The Relationship Between Peripheral Edema and Diabetes

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Peripheral edema is swelling in the feet, ankles, and legs. It can occur in one or both of your lower limbs. If you have diabetes, you need to take extra precautions when you have edema.

Fluid can build up when tiny blood vessels are damaged or when they leak into surrounding tissues. The result is swelling.

People with diabetes often have problems with blood flow. When blood doesn't circulate well, wounds heal slowly or not at all. Swelling makes it harder for wounds to heal. That's why it's so important to control it.

This article explains how diabetes and other health conditions could cause your lower legs to swell. It also offers some advice on how to treat it and when to get medical care.

edema management
 Verywell / Emily Roberts

Symptoms

If you have edema, you may notice:

  • Stretched or shiny skin
  • Swelling or puffiness
  • Skin that pits (stays indented) when you press it
  • Swelling that stays firm and doesn't pit

Causes

Your legs may swell for reasons that have nothing to do with diabetes. Some examples are:

  • Not being active enough
  • Standing or sitting a long time
  • Surgery
  • Burns
  • Hot weather
  • Pregnancy
  • Menstruation
  • Menopause
  • Birth control pills
  • Medications
  • Too much salt in your diet
  • Poor diet

If you have swelling in one leg or foot but not the other, it may be:

Diabetes-Related Causes

Swelling can also come from heart disease, blood flow problems, liver disease, and kidney disease. Diabetes can increase the risk of each of these conditions.

Some diabetes medications, like Actos (pioglitazone), can cause swelling. They may also cause heart problems.

These medications should not be used by anyone with congestive heart failure. This is a condition in which the heart doesn't pump well, causing blood and fluid to back up into tissues.

People with diabetes are twice as likely to have heart disease or heart failure. If diabetes has damaged your nerves, you might not notice the symptoms. That's why it's vital to let your healthcare provider know if your legs or feet swell.

Recap

Swollen legs or feet may or may not be related to diabetes. Your diet, activity level, hormone changes, and even the weather can make you swell up. Other health conditions–some of them serious–could be the reason. To find out why you're swelling, see your healthcare provider.

Care

Here are some steps you can take to bring down swelling:

  • Elevate the swollen leg or foot
  • Wear support stockings
  • Exercise
  • Opt for a low-sodium diet

If you have a wound, cellulitis (a skin infection), scaling, or itching, make sure your care plan treats those symptoms.

Seek medical help as soon as you can if:

  • The swelling does not improve or gets worse
  • You have liver disease and your legs or abdomen swell
  • Your swollen area is red or warm
  • You have a fever
  • You're urinating less
  • You have arterial disease and swelling
  • You are pregnant and have sudden moderate to severe swelling.

When to Get Medical Help

New swelling in one or both legs needs urgent care. Edema in only one leg could be a sign of DVT, which may be life-threatening.

Call 911 if you have shortness of breath or chest pain.

Summary

Peripheral edema is fluid buildup in your lower legs or feet. If you have diabetes, changes to your blood vessels may be partly to blame for swelling. Your medications or related health conditions could also cause the problem.

It's possible that something besides diabetes is making your lower legs swell. To find out for sure, talk it over with your healthcare provider. Don't ignore swelling in your feet or lower legs because a serious health condition could be developing.

Frequently Asked Questions

  • Does diabetes cause water retention?

    People with diabetes often retain water. Diabetes itself might or might not be the cause.

    Fluid retention is a sign of heart failure and kidney damage. Both can affect people with diabetes. The diabetes medication Actos (pioglitazone) can also cause fluid buildup. 

  • How do you reduce swelling in the feet and ankles?

    Gravity makes lower-leg swelling worse. To reduce it, raise the affected foot or feet. If swelling keeps coming back, try cutting the amount of sodium in your diet. 

  • When should I be concerned about swollen feet?

    If your feet sometimes swell but it goes away overnight, there's probably no cause for concern. Call your healthcare provider if it lasts longer than a day, happens regularly, affects only one limb, or comes with other symptoms. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Foot, leg, and ankle swelling.

  2. MedlinePlus. Edema.

  3. National Institute of of Diabetes and Digestive and Kidney Diseases. Diabetes and foot problems.

  4. MedlinePlus. Swelling.

  5. Trayes KP, Studdiford, JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Physician. 2013 Jul 15;88(2):102-110.

  6. Wu SC, Crews RT, Skratsky M, et al. Control of lower extremity edema in patients with diabetes: Double blind randomized controlled trial assessing the efficacy of mild compression diabetic socks. Diabetes Res Clin Pract. 2017;127:35-43. doi:10.1016/j.diabres.2017.02.025

  7. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, heart disease, and stroke.

By Elizabeth Woolley
Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.