Edema: When to Seek Medical Help for Diabetes and Hypertension

Generalized edema

Hello Doctor: My mother has diabetes and hypertension, and she is currently injecting insulin every morning and evening.
Recently, she has experienced edema in her lower extremities, and now facial swelling has also appeared.
She mentioned that her urine output has decreased, even though she is taking the diuretics prescribed by the hospital, and her condition remains the same.
Which department should she consult for her current situation? Thank you.

Ji Xu Jie Da, 20~29 year old female. Ask Date: 2006/10/29

Dr. Cai Jueren reply Family Medicine

Hello, based on the situation you described regarding your mother, it seems that she is not suitable for home care.
Her condition appears to be related to diabetes with nephropathy and edema, which may have been present for some time.
I recommend that you take her to a large hospital's nephrology department for evaluation.
Please remember to bring a summary of your mother's medical history and her medication bag.
Thank you for your letter, and I hope the above information helps address your concerns.

Sincerely,
Dr.
Tsai Jue-Ren
Hualien Hospital

Reply Date: 2006/10/29

More Info

Hello,
Thank you for reaching out with your concerns regarding your mother's health. Given her history of diabetes and hypertension, along with the recent onset of edema (swelling) in her lower extremities and face, as well as decreased urine output despite taking diuretics, it is crucial to address these symptoms promptly.

Understanding Edema in the Context of Diabetes and Hypertension
Edema can occur for various reasons, particularly in individuals with diabetes and hypertension. In your mother's case, the swelling could be related to several factors:
1. Fluid Retention: This can be exacerbated by medications, including certain antihypertensives and diuretics. While diuretics are intended to reduce fluid retention, they may not be effective if the underlying cause of the edema is not addressed.

2. Kidney Function: Diabetes can lead to diabetic nephropathy, a condition that affects kidney function. If the kidneys are not filtering waste effectively, this can lead to fluid retention and decreased urine output.
3. Heart Function: Congestive heart failure (CHF) can also cause edema. In patients with hypertension, the heart may struggle to pump effectively, leading to fluid buildup in the body.

4. Medication Side Effects: Some medications used to manage diabetes and hypertension can contribute to fluid retention. It’s essential to review her medication regimen with her healthcare provider.

When to Seek Medical Help
Given the symptoms you described—facial swelling, lower extremity edema, and decreased urine output—it is advisable to seek medical attention promptly. Here are some steps you can take:
1. Visit a Nephrologist: Since your mother has diabetes and is experiencing edema and changes in urine output, a nephrologist (kidney specialist) would be an appropriate specialist to consult. They can evaluate her kidney function through blood tests (like serum creatinine and blood urea nitrogen) and urine tests.

2. Consult a Cardiologist: If there is any suspicion of heart-related issues, a cardiologist can perform tests such as an echocardiogram or stress test to assess heart function.

3. Primary Care Physician: If you are unsure where to start, her primary care physician can provide a comprehensive evaluation and refer her to the appropriate specialists based on her symptoms.

Additional Considerations
- Monitor Symptoms: Keep a close eye on her symptoms, including any changes in weight, the extent of swelling, and any new symptoms such as shortness of breath or chest pain.

- Medication Review: Ensure that her healthcare provider reviews all her medications, including the diuretics, to determine if adjustments are necessary.

- Dietary Considerations: A low-sodium diet may help manage fluid retention. Discuss dietary changes with her healthcare provider or a dietitian.

- Regular Monitoring: Regular monitoring of blood pressure, blood sugar levels, and kidney function is essential in managing her conditions effectively.

In summary, your mother's current symptoms warrant a thorough evaluation by a healthcare professional. It is crucial to address these issues promptly to prevent potential complications. Please ensure she receives the necessary medical attention as soon as possible.

Best wishes for your mother's health and well-being.

Similar Q&A

Managing Complications of Hypertension and Diabetes: When to Seek Emergency Care

Hello, my grandmother has a long history of hypertension and diabetes, and she has been taking her medications on time. A few months ago, she experienced hypoglycemia due to her medication, but she has since switched medications. Recently, she has developed spider web-like blood ...

Dr. He Dongjin reply Cardiology
Hello, if you have an infection, please go to the emergency room immediately. Ping An Changhua Hospital cares about you.

Managing Edema in Elderly Patients with Multiple Health Conditions

My father is 78 years old and has a history of hypertension, heart disease, diabetes, and gout, for which he has been on long-term medication. Currently, he is experiencing severe edema in both feet, palms, and forearms. Blood and urine tests indicate malnutrition, proteinuria, a...

Dr. Yang Jun reply Internal Medicine
Hello: In response to your question regarding the causes of edema, it is primarily due to conditions such as heart failure, nephrotic syndrome, cirrhosis, or malnutrition. This occurs because of a decrease in albumin levels or excess fluid in the body. Your father suffers from hy...

Understanding Bilateral Leg Edema: Causes, Symptoms, and Treatment Options

Hello, doctor. About three weeks ago, I started noticing mild swelling in both of my legs. A week ago, the condition worsened, and I gained 3 to 4 kilograms. I feel better upon waking, but my eyelids are puffy, and my scalp feels swollen. I spend most of the day sitting at work, ...

Dr. Wu Zongying reply Family Medicine
Hello, Thank you for your inquiry regarding the causes of edema. There are many potential causes of edema, including heart failure, kidney disease, liver cirrhosis, the use of certain medications, and pregnancy. Additionally, mild edema can be triggered by factors such as prolo...

Understanding Systemic Edema: When to Seek Medical Attention

Hello Dr. Wu, I am a 63-year-old woman who has had a hysterectomy. Recently, I have been experiencing gradual swelling all over my body, especially in my face, which has become very round. My appetite has increased, and I have been experiencing a rapid heartbeat and cold sweats. ...

Dr. Wu Fangcan reply Family Medicine
I am unsure if you are taking any medications, dietary supplements, or radio-promoted drugs. Do you experience increased or decreased urination? Is there any foaming in your urine? Can you lie flat while sleeping? It is advisable to consult a family medicine or endocrinology spec...