Diabetes and Swollen Feet: Causes, Treatment, and Prevention
Living with diabetes requires daily diligence, from monitoring blood glucose levels to maintaining a healthy lifestyle. However, one often overlooked but critical aspect of diabetic care is foot health. Among the many complications that can arise, diabetes-related swollen feet—also called diabetic foot edema—is a common and potentially serious issue that demands attention.
This in-depth article explores everything you need to know about diabetes and swollen feet, including causes, risk factors, symptoms, diagnostic methods, treatment options, and practical prevention strategies.
What Causes Swollen Feet in People with Diabetes?
Swelling in the feet, known medically as peripheral edema, occurs when excess fluid accumulates in the tissues of the lower limbs. For people with diabetes, there are several underlying reasons this may happen.
1. Poor Circulation
High blood sugar levels over time damage the lining of small and large blood vessels. This condition, called diabetic angiopathy, can impair circulation, leading to pooling of blood and fluids in the feet and ankles.
2. Neuropathy (Nerve Damage)
Diabetic peripheral neuropathy is another common complication. It reduces the ability to feel pain, pressure, or temperature changes in the feet, which may cause injuries to go unnoticed. Inflammation from unnoticed trauma can lead to swelling.
3. Kidney Dysfunction
Diabetes is a leading cause of chronic kidney disease (CKD). When kidneys fail to function properly, the body retains fluid, causing swelling in the lower extremities.
4. Heart Failure
Diabetic individuals are at higher risk for congestive heart failure (CHF). When the heart doesn't pump efficiently, fluid backs up into the lungs and lower extremities, including the feet.
5. Infections and Ulcers
Infections, especially in cuts or ulcers that don't heal properly, can cause significant swelling. Swelling is the body's natural immune response to infection.
6. Medication Side Effects
Certain medications used to treat diabetes, high blood pressure, or other related conditions—such as calcium channel blockers or thiazolidinediones (like pioglitazone)—can cause water retention and swelling.
Learn how at-home kidney tests can help identify underlying issues early.
Symptoms of Diabetic Foot Swelling
Recognizing the signs of swollen feet early is vital. Here are the most common symptoms:
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Noticeable puffiness or tightness in the feet or ankles
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Indentations after removing socks or shoes
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Stretched or shiny skin on the feet
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Aching or a feeling of heaviness
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Warmth or redness (potential sign of infection)
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Pain or tenderness (may be absent due to neuropathy)
Swelling may affect one or both feet, and the severity can range from mild to severe. Any sudden or unexplained swelling warrants immediate medical attention.
Neuropathy may mask pain, so watch for glucose in urine and other silent indicators of damage.
Complications of Swollen Feet in Diabetics
Ignoring swollen feet in diabetics can lead to a range of complications, some of which can become life-threatening:
1. Foot Ulcers
Excess pressure and poor circulation can result in skin breakdown, leading to chronic ulcers that are difficult to heal.
2. Infections
Because diabetics have a weakened immune response, even small wounds can become infected rapidly. These infections may spread to deeper tissues or bones (osteomyelitis).
3. Charcot Foot
Swelling and neuropathy may lead to a rare condition known as Charcot foot, where the bones weaken and fracture, often leading to deformities.
4. Gangrene
Lack of blood supply and infection can result in tissue death, sometimes requiring amputation.
Chronic kidney disease is a major contributor to fluid buildup in the lower limbs.
How Are Swollen Feet Diagnosed in People With Diabetes?
A thorough diagnosis involves both physical examination and various tests:
1. Physical Examination
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Palpation to assess tenderness and fluid buildup
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Checking for pulse, warmth, and discoloration
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Inspection for ulcers, infections, or deformities
2. Medical History Review
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Reviewing history of diabetes, medications, kidney or heart disease
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Assessing symptoms such as fatigue, chest pain, or shortness of breath
3. Diagnostic Tests
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Blood tests: Check kidney function (creatinine, BUN), electrolytes, glucose levels
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Urinalysis: Looks for protein or other signs of kidney dysfunction
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Doppler ultrasound: Assesses blood flow and rules out blood clots
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X-rays or MRI: Check for Charcot foot, fractures, or soft tissue infections
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Electromyography (EMG): Evaluates nerve damage
Learn more in our guide to understanding creatinine levels.
Treatment Options for Diabetes-Related Swollen Feet
Treatment depends on the underlying cause but may include:
1. Manage Blood Sugar Levels
Tight glycemic control is the foundation for preventing further complications. This may involve:
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Regular blood glucose monitoring
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Medications or insulin therapy
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Low-glycemic index diet
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Regular physical activity
2. Elevation and Compression
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Elevating feet above heart level for 15-20 minutes several times a day
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Wearing compression stockings to reduce swelling and improve circulation
3. Medications
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Diuretics (for fluid retention due to heart or kidney issues)
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Antibiotics (for infections)
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Pain relievers (use cautiously, especially with kidney issues)
4. Physical Therapy
Helps improve circulation and joint mobility. Foot-specific exercises can be useful in reducing swelling.
5. Surgery
In severe cases of ulcers, infections, or Charcot foot, surgical intervention may be necessary to remove damaged tissue or correct deformities.
