Diabetic Complications

The lymphatic (lymph) system is an important part of the immune system. One of its jobs is to protect the body by fighting infections. It also drains excess fluid and toxins from tissues and cells. In addition, it transports lymph fluid, which contains infection-fighting white blood cells, to the body. Blockage, disease, or infection can affect the lymphatic system. Diabetes can cause damage to the lymph system because high blood sugar can damage the arteries and capillaries of the lymph nodes. As a result, lymphedema can develop.

Lymphatic System

The lymphatic system comprises lymph nodes, ducts or vessels, and organs. Lymph nodes are in the neck, armpit, chest, abdomen, and groin. In addition, the tonsils, spleen, appendix, and bone marrow are also part of the lymph system. In a nutshell, they work together to move lymph back to the bloodstream.

What is Lymphedema?

Lymphedema occurs when tissues swell because of an accumulation of fluid (edema) that is not drained through the body’s lymphatic system. Damage to the lymph system can prevent fluid from returning to the blood. To put it another way, lymphedema results when the drainage of lymph fluid gets blocked. It usually affects the hands, arms, legs, feet, and ankles, but can also occur in the face, neck, and abdomen.

While there is no cure for lymphedema, there are treatments for reducing the swelling and complications.

Signs of Lymphedema

• Swelling in the breast, chest, shoulder, arm, or leg
• Tight or heavy-feeling skin
• Burning or itchy skin
• Inability to move or flex joints
• Jewelry and clothes not fitting and feeling tight
• Recurring skin infections
• Fluid leaking through the skin or developing blisters
• Hardening and thickening of the skin known as fibrosis

Risks and Treatments

There are many risks to developing lymphedema, but there are also many natural remedies.

Risks of Lymphedema

• Risk of skin infections
• Difficulty walking and restricted range of motion

Skin Infection

My experience with lymphedema is when I had a bacterial infection on my leg called cellulitis. The skin was red and hot to the touch. Luckily, oral and iv antibiotics cured the cellulitis, but my left leg has never been the same and still swells occasionally. Walking, compression socks, and ankle pumps have helped tremendously.

To prevent cellulitis, keep your skin clean and treat cuts and cracks on your skin with soap and water and apply an antibacterial ointment. Bacteria can enter through broken skin, causing cellulitis.

Also, many diabetics have dry skin. This is because excess sugar in the blood causes the body to pull fluid from its cell to produce enough urine to remove the sugar. This leaves skin dry and causes itchiness (https://backtonaturediabetic.com/itchy-scalp-and-skin-its-your-diabetes). Dry and cracked skin also increases the risk of infection. Therefore, it’s important to not scratch itchy skin, moisturize, and manage blood sugar levels.

Natural Remedies for Lymphedema

• Elevate your feet and arms if they are swollen
• Use compression socks/bandages
• Avoid tight clothes, especially with tight bands or elastic
• Get a massage or manual lymphatic drainage
• Lose weight if needed
• Don’t cross your legs when sitting
• Avoid applying heat or cold to affected limbs

Exercise

Exercise is good for the lymphatic system because it stimulates lymphatic flow. For example, exercise works muscles, increases the flow of lymph fluid, and moves it away from swollen areas. One of the best exercises is rebounding, also known as jumping on a trampoline. Rebounding increases lymph flow by 15-30 times (https://wellbeingjournal.com/rebounding-good-for-the-lymph-system/).

Along with physical exercise, you can also do deep breathing exercises, which stimulate the movement of lymph fluid. To clarify, I’m talking about diaphragmatic breathing. Check out this article on how to do this type of breathing (https://www.fluidmotionmassage.com/post/the-simplest-way-to-stimulate-your-lymphatic-system-diaphragmatic-breathing).

In addition, dry brush your skin with a natural bristle brush which increases blood circulation and promotes lymph flow and drainage. Brush your dry skin in a circular motion for 10 minutes before taking a shower or bath.

Another great exercise is ankle pumps, which are one of the most effective ways to reduce leg swelling. They’ve worked so well for me that I no longer need compression socks. You can do them on the floor, bed, chair, and recliner. First, flex your toes so they are pointing up. Then point your toes forward. Alternate repeatedly by pointing your toes upward and then forward. See the pic below.

