What to do if diabetes makes your feet swell

When someone is diagnosed with diabetes, they must keep a close eye on their blood sugar levels—but, surprisingly, they must also keep a close eye on their feet. People with diabetes are more prone to swelling in the lower legs and feet, a condition called lower extremity edema. Essentially, this is an excess buildup of fluid in the lower extremities. The result is feet can become puffy-looking, with the skin looking stretched and shiny. 

While swollen feet can be disconcerting for anyone, for people with diabetes, it can be a sign that blood sugar is not well-controlled. Supplements like magnesium and lifestyle changes like compression socks can help treat and prevent this complication. Here’s what you need to know if you have diabetes and your feet are swollen. 

RELATED: Tips for diabetic feet problems

Is swollen feet a sign of diabetes?

High blood sugar, a hallmark of diabetes, can damage blood vessels and make it easier for fluid to pool in your legs and feet. Diabetes can also cause nerve damage in your lower extremities, which could lead to fluid leaking and causing swelling. All that to say, swollen feet could be a sign of diabetes if you’re not already diagnosed.

RELATED: Early signs of diabetes

Can diabetes cause edema?

Edema caused by diabetes is primarily due to poor circulation. “It is very common for people with diabetes to have problems with their heart, kidneys, and circulation,” says Ana Maria Kausel, MD, an endocrinologist and co-founder of Anzara Health in Miami. 

High blood sugar levels can damage blood vessels over time, which can make it hard for your circulatory system to move blood throughout your body. Normally, valves in the veins in your legs ensure that blood flows toward the heart—but they can start to leak, which makes it hard to keep sending the blood upward. When this occurs, blood begins to collect in the lower legs and feet. When excess fluid builds up in the tissues of your body, it causes swelling. 

Although lower limb swelling is common in people with diabetes, several factors can cause edema in the ankles and feet, such as sitting or standing too long, being overweight, eating too much salty food, injuries, infections, pregnancy, or certain medications. 

Swollen feet can also be a side effect of some medications—including those used to treat diabetes, such as Actos (pioglitazone) and Avandia (rosiglitazone). 

How to treat swollen feet from diabetes

If you notice your feet swelling for the first time or you experience swelling only occasionally, you can try resolving it with a few of the following home remedies. 

• Elevate your feet. If you notice your ankles and feet looking puffy, lay down and put your feet on a pillow to get them higher than your heart.
• Drink more water. Though it may seem like extra fluids could add to fluid buildup, consuming more water will actually help reduce swelling, as it promotes urination, which rids your body of excess fluid and toxins. 
• Move around. If you tend to be sedentary, get up and move around to get your blood flowing. 
• Wear compression socks. Compression socks are tighter than regular socks, so they gently squeeze your feet and legs. They’re designed to prevent the further progression of venous disorders like edema and to prevent swelling. Research suggests that compression therapy is safe for people with diabetes, but you may want to talk to your provider about the best type for you, as well as how long you should wear them. 

If you have persistent swelling, you should speak with your healthcare provider, who may recommend medication if it’s not signaling a more significant problem. “In many instances, the prescription of a diuretic, such as hydrochlorothiazide (HCZT), can help reduce foot and leg swelling,” says Bruce Pinker, DPM, a foot and ankle surgeon and founder of Progressive Foot Care in Nanuet, New York. 

Unsafe diabetic leg swelling treatments to avoid

Two things you should not try to treat swelling are Epsom salt baths and certain OTC pain relievers. 

Epsom salt baths are generally not recommended for people with diabetes, according to the Institute for Preventive Foot Health, as they can dry out feet and leave them more vulnerable to wounds, which are already a risk for people with diabetes. 

As for pain meds, Dr. Kausel says to “avoid any ibuprofen, naproxen, and high-dose aspirin since it can affect the kidney.” After your provider checks your kidney function, they may give you the okay to use it for occasional swelling.

