Diabetes and varicose veins seem to co-exist in many patients. Therefore, many people who seek varicose vein treatment are diabetics or pre-diabetics. This is likely because it is a well established fact that high blood sugar damages vessel walls and the nerves that feed them. This is the same reason, in fact, that many diabetics actually die of cardiopulmonary disease, a major complication of their diabetes, not from their diabetes directly.
When being evaluated at a varicose vein treatment center, like Metro Vein Centers, you should be sure to tell your vein doctor if you have diabetes or even pre-diabetes (the threshold between the two is rather arbitrary anyway). There may be special considerations when recommending both conservative varicose vein treatment and clinical varicose vein treatment to a diabetic.
One of the most important types of conservative varicose vein treatment is wearing graduated compression socks on a daily basis. Usually, the patient is professionally fitted and then instructed on how to properly put on her compression stockings. Without a proper fit, the compression will not work properly. However, with a diabetic, it can sometimes be far more difficult to do this task because of peripheral neuropathy and a loss of sensation in the legs, around the ankles, and in the feet. In these cases, the patient may need to work with someone more closely to learn a different way of putting on her compression socks properly.
There are other potential issues with wearing compression socks in diabetics. For example, with diabetics, it is very important to keep the feet dry. Therefore, they cannot wear non-breathable material that keeps the feet wet all day. For this reason, the fabric for compression stockings may have to be more carefully selected and will need to be a moisture wicking, fully breathable fabric. Extra padding may also need to be incorporated into the compression stockings to prevent injury and to keep the feet warm and dry. The patient may also need to be evaluated for arterial insufficiency. If this condition is too advanced, then compression stockings can actually be dangerous to wear!
During sclerotherapy varicose vein treatment, vein doctors may decide to use a different sclerosant chemical in a diabetic patient. For example, some sclerosants actually have a high glucose content. These are generally avoided in a diabetic patient. The veins in diabetics may also be more sensitive to certain types of sclerosants.
Diabetics also have a compromised immune response so more care must be taken in sterilizing the equipment used to make the puncture where the sclerosant is added. Diabetics must also more closely monitored for infection. This is also true with endovenous laser treatments when the catheter is inserted. More compression may need to be added immediately following a varicose vein treatment in a diabetic due to an extra propensity to bleed out.
An Italian study documented that in diabetics with controlled blood sugar, with an A1C level of 6.5 or less, the long-term outcomes for sclerotherapy varicose vein treatment were actually similar to non-diabetic patients. However, this study, the only study of its kind, did not evaluate the effect of sclerotherapy on diabetics whose blood sugar was not as tightly controlled. Some vein doctors may be inclined to suggest that a diabetic patient get their blood sugar under control first before they have sclerotherapy or any other type of varicose vein treatment.
Metro Vein Centers offers free vein evaluations to new patients. This is an excellent opportunity to have your veins evaluated by some of the best in the business. If you are diabetic, you’ll need to be very upfront about this so the vein doctor at Metro Vein Centers can discuss with you the exact details of your diabetes and the corresponding best treatment(s) for your specific case. It may come down to a safety issue where the risks are higher with certain types of varicose vein treatment procedures in diabetics who have weakened veins.
There does seem to be general agreement among vein doctors that foam sclerotherapy is well tolerated by most diabetics so you can bring this up in your discussion with your vein doctor when you are evaluated. However, you should always be fully evaluated before you and your doctor make the final decision together as to when you should have varicose vein treatment and the type of treatment that has the highest chance of success.
Success may also depend on whether or not there are any complications due to your diabetes. For example, if you kidney disease, this may affect whether or not you can have certain types of varicose vein treatment. This is yet another reason you should try to communicate very clearly with your vein doctor about your diabetes so he or she will have all the pertinent facts they need to best help you.
One final note of caution: if you are diabetic, you should be ready to face a longer than average healing time after your varicose vein treatment. This is because wound healing notoriously takes longer in diabetics than in non-diabetics. This doesn’t mean the wound won’t heal but that it will simply take longer so you may need to be more patient.
Good luck in your fight against diabetes and varicose vein disease!
