Leg swelling or peripheral edema is produced by expansion of fluid within the surrounding tissues. Generalized swelling results from increased fluid pressures across the capillary beds, reduced capillary oncotic pressure or increased capillary permeability. Sodium or salt retention by the kidneys can also produce swelling. It is not uncommon for diabetics to have some level of kidney disease. It may also be compensatory in response to reduced arterial blood volume resulting from heart failure and liver disease. Peripheral swelling can also result from poor blood circulation particularly related to venous blood flow. There are drugs that can influence organ systems specifically heart, liver and kidney that can also be associated with swelling. When looking at swelling of the legs, we often characterize the presentation as nonpitting or pitting. By their own name presentation, pitting swelling produces a dimpling effect when the tissues are pressed on with gradual expansion back to their swollen state. Pitting swelling is frequently related to the previously mentioned organ disease. Non-pitting edema does not produce a dimpling effect and may be associated with vein insufficiency or chronic lymphedema. Any type of acute single leg swelling should always raise the possibility of blood clot such as deep vein thrombosis that needs to be acutely evaluated. Given the history as presented, I do believe this swelling more than likely is related to her diabetes and potential impact on other organ systems by the disease itself or medications that are required. Elevation of the extremities can be extremely beneficial when sedentary to help manage the expansion of fluid out of the vascular system. It is imperative that the cause of the swelling be established in order to provide an effective treatment. This would be best handled by your primary care physician who can assess current medications, obtain appropriate laboratory studies, and assess organ systems.