What could cause swelling under my father's eyes and shortness of breath with diabetes and high blood pressure?

Question #30715

19 hours ago

What could cause swelling under my father's eyes and shortness of breath with diabetes and high blood pressure? - #30715

Client_795f6b

My father is 49 years old and has diabetes and high blood pressure. He had liver problems in the past. He takes Metformin, Vasant Kusumakar Ras, Jiva Ayurveda medicines, Kapiva Dia Free Juice, and Dabur Giloy Neem Tulsi Juice. For the last 2-3 months, swelling under his eyes has been increasing and remains the same throughout the day. He sometimes experiences shortness of breath. Previous kidney tests in November 2025 were normal. Earlier, he had foamy urine, but not now. There is no swelling in his legs. What could be the cause, and what tests are needed?

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Doctors' responses

Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

10 hours ago

Hello dear
See as per clinical history
Following findings are there
Rebound hyperglycemia
Uncontrolled diabetes
Chances of Insulin resistance
High blood pressure
Liver issues
Kidney issues rare
Iam suggesting some tests for confirmation
Please share the result with diabetologist or concerned physician only for better clarity
Please donot stop it take any medication without consulting the concerned physician
HbA1c
Serum ferritin
Serum insulin
Rft
Lft
Serum rbs
Ott
Bp evaluation
ECG
Serum troponin
Serum LDH
Albumin
Serum cck
D dimer
Crp
Hopefully you recover soon
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

4 hours ago

Hello dear
Swelling under the eyes that has persisted for 2–3 months, especially in a person with diabetes, high blood pressure, and occasional shortness of breath, should be evaluated by a doctor. Although previous kidney tests were normal, kidney disease can develop over time, and early diabetic kidney disease may not always be obvious on routine testing.
Possible causes include kidney disease with protein loss in the urine, heart-related fluid retention, liver disease causing low blood protein levels, thyroid disorders, medication effects, allergies, or simply age-related changes around the eyes. The associated shortness of breath makes heart and kidney causes more important to rule out.
I would recommend seeing his physician for an examination and tests including:
* Kidney function tests (creatinine, urea, electrolytes)
* Urine routine examination and urine albumin/protein-to-creatinine ratio
* Liver function tests including albumin
* Complete blood count
* Thyroid function tests
* Blood pressure and diabetes review (including HbA1c)
* Chest X-ray and ECG
* An echocardiogram may also be needed if heart failure is suspected
Because he has a history of liver problems and is taking multiple herbal/Ayurvedic products, it is important for his doctor to review all medications and supplements, as some herbal preparations can affect the liver, kidneys, or interact with prescribed medicines.
If the shortness of breath is worsening, occurs at rest, is associated with chest pain, or he develops new swelling of the legs, he should seek urgent medical attention.
Take care
Feel free to reach out

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

4 hours ago

The combination of progressive swelling under the eyes for 2–3 months, diabetes, high blood pressure, a history of liver problems, and occasional shortness of breath warrants a medical evaluation. Although kidney tests were reportedly normal in November 2025, kidney disease related to diabetes can develop or worsen over time, and under-eye puffiness can sometimes be an early sign of fluid retention from kidney disease, even before leg swelling appears. Other possibilities include protein loss in the urine, heart-related fluid retention, liver disease, thyroid disorders, allergies, medication effects, or sleep-related issues.
Given his history, the most important tests would include:
Kidney function tests (serum creatinine, urea, eGFR)
Urine routine examination and urine albumin/protein test (including urine albumin-to-creatinine ratio)
Liver function tests (LFTs) and blood protein/albumin levels
Blood pressure and blood sugar assessment (HbA1c)
Complete blood count (CBC)
Thyroid function tests (TSH, Free T4)
If shortness of breath is significant, a chest X-ray, ECG, and possibly an echocardiogram may be needed to assess heart function.
It is also important that his doctors know about all medications and supplements he is taking, including Ayurvedic products, since some herbal preparations can occasionally affect the kidneys, liver, or fluid balance.

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

2 hours ago

Hello,
The combination of progressive swelling under the eyes for 2–3 months and intermittent shortness of breath in a 49-year-old man with diabetes and hypertension deserves medical evaluation and should not be attributed to aging or fatigue alone.
The most important possibilities include:
1. Kidney disease (even if previous tests were normal)
Diabetes and high blood pressure are two of the most common causes of kidney disease.
Early kidney disease can cause:
Puffiness around the eyes, especially in the morning
Protein leakage in urine
Fluid retention
Later, swelling in the legs and shortness of breath
Normal kidney tests several months ago do not completely rule this out, especially if symptoms have developed since then.
2. Heart-related fluid retention
Shortness of breath together with facial puffiness raises concern about possible heart involvement.
Diabetes and hypertension increase the risk of:
Heart failure
Reduced heart pumping function
Fluid accumulation
Not everyone develops leg swelling initially.
3. Low blood protein levels
This can occur due to:
Kidney protein loss
Liver disease
Nutritional issues
Low albumin levels can cause swelling around the eyes.
4. Liver disease
Since he has a history of liver problems, liver function should be reassessed, although isolated under-eye swelling is less typical than abdominal swelling or leg swelling.
5. Medication or supplement-related effects
It is important to review all medications and supplements, including Ayurvedic preparations.
Some herbal or traditional medicines may:
Affect kidney function
Affect liver function
Contain heavy metals or substances that contribute to fluid retention
Recommended tests
I would suggest the following:
Kidney evaluation
Serum creatinine
Blood urea (BUN)
eGFR
Urine routine examination
Urine albumin-to-creatinine ratio (ACR) or urine protein
Diabetes evaluation
HbA1c
Fasting blood glucose
Liver evaluation
Liver function tests (LFTs)
Serum albumin
Heart evaluation
ECG
Echocardiography (if shortness of breath is significant)
Chest X-ray
General
CBC
Blood pressure monitoring
Important questions
Is the shortness of breath mainly during exertion, lying down, or even at rest?
Does he wake up at night feeling breathless?
Is the swelling worse in the morning?
What are his recent blood pressure and blood sugar readings?
Given the history of diabetes, hypertension, increasing facial swelling, and shortness of breath, I would prioritize evaluating kidney function and heart function, even if previous kidney tests were normal.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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