<s>[INST] Hi, my mother has been diabetic for years she just started insulin shots at night. She works 8 hours a day on her feet. Since taking the shots she noticed blue/purple spots on her ankles.. it looks like a cluster of vericose veins. Her feet hurt all the time. What is causing this? [/INST] Dear friendvericose vein is the condition in which veins that have become enlarged and twisted. Veins have valves to prevent blood from flowing backwards. Leg muscles pump the veins to return blood to the heart against the effects of gravity. When the valves do not work (valvular incompetence), it causes blood to flow backwards and likewise enlarging and twisting the veins even more. This is the varicose vein. The related factors in the cause of varicose vein are prolonged standing, leg injury, abdominal straining etc. the blue/purple staining/spots you noticed on your mothers' ankle is due to varicose vein. Treatment of varicose vein are surgical, and non-surgical treatment includes elastic stockings, elevating the legs, and exercise and chemotherapy. So you should counsel your mother not to work on her feet as much as possible. Whenever possible elevate both legs, this will pump blood towards heart. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend Chat Doctor.  </s>