Foods that Promote Lymph Flow

• Green leafy vegetables such as spinach, kale, and arugula lettuce
• Low-sugar fruits such as berries
• Cruciferous vegetables like broccoli, cabbage, cauliflower, and brussels sprouts
• Citrus fruits like lemons and limes
• Water

Foods that Make Lymphedema Worse

• Alcohol
• Hydrogenated fats and trans fats
• Sugar
• Caffeine
• Salt

I can attest to the fact that alcohol makes lymphedema worse. The lymph nodes under my armpit swell when I drink. It is painful to place my arm next to my side and causes discomfort when I sleep. Therefore, I rarely drink anymore.

Diuretics

While diuretics may seem like a good way to remove excess fluid, they can be harmful. This is because they can dry out other parts of the body rather than the lymphedema, but you should check with your doctor.

Lymphedema Support Organizations

To get support, you can join one of the lymphedema organizations listed here https://lymphaticnetwork.org/living-with-lymphedema/related-organizations.

Conclusion

While diabetes may increase your risk of developing lymphedema, there are many natural remedies, most of which you can do at home. However, visit your doctor if you have persistent swelling or a skin infection.

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“Remember, you’re not less than anybody because you have diabetes” – DeAndre Carter, NFL Wide Receiver

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Disclaimer

Please remember this is not medical advice or intended to replace the advice of your doctor. This is my experience with the natural supplements that have helped me manage my diabetes.  They are not intended to cure any disease. Please do not self-diagnose. Always check with your healthcare provider before trying new treatments.

Also, natural does not mean safe. Many natural remedies have side effects and can interact with medication and supplements. It should be noted that the FDA does not regulate dietary supplements but treats them like foods and not medication. Unlike drug manufacturers, supplement makers do not have to show their products are safe or effective.

I ask you to please keep an open mind; be a diabetic detective and do your own research; work with your healthcare team; see what works best for you, and monitor your blood sugars.

When I get accused of being “woo woo” about natural remedies, I remind people that a popular medication, aspirin, originally came from nature, in willow bark. Willow bark has a long history, with Assyrians and Egyptians using it to relieve pain. Besides treating pain and fever, doctors often advise their diabetic patients to take low-dose aspirin, also known as baby aspirin, to reduce the risk of cardiovascular disease (CVD).

Willow Bark, the Original Aspirin

In 1828, Johann Buchner, a professor of pharmacy at Munich University, extracted the active ingredient from willow bark and named it salicin, which means “willow” in Latin. Salicin would later form the basis of aspirin. Once ingested, your body turns salicin into another chemical substance called salicylic acid.

In 1897, Felix Hoffmann, a German scientist working for Bayer, altered salicylic acid to make acetylsalicylic acid, which was given the name aspirin.

Aspirin to Reduce Heart Attack Risk

An aspirin a day was first recommended to patients to reduce heart attack risk in 1948 when California physician Dr. Lawrence Craven observed positive results in his patients.

Subsequently, the discovery of how aspirin accomplishes this won a Nobel Prize in medicine in 1982. Researchers uncovered aspirin’s ability to block the production of hormones called prostaglandins. Prostaglandins form clots that cause heart attacks and strokes. A clot that cuts off blood flow to the heart leads to a heart attack; one that cuts off blood flow to the brain causes a stroke. Aspirin acts as an anticoagulant, meaning it helps to prevent blood clots from forming.

Heart Disease in Diabetics

According to the International Diabetes Federation, cardiovascular disease is the most common cause of death in people with diabetes (https://www.idf.org/aboutdiabetes/complications.html).

Moreover, the CDC warns that if you have diabetes, you’re twice as likely to have heart disease or a stroke than someone who doesn’t have diabetes. And, the longer you have diabetes, the more likely you are to have heart disease.

(https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html)

Why are Diabetics at an Increased Risk for Cardiovascular Disease?

Diabetics may have the following conditions that put them at risk for developing cardiovascular disease:

• High blood sugar
• High blood pressure
• High cholesterol
• Obesity
• Lack of physical activity
• Other factors such as smoking, drinking too much alcohol and eating a diet high in saturated fat

American Diabetes Association 2020 CVD Risk Management Antiplatelet Guidance

The ADA recommends aspirin as primary prevention for diabetics over 50 with at least one other major risk factor (family history of CVD, hypertension, smoking, or chronic kidney disease) who are not at higher risk of bleeding (older age, anemia, and renal disease).