How to prevent swollen feet from diabetes

Making some adjustments to your diabetes care plan and trying certain lifestyle changes can help reduce the likelihood that you’ll develop swollen feet. Consider these tips:

• Manage your glucose. Keeping your blood sugar levels in your target range can help stave off damage—or prevent additional damage—to your blood vessels. If you struggle to control your blood glucose levels, talk to your healthcare provider. You may need to change your medications or dosage. 
• Try a magnesium supplement to help with water retention and swelling. About 200 to 400 mg per day may be helpful. Or you can boost your intake of magnesium-rich foods, like nuts and seeds, legumes, and greens. However, you should always consult your healthcare provider before taking any supplements, as they could interact with other medications you’re taking or cause unwanted side effects. 
• Don’t smoke. According to the American Diabetes Association, smoking makes your arteries harden faster, which impedes the normal circulation of blood through your body—including to your feet and legs. Smoking cessation can help diabetic foot circulation and has many other health benefits.
• Cut back on salt. Try reducing your salt intake since eating a lot of salty food can lead to excess fluid retention and cause swelling. Look for low- and reduced-sodium versions of products that you often use. Also, try fresh or dried herbs instead of salt to boost the flavor of your food.
• Lose weight. This isn’t a quick fix, but losing some weight if you are overweight may help reduce the burden on your circulatory system. That’s because obesity is one of the risk factors for foot swelling. Weight loss, even if it’s just losing a few pounds, may help reduce swelling.
• Exercise regularly. Regular exercise can help you improve your blood circulation and maintain better control of your blood sugar levels. Plus, it can help you lose a few pounds and maintain a healthier weight. Aim for 30 minutes a day on most days of the week. 
• Stay hydrated. Drinking more water and staying hydrated may help you avoid or reduce swelling in the future.
• Wear the right shoes. The best shoes for someone with diabetes will be a prescription pair of diabetic shoes, which help with circulation issues. However, if that isn’t an affordable (or covered) option, choose a pair of shoes that are the correct size, have a large toe box, provide lots of cushioning for the heels and balls of the feet, and have proper arch support.

Is diabetic edema serious? When to see a doctor

Lower limb edema is often a sign of future diabetes complications. Fluid retention puts stress on the cardiovascular system, which can lead to congestive heart failure in severe cases. There’s also an association between amputation and peripheral edema. Meaning, people who develop this condition seem more likely to eventually lose a limb.  

When you first notice swelling in your feet, lower legs, or ankles, it’s a good idea to check in with your provider. While it’s not typically an emergency situation, there are times when it can be a sign of a serious problem. “Any new onset swelling has to be evaluated by a physician to make sure it’s not due to kidney failure, heart failure, lung failure, liver disease, etc.,” Dr. Kausel says. 

Additionally, swelling in just one leg or foot can be a symptom of deep vein thrombosis (DVT), a type of blood clot that forms in the legs and can break loose and travel to one of your lungs, blocking the flow of blood and causing a pulmonary embolism. People with diabetes are at elevated risk for developing deep vein thrombosis. Other symptoms of DVT include cramping, pain in the affected limb, a sensation of warmth on the skin of the affected area, or redness or a purple cast to the skin in the area. If you start to feel short of breath, chest pain, or dizziness, seek emergency medical care.

If you have diabetes, it’s important to check your feet regularly, even if you’re not currently experiencing swelling or other problems. Diabetes can cause diabetic neuropathy, or nerve damage that causes numbness in your feet, which can make it hard to know if you’ve developed calluses, blisters, ulcers, or sores without taking a look. The American Diabetes Association recommends washing, drying, and moisturizing your feet daily and inspecting them for any changes. Pay extra attention to drying the area in between your toes. 

Once a year, you should also get a comprehensive foot exam, preferably by a podiatrist, but your primary care provider can do this as well. If you have high blood pressure or poorly managed blood sugar levels, you may need to get your feet checked by your healthcare provider every three to six months, according to the CDC.