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Do You Have Swollen Diabetic Legs?

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Do You Have Swollen Legs? Always uncomfortable and sometimes serious, you need to find the cause.

Our blood and body cells contain fluid, nutrients and other chemicals.  Extra cellular fluid (ECF) and lymphatic channels return excess fluid waste to our blood for excretion by our kidneys. Our brains, kidneys and other organs constantly monitor and adjust this balance, but if things go wrong, fluid accumulates and produces swelling (oedema), usually in the feet and legs – press this gently with a finger and it will leave a dent.

Varicose Veins

Blood from skin veins drains through tiny channels into deeper leg veins and the pumping action of our calf muscles helps it to return to the heart. This struggle against gravity means we often get temporary oedema after sitting for too long, or in warm weather when veins dilate. If your veins are weakened or under pressure (for example, because of a family tendency, pregnancy, obesity, prolonged standing, or a blood clot/thrombosis/DVT) back pressure can force fluid and proteins out into surrounding tissues. This produces skin damage, including varicose eczema and ulcers, or permanent ‘woody’ swelling. Self-care is important, but diuretics (water pills) don’t help much as the problem is poor drainage.

Medical support stockings can be used to help treat or prevent oedema in varicose veins or after a DVT, providing an ultrasound scan shows they won’t reduce arterial flow. Your GP may refer you for varicose-vein surgery, or four-layer compression bandaging for ulcers.

Heart Failure

Oedema affecting the legs (and sometimes the lungs) develops when heart muscles can’t pump efficiently. Heart failure affects 10% of people over the age of 70 and some young people too. It’s triggered by damage to the heart’s arteries, muscles or valves, anaemia, abnormal heart rhythms, medication toxins, lung disease and many other diseases.

You may notice breathlessness, fatigue, palpitations and symptoms relating to the cause, and will need blood tests, a heart electrical tracing (ECG) an ultrasound scan (echocardiogram) and other checks. It’s treated with medication to strengthen the heart, diuretics and/or a pacemaker if needed.

Liver and Kidney Disease

These can both lead to fluid retention, oedema and a toxic build-up of waste chemicals, with fatigue and skin yellowing (jaundice or uraemia). You may need detailed blood tests and scans to identify and treat the cause – there are many.

Kidney failure is treated with medication or occasionally dialysis (a blood-cleansing procedure). In severe liver disease, fluid may also accumulate in the tummy (ascites). It’s treated with medication and occasionally drainage.

Lymphatic Disease

Lymph channels can become blocked, leading to a fluid build-up for example, arms swelling after the removal of lymph glands in breast cancer, or a genetic tendency to lymphoedema. Drainage is encouraged by elevating the affected area, specialised massage, exercises and wearing a compression sleeve/stocking. It’s important to protect yourself against minor injuries, which can lead to infection.

Lipoedema, which resembles lymphoedema, is caused by a build up of abnormal fat cells, not fluid and produces swelling that doesn’t ‘dent’, especially in the legs and buttocks. This should be diagnosed by your doctor first, but treatment (liposuction) isn’t usually provided by the NHS.

5 Ways to Help Swollen Legs

1. Get a diagnosis – urgently if one leg is swollen, red and painful (this could be due to a blood clot or infection).

2. Maintain a healthy weight to reduce the pressure on your legs.

3. Walk, swim or cycle to encourage fluid to circulate. Support tights help, especially if you stand a lot.

4. Put your feet up when you can and regularly ‘pump’ your calf muscles by tensing and relaxing them, pulling your toes up towards you and/or rotating your feet at the ankles.

5. Moisturise the skin on your legs daily and show any red, scaly patches or infections to your doctor.

E256 – Do You Have Swollen Diabetic Legs? –

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