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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Swollen Legs And Blood Blisters While Suffering From Diabetes?

My mother is 92, has Type II Diabetes (managed with diet and a pill). She has developed an odd assortment of symptoms in her right leg which may or may not be related. For about a week or so she had what she described as a pain in the muscle of her right thigh. We put heat on it and she massaged it herself. That pain went away and then she woke up with a swollen right knee with what looked like blood blisters and heavy bruising under the skin. We iced that for several days. Now the knee is improving but the lower leg is swollen and the skin is very tight and shiny in appearance and dark brownish red in color. From the first symptom to the current about 4 weeks have elapsed. Ideas?
Fri, 10 Apr 2015
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Diabetologist 's  Response
Hi,
After going through your mother's case record there is a development of right Diabetic Foot.

Her symptoms started with pain in right thigh after applying heat and massaging the symptoms aggravated.
(Applications of heat and massaging should be avoided in Diabetes patients.)

Subsequently there is decreasing knee swelling but development of swollen leg with overlying tight, brown, shiny skin.
Skin changes denote possibility of cellulitis (infection) with compartment syndrome (swelling of leg muscles and other tissues underneath overlying skin leads to increase in pressure which hampers blood supply to leg.)

Diabetic patients are more prone to develop foot problems because -
1) loss of protective sensation of foot (diabetic neuropathy) which make patient more prone for injuries to feet.
2) Impaired blood supply due diabetic vasculopathy, which impaires nutrition of leg.
3)Diabetes patients are more prone for infections and poor, delayed wound healing.

I will advise you to consult your doctor immediately.
She requires detailed foot Examination.
Blood investigation.
Intravenous antibiotics.
Strict blood sugar level monitoring and control.
Arterial and venous doppler of right leg to assess blood supply of leg.
Depending upon her clinical condition and test results she may require surgical intervention.

I think this much information is enough for you to make further decision.
You are free to contact me for further queries.

Dr Abhay Mali.

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What Causes Swollen Legs And Blood Blisters While Suffering From Diabetes?

Hi, After going through your mother s case record there is a development of right Diabetic Foot. Her symptoms started with pain in right thigh after applying heat and massaging the symptoms aggravated. (Applications of heat and massaging should be avoided in Diabetes patients.) Subsequently there is decreasing knee swelling but development of swollen leg with overlying tight, brown, shiny skin. Skin changes denote possibility of cellulitis (infection) with compartment syndrome (swelling of leg muscles and other tissues underneath overlying skin leads to increase in pressure which hampers blood supply to leg.) Diabetic patients are more prone to develop foot problems because - 1) loss of protective sensation of foot (diabetic neuropathy) which make patient more prone for injuries to feet. 2) Impaired blood supply due diabetic vasculopathy, which impaires nutrition of leg. 3)Diabetes patients are more prone for infections and poor, delayed wound healing. I will advise you to consult your doctor immediately. She requires detailed foot Examination. Blood investigation. Intravenous antibiotics. Strict blood sugar level monitoring and control. Arterial and venous doppler of right leg to assess blood supply of leg. Depending upon her clinical condition and test results she may require surgical intervention. I think this much information is enough for you to make further decision. You are free to contact me for further queries. Dr Abhay Mali.