to the doctor for days, since his surgery is tomorrow. What can I do to get the swelling down, and should I go to for medical help today? Thank you for your help.

Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello and Welcome

I appreciate your concern

Based on your history, there can be a few causes related to the swelling. Bilateral pedal and ankle edema extending up to the knees can be a cause. Since you are on diuretics and you are hypertensive as well these medication may need adjustment with regards to the swelling, if indeed there is pitting edema on physical examination. Even though there is bilateral swelling, a vascular cause related to lower limbs like DVT should still be ruled out via a Doppler ultrasound of the lower limbs. If the swelling is associated with pain then uric acid levels, ESR, RA factor, Joint aspiration can be advised. NSAIDs like lornoxicam can be used to subside the associated inflammation. I would suggest that you pay a visit to your GP just to determine whether any specialist referral is needed or not for extensive workup. If not then empiric NSAIDs can be advised to see for improvement.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar