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What causes swelling in ankles when suffering from diabetes?

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Posted on Tue, 8 Jul 2014
Question: Dear doctor. I am a obesse male of 35.

I am a diet controlled diabetic.

I have for last 2 months off and on getting puffy and slightly swollen ankles.

I have attached some pics to show.

My bloods were done within last 2 months and these were ok.

The results are attached aswell.

What could be causing this? Kidneys? Heart?

I work alot and am very active.

In the morning my ankles are fine its just gravity and worst at night.

Could this be the weather? Or am i tjinking too much?
doctor
Answered by Dr. Binu Parameswaran Pillai (56 minutes later)
Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.

There are many reasons for ankle swelling in a diabetic.
Some of the medicines can cause fluid retention ( like pain killers and some diabetes/hypertension pills). But you mentioned that you are not on any pills.

Other reason is kidney dysfunction. Please get a urine protein, serum albumin and serum creatinine and a GFR test.

Hypothyroidism is another cause ( a Thyroid function test will help).

Gravity can also cause ankle oedema if you stand or sit for a long time.

Varicose veins is another cause. Do you have them?

Peripheral neuropathy is a common cause of oedema in legs. Do you have tingling, numbness in your feet?

Unfortunately, the blood works and photos were not seen. could you attach them again?

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (10 minutes later)
Hi sorry pls see attached.

Pls note i am a diet controllled diabetic (hba1c 6.2), so its well controlled.

Whats peripheral neuropathy? I dont have tingling or pins and needles.

But they are restless wspwcially at night.

My job does involve climbing stairs, ladders and i do go to intensive gym seasions 3 times aweek.

I also suffer from anxiety.

I am not sure if i am just thinking this.

Hi sorry pls see attached.

Pls note i am a diet controllled diabetic (hba1c 6.2), so its well controlled.

Whats peripheral neuropathy? I dont have tingling or pins and needles.

But they are restless wspwcially at night.

My job does involve climbing stairs, ladders and i do go to intensive gym seasions 3 times aweek.

I also suffer from anxiety.

I am not sure if i am just thinking this.
doctor
Answered by Dr. Binu Parameswaran Pillai (7 hours later)
Brief Answer:
hello

Detailed Answer:
Hello,
Good day.
Got the photos and blood reports.
Nited that your Hba1c is 6.2. but what about blood sugar reports? HbA1c can not be completely relied upon.

The photos shows some pigmentation in your feet and both great toes laterally rotated ( BUNION). There is mild swelling in ankles. All these may point towards peripheral neuropathy. This is the involvement of nerves of feet. This could be due to diabetes. Other causes include smoking, alochol etc. Please ask your GP to test for neuropathy

Noted that your kidney functions are normal. Liver function tests shows a high protein and globulin levels. Please repeat this along with a CBC and ESR.

Please do a thyroid function test as well.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (50 minutes later)
Ao is there anythjnh to worry aboit?
doctor
Answered by Dr. Binu Parameswaran Pillai (20 minutes later)
Brief Answer:
Hello

Detailed Answer:
Not really. Just need to find out the cause. Please meet your GP. He might check for neuropathy and may repeat some of the blood tests.
Please monitor your blood glucose at home more often and if it is high, may need treatment.
Regards XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes swelling in ankles when suffering from diabetes?

Brief Answer: Hello Detailed Answer: Hello, Good day. There are many reasons for ankle swelling in a diabetic. Some of the medicines can cause fluid retention ( like pain killers and some diabetes/hypertension pills). But you mentioned that you are not on any pills. Other reason is kidney dysfunction. Please get a urine protein, serum albumin and serum creatinine and a GFR test. Hypothyroidism is another cause ( a Thyroid function test will help). Gravity can also cause ankle oedema if you stand or sit for a long time. Varicose veins is another cause. Do you have them? Peripheral neuropathy is a common cause of oedema in legs. Do you have tingling, numbness in your feet? Unfortunately, the blood works and photos were not seen. could you attach them again? Regards Binu