Swollen feet, caused by a buildup of fluid called edema, are a possible symptom of diabetes and an indication of a problem with blood flow to the feet and lower legs.
People with lower extremity edema are more likely to require amputation than people without edema.
Diabetes can affect every bodily system. Approximately 13% of U.S. adults had diabetes in 2018, according to a report from the Centers for Disease Control and Prevention (CDC).
The same report noted that in 2016, 130,000 people with diabetes required lower extremity amputation.
Several factors may contribute to swollen feet caused by diabetes.
Diabetes is a major risk factor for congestive heart failure and kidney disease. Both conditions are associated with lower extremity edema.
High blood sugar also causes changes in blood vessel walls, making it easier for fluid to leak from the bloodstream and into surrounding tissues. This leakage can lead to swollen feet.
Some medications that decrease blood sugar may also cause foot edema as a possible side effect.
Medications from a class called thiazolidinediones, which includes pioglitazone (Actos) and rosiglitazone (Avandia), are associated with foot edema when used at the same time as insulin.
Other types of medications can also cause foot edema. These include:
- calcium channel blockers, including:
- verapamil (Calan)
- amlodipine (Norvasc)
- diltiazem (Cardizem)
- nicardipine (Cardene)
- vasodilators like minoxidil (Loniten) and hydralazine
- nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen (Advil)
- medications used for nerve pain, like pregabalin (Lyrica)
In rare cases, rapid correction of blood sugar levels with insulin can result in insulin edema syndrome. This condition typically occurs in people whose blood sugar is not well-controlled when they start insulin therapy.
You may be able to manage swollen feet associated with diabetes through lifestyle changes or medical treatments.
Exercise
Exercise may help stimulate blood flow to your feet. If you have diabetes, wearing comfortable, supportive walking shoes for exercise can be helpful.
Footwear
Several manufacturers produce footwear with adjustable Velcro closures for people with foot edema. A doctor can recommend types of shoes to help manage the swelling.
Mild compression socks
Most socks marketed as “diabetic socks” are soft, stretchy, have a seamless toe, and have no compression. Socks that offer compression could potentially restrict blood flow.
Mild compression socks may help prevent foot swelling from diabetes. A small 2017 study showed that correctly fitted mild compression socks were safe and effective for swollen feet.
A doctor can advise on which type, size, and brand of compression socks to prevent or relieve swollen feet.
Diet
If you have swollen feet, consider limiting your sodium intake. Salt causes the body to retain water, which may worsen edema.
Medications
Your doctor may prescribe diuretic medications to help your body eliminate the excess fluid causing the edema. Diuretics increase urine output.
Diuretics can lower blood pressure and cause imbalances in sodium and potassium levels, so take them as directed and keep any appointments for lab testing.
While you’re on diuretics, your doctor may also want you to weigh yourself daily. They may also ask you to check your blood pressure at home or take measurements of your foot or calf circumference. This allows you and your doctor to track trends in your edema and overall fluid balance.
If another medication you’re taking, such as a calcium channel blocker, is causing the swelling, your doctor may switch you to a different medication.
The better your diabetes is managed, the lower the risk of long-term complications and symptoms such as swollen feet. Talk with your doctor about ways to manage diabetes.
Visit your doctor if you develop swollen feet with diabetes or if the swelling worsens.
If you’re monitoring your weight, foot circumference, or blood pressure daily, ask your doctor when to notify them about changes in these measurements.
Sometimes, a blood clot in the deep veins of the calf can cause edema. Symptoms of this condition, known as deep vein thrombosis (DVT), include:
- redness
- the affected leg feels hotter than the other leg
- swelling in the calf, especially on only one side
- fever
- a bluish or pale foot, indicating obstruction of blood flow
Occasionally, the clot in the leg can break free and travel through the bloodstream to the lungs. This is an emergency called a pulmonary embolus. If you have signs of DVT, seek immediate medical care.
Swollen feet with diabetes are a sign your diabetes treatment plan needs to be evaluated and adjusted. Your doctor can help you identify and treat the cause of the edema.
Lifestyle changes such as a lower-sodium diet and regular exercise can help reduce edema. If you are prescribed medication or advised to wear compression socks for your edema, use them exactly as directed.
Keep all appointments with your doctor and for lab work. Ask questions about which footwear is most appropriate for your particular condition.
