Question: Is there a way to recover from long-term symptoms of diabetes? I have pain and discoloration in my ankle and calves.

Dr. Hibberd's Answer:

The pigment changes with brownish discoloration of your legs may reflect venous stasis (back-up, clotting, or blockage of blood return) and is often seen in vascular disease so commonly seen in diabetic patients.

You may also have severe arterial disease associated with your diabetes mellitus (large vessel and small vessel involvement), especially with your mention of a pain component. Unfortunately, many of these changes with diabetes are there to stay, but can often be arrested. Reversal of these changes once present will take more than simple control of your diabetes, though meticulous control will delay (or even prevent) the onset of these problems.

You can elect to undergo bleaching procedures, but you will need to be cautious given a likely precarious microcirculation given your long standing diabetes mellitus.

Before embarking on any cosmetic procedures, see your doctor for discussion of ways to further optimize your diabetic and microcirculation problems first. A dermatologist may be able to mask some of these unsightly areas for you, but don’t forget to treat the underlying causes aggressively in addition.

The pain you are experiencing should be properly investigated and treated before any cosmetic procedure is advised. Venous stasis and edema are eminently treatable and should be corrected before cosmetic correction of pigment changes is considered.

Pain may also be caused by arterial insufficiency (poor supply of blood) or thrombosis (blood clots), and must be evaluated for and specifically treated. Larger vessels may be ammenable to angioplasty or bypass procedures, and good medications are available to optimise circulation and control pain in affected extremities.

Many diabetics develop a peripheral neuropathy (loss off sensory nerve function) that numbs the sensation in your periphery (hands and feet), making your mention of pain assume an even greater significance. Gangrene with its amputation treatment can be avoided by paying attention to warning signs and symptoms, and aggressively treating the underlying disorders.