by Rajiv Madhav
QUESTION: I have diabetes, take Glizid M and Volphage as prescribed, walk for about 40 minutes, and do light yoga and stretching. My knee hurts while walking. Could diabetes or my medicines be responsible, and what should I do?
Diabetes does not automatically explain knee pain. Common causes include osteoarthritis, a recent or old injury, tendon or ligament irritation, gout, or an exercise-related problem. Poor leg circulation usually causes aching or cramping in the calf, thigh, or buttock during walking rather than isolated pain inside the knee. Because the pain is limiting your walking, arrange an examination before continuing the same exercise intensity.
Answer by Dr. Albana Greca, MD, MMedSc
Hi Rajiv,
Congratulations on stopping smoking. This is one of the most important steps for protecting the heart, blood vessels, kidneys, and legs. Continue taking your diabetes medicines as prescribed, but bring the exact packages to your appointment because brand names and ingredients can vary between countries.
The location, onset, swelling, stiffness, and relationship to movement help identify the cause. Possibilities include:
Diabetic neuropathy usually causes burning, tingling, numbness, or reduced sensation, most often in the feet. It may alter walking and indirectly place extra strain on the knee, but it should not be assumed to be the cause of joint pain. Learn more about diabetic neuropathy symptoms.
Diabetes and previous smoking increase the risk of peripheral artery disease. Claudication usually causes reproducible aching, cramping, heaviness, or fatigue in the calf, thigh, hip, or buttock during walking and improves within several minutes of rest.
Tell your doctor if one foot is colder, pulses seem weak, the skin changes color, leg hair is lost, or a wound heals slowly. A vascular examination and, when appropriate, an ankle-brachial index can help assess circulation. Our guide to diabetes and leg pain explains the different patterns.
Metformin is not a common cause of isolated knee-joint pain, although muscle aches have been reported. Glizid M may contain a sulfonylurea combined with metformin, but the exact formulation must be confirmed from the package.
Do not stop either medicine because of knee pain. Because both brand products may contain metformin, ask a doctor or pharmacist to confirm every active ingredient and the total daily dose so that medicine is not duplicated accidentally. If the pain began after a medicine change, report the timing. Also mention every cholesterol medicine, steroid, supplement, and pain reliever you use.
Do not force a 40-minute walk through increasing pain. Temporarily shorten the distance, walk on a flat surface, and avoid deep squats, kneeling, twisting, or stretches that reproduce pain. Lower-impact activity such as a stationary bicycle or water exercise may be suitable after assessment.
If there was a recent injury, use a wrapped cold pack for up to about 20 minutes at a time, avoid direct ice on the skin, and rest from the aggravating activity. A physiotherapist can prescribe strengthening and mobility exercises after determining the cause.
Do not place melted candle wax, heated salt, or very hot packs directly on the knee. Diabetes-related reduced sensation or circulation can make burns harder to notice and slower to heal. Balms may irritate the skin and do not treat a ligament injury, infection, gout, or poor circulation.
Do not massage a suddenly swollen, red, or painful calf because a blood clot must first be excluded.
A clinician or pharmacist should review pain relief because diabetes may coexist with kidney, heart, blood-pressure, or stomach problems. A topical anti-inflammatory gel may be considered for knee osteoarthritis, but oral anti-inflammatory medicines can affect the kidneys, stomach, blood pressure, and cardiovascular system.
Do not begin regular ibuprofen, diclofenac, naproxen, or another pain medicine without checking your kidney function, other medicines, and medical history.
Continue daily foot inspection and wear supportive, well-fitting footwear. See our diabetic foot-care guide.
Seek urgent care for a hot, red, severely swollen knee; fever; inability to bear weight; a deformed knee; a popping injury with instability; or a rapidly worsening wound. Seek emergency care for sudden calf or whole-leg swelling with chest pain or breathlessness, or for a suddenly cold, pale, blue, numb, or extremely painful foot or leg.
Knee pain that interferes with walking should be examined rather than treated with heat, wax, salt, or an unverified balm. Reduce painful activity temporarily, continue prescribed diabetes treatment, and ask the clinician to assess the joint, circulation, nerves, footwear, and exercise plan.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical, orthopedic, or vascular assessment. Do not start, stop, or change diabetes medicines, pain medicines, supplements, or exercise plans without speaking with your healthcare provider.
Last reviewed: July 2026.
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