Use blood sugar test kits to keep your levels in check at home.
Home Remedies for Diabetic Swollen Feet
While medical treatment is essential, certain home care strategies can support healing and prevention:
1. Epsom Salt Soak (With Caution)
Soaking feet in warm (not hot) water with Epsom salt may reduce inflammation. However, check with your doctor first, as prolonged soaking can dry the skin and increase the risk of infection.
2. Regular Foot Massage
Gently massaging the feet stimulates circulation and reduces swelling.
3. Stay Active
Light walking or water aerobics can enhance circulation without putting too much pressure on the feet.
4. Hydration
Drinking plenty of water helps flush out excess sodium and reduces fluid retention.
Learn to spot signs of dehydration that can worsen swelling.
5. Reduce Salt Intake
Too much sodium in your diet contributes to fluid retention and swelling.
When to See a Doctor
Seek medical attention immediately if you experience:
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Sudden, severe swelling in one foot
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Discoloration (blue or black skin)
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Fever, chills, or pus (signs of infection)
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Numbness or tingling
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Open sores or wounds
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Skin that feels unusually warm or cold
Prompt diagnosis and treatment can make the difference between a manageable condition and a serious complication.
Regular urinalysis can help detect hidden issues before they escalate.
Preventing Swollen Feet in Diabetics
Preventive care is the cornerstone of diabetic health. Here’s how to reduce your risk:
1. Inspect Your Feet Daily
Check for cuts, blisters, redness, or swelling. Use a mirror or ask for help if needed.
2. Wear Proper Footwear
Choose shoes with good support and roomy toes. Don’t walk barefoot, even indoors, and replace worn-out shoes regularly.
3. Maintain Healthy Blood Sugar
Follow your meal plan, monitor your A1C, and take medications as prescribed to keep your blood sugar in control.
4. Control Other Health Conditions
Manage blood pressure and cholesterol. Regularly check your heart and kidney function to prevent fluid buildup.
5. Keep Active Safely
Avoid sitting or standing too long. Try low-impact exercises like swimming or cycling to boost circulation.
The Link Between Swollen Feet and Other Diabetes Complications
Swollen feet may also signal broader systemic issues such as:
Diabetic Nephropathy
Kidney disease is often silent in its early stages but swelling in the feet can be a first noticeable symptom.
Diabetic Retinopathy
While not directly related, people with eye complications often also have microvascular damage in the lower limbs.
Peripheral Artery Disease (PAD)
Swelling with pain during walking (claudication) can indicate PAD—a serious circulatory problem.
Venous Insufficiency
Diabetics may develop poor vein function in addition to arterial disease, worsening fluid retention.
Myths About Diabetes and Swollen Feet
Myth 1: Swollen feet are always harmless.
Reality: In diabetics, foot swelling can signal serious issues like infection, kidney failure, or even impending amputation if untreated.
Myth 2: Only type 2 diabetics experience foot swelling.
Reality: While more common in type 2 due to age and duration, type 1 diabetics are also at risk, especially with poor glucose control.
Myth 3: If it doesn’t hurt, it’s not serious.
Reality: Diabetic neuropathy can block pain signals. A painless but swollen foot may still be severely infected or damaged.
Conclusion
Swollen feet may seem like a minor inconvenience, but for individuals living with diabetes, they can signal underlying health problems that require immediate attention. Understanding the causes, recognizing the symptoms, and adopting a proactive approach can help prevent complications and improve quality of life.
Managing diabetes and swollen feet is not just about alleviating discomfort—it’s about protecting your mobility, independence, and long-term health.
Noticing swollen feet or just want peace of mind?
Explore Ribbon Checkup’s at-home health tests for simple, lab-quality insights you can trust.
Related Resources
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Understanding High Glucose in Urine: Causes, Symptoms, and Management
Learn what it means when glucose appears in your urine and how it connects to diabetic complications. -
How to Reverse Kidney Damage from Diabetes
Explore strategies and tests to detect and manage diabetic kidney issues early. -
Urine Protein Test Strips: How to Use Them
A simple guide to tracking kidney function and protein levels at home.
References
Boulton, A., Armstrong, D., Krisner, R., Attinger, C., Lavery, L., Lipsky, B., … Steinberg, J. (2018). Diagnosis and Management of Diabetic Foot Complications. ADA Clinical Compendia, 2018(2), 1–20. https://doi.org/10.2337/db20182-1
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Diabetic nephropathy (kidney disease) - Symptoms and causes. (2025a). Retrieved July 21, 2025, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556
Diabetic nephropathy (kidney disease) - Symptoms and causes. (2025b). Retrieved July 21, 2025, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556
Hecht, M. (2018, June 25). What Is Peripheral Edema and What Causes It? Retrieved July 21, 2025, from Healthline website: https://www.healthline.com/health/peripheral-edema
Murphy-Lavoie, H. M., Ramsey, A., Nguyen, M., & Vadakekut, E. S. (2025, April 11). Diabetic Foot Infections. Retrieved July 21, 2025, from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK441914/
Packer, C. F., Ali, S. A., & Manna, B. (2023, July 17). Diabetic Foot Ulcer. Retrieved July 21, 2025, from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK499887/