• Use aspirin therapy (75–162 mg/day) as a secondary prevention strategy in those with diabetes and a history of atherosclerotic cardiovascular disease. 
• For patients with atherosclerotic cardiovascular disease and documented aspirin allergy, clopidogrel (75 mg/day) should be used. 
• Dual antiplatelet therapy (with low-dose aspirin and a P2Y12 inhibitor) is reasonable for a year after an acute coronary syndrome and may have benefits beyond this period. 
• Aspirin therapy (75–162 mg/day) may be considered as a primary prevention strategy in those with diabetes who are at increased cardiovascular risk, after a comprehensive discussion with the patient on the benefits versus the comparable increased risk of bleeding. 

Source: https://diabetesjournals.org/care/article/43/Supplement_1/S111/30374/10-Cardiovascular-Disease-and-Risk-Management

Who Should Not Take Aspirin?

Aspirin can be a double-edged sword: the same mechanism that stops blood clots from forming can also raise a person’s risk of bleeding by preventing blood from clotting at a wound site.

In other words, aspirin thins the blood and prevents blood clots from forming. However, you need blood clots to stop heavy bleeding from wounds.

The American College of Cardiology (ACC) and The American Diabetes Association (ADA) updated their guidelines recently to recommend that adults over 70 should not take low-dose aspirin to prevent heart attacks or strokes. The reason is that the risk of internal bleeding outweighed the benefits.

Bleeding risks for adults in their 60s and up who haven’t had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its updated guidance.

There are others who shouldn’t take aspirin:

• If you consume three or more alcoholic drinks each day. Heavy drinking can increase your risk of stomach bleeding while taking aspirin
• If you are on anticoagulant (or blood thinner) therapy
• If you are allergic to aspirin
• If you have hemophilia or another bleeding disorder

Side Effects/Interactions

Aspirin may interact with herbal supplements that possess antiplatelet activity which prevents platelets from clumping and also prevents clots from forming. They include ginkgo, garlic, ginger, bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet, and willow. Aspirin may also interact with supplements containing coumarin (chamomile, motherwort, horse chestnut, fenugreek, and red clover) and with tamarind, increasing the risk of bleeding.

(https://pubmed.ncbi.nlm.nih.gov/12472978/#:~:text=Non%2Dsteroidal%20anti%2Dinflammatory%20drugs,with%20those%20containing%20coumarin%20(chamomile%2C)

Also, do not take aspirin with ibuprofen or naproxen. Aspirin, ibuprofen, and naproxen belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).

Finally, ask your doctor if you should stop aspirin before surgery, since it may increase bleeding.

Conclusion

Having diabetes may put you at a higher risk for cardiovascular disease. As well as taking low-dose aspirin with your doctor’s permission, there are lifestyle changes you can make to reduce cardiovascular disease. They include managing your ABCs (A1C, blood pressure, and cholesterol), eating a heart-healthy diet, managing weight, and quitting smoking.

Diabetic News

The University of Florida researchers said Type II diabetics can add over a decade to their lives through lifestyle changes such as slimming down to a healthy weight and controlling blood pressure and sugar levels. Researchers monitored 421 patients aged 50 to 80 for nine months. See their results in the graph below.

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“About 80 percent of deaths from premature heart disease and stroke could be prevented by changes in physical activity, diet, smoking, and management of common medical conditions. The good news is that it’s not too late to make small changes that matter to heart health. At any age as adults, we all need to find out if you need to take daily aspirin, get control of high blood pressure and cholesterol with changes in diet, and by taking medicine. Stop smoking and be more physically active.” Dr. Anne Schuchat, CDC Deputy Director.

Disclaimer

Please remember this is not medical advice or intended to replace the advice of your doctor. This is my experience with the natural supplements that have helped me manage my diabetes.  They are not intended to cure any disease. Please do not self-diagnose. Always check with your health care provider before trying new treatments.

Also, natural does not mean safe. Many natural remedies have side effects and can interact with medication and supplements. It should be noted that the FDA does not regulate dietary supplements but treats them like foods and not medication. Unlike drug manufacturers, supplement makers do not have to show their products are safe or effective.

I ask you to please keep an open mind; be a diabetic detective and do your own research; work with your healthcare team; see what works best for you, and monitor your blood sugars.