Diabetes and Vein Health: How Diabetes Affects Your Veins

People with diabetes are at a higher risk for developing vein disease. Over time, high blood sugar damages blood vessels throughout the body and slows healing, which can make leg problems such as swelling, skin changes and slow-healing sores harder to manage. Diabetes also raises the risk of artery disease, which is a different condition from chronic venous insufficiency and other vein disease.

Diabetes is one of several medical conditions that can worsen vein health. Below, we explain how diabetes and vein disease are linked, which leg problems to watch for, and when to see a vein specialist.

How Diabetes Affects Your Vein Health

Diabetes affects about 40.1 million Americans, and about 11 million of them don't know they have it according to the American Diabetes Association. About 90% to 95% of people with diabetes have type 2, which can often be prevented or delayed with lifestyle changes.

Consistently high blood glucose can affect multiple organs, including the heart, eyes and kidneys. Many people don't realize that it also affects blood vessels. Diabetes can damage vessel walls and increase inflammation. Much of this damage causes no symptoms at first, so it often progresses unnoticed.

Diabetic nerve damage can also make problems harder to notice, because numbness may hide early warning signs in your legs and feet.

Common Vein Problems in People With Diabetes

People whose diabetes has been unmanaged for a long time can face a range of leg problems. These problems result from poor circulation and inflammation. Vein-related conditions to know about include:

• Chronic Venous Insufficiency (CVI): CVI happens when the valves in your leg veins stop working well, so blood pools in the legs instead of flowing back to the heart. Diabetes doesn't directly cause CVI, but the two often occur together, and diabetes is one of several health conditions studied as a factor in slower healing of leg ulcers.
• Varicose Veins: Varicose veins are enlarged, twisted veins caused by weakened valves and vein walls. Having diabetes doesn't mean you'll develop them, but if you have both, keep an eye on swelling, skin changes and any sore that's slow to heal.
• Deep Vein Thrombosis (DVT): Some studies link diabetes with a modestly higher risk of blood clots in the veins, while others find little or no link, so the evidence is mixed. Other factors, such as recent surgery, long periods of sitting and excess weight, play a larger role.

Venous Ulcers vs. Diabetic Foot Ulcers

Leg and foot sores are a serious concern when you have diabetes, but not every sore has the same cause, and the cause decides the treatment.

• Venous ulcers usually form on the lower leg, often around the inner ankle. They tend to be shallow, with swelling, heaviness and brown or discolored skin around them. They're caused by blood pooling in the leg veins.
• Diabetic foot ulcers usually form on the bottom of the foot, the toes or other pressure points. Because of nerve damage, they're often painless, and poor blood flow in the arteries can make them worse.
• Arterial ulcers are caused by poor blood flow through the arteries. They often appear on the toes, heels or outer ankle.

If you have a sore on your leg or foot that's slow to heal or getting worse, see your doctor. A vein specialist can check whether vein disease is part of the problem, while your diabetes care team, a podiatrist or a wound care clinic manages foot ulcers.

Artery vs. Vein Problems: Why It Matters

According to the American Heart Association, people with diabetes are at higher risk of atherosclerosis, the buildup of plaque in the arteries, because of obesity, high blood pressure, inflammation and high cholesterol, among other risks. When plaque narrows or blocks the arteries in the legs, it's called peripheral artery disease (PAD).

PAD affects the arteries, which carry blood to your legs. Vein disease affects the veins, which carry blood back to your heart. Learn more about arterial vs. venous disease in our guide. The two can cause similar symptoms, so it's important to know which one you have.

Symptoms of PAD include:

• Foot or leg cramping and numbness
• A feeling of coldness in one leg
• Leg or foot ulcers that won't heal
• A weak pulse in the legs or feet
• Hair loss on the affected leg

Some people with PAD have no symptoms at all, so if you have diabetes, ask your doctor whether you should have your circulation checked. Early detection is the best way to avoid complications.

The Impact of Diabetic Neuropathy on Vein Health

Long-standing diabetes can lead to nerve damage, known as diabetic neuropathy. This condition can cause pain and numbness in the legs and feet, and numbness can make it easier to miss swelling, skin changes or a sore. Treatment options include:

• Insulin or antidiabetic medications
• Medications used to treat neuropathy
• TENS therapy
• Foot care

Managing Vein Health With Diabetes

If you have diabetes, keeping your blood sugar in your target range is one of the best ways to protect your blood vessels. Regular exercise, a balanced diet and quitting smoking can all help.

Compression stockings can ease leg swelling and aching from vein disease. However, check with your doctor before you start wearing them: compression may not be safe if you also have peripheral artery disease, so your doctor may check the blood flow in your legs first.

Diabetes often comes with other conditions that affect the veins, such as high blood pressure. If you take a GLP-1 medication, read about Ozempic and vein health.

What Are the Treatment Options for Vein Disease?

Treatment for vein disease depends on what your vein evaluation shows. A vein specialist can recommend minimally invasive treatments or lifestyle changes to help relieve symptoms of vein disease. Managing your diabetes, including any medication your doctor prescribes, such as Metformin, protects your blood vessels overall, but it doesn't treat vein disease itself.

Lifestyle changes:

• Exercise: Losing excess weight can reduce pressure on your veins and improve blood sugar levels.
• Hydration: Drinking enough water supports healthy circulation.
• Low-carb diet: A low-carb diet helps keep your blood sugar steady by preventing spikes in glucose.
• Compression: Compression stockings can relieve symptoms, with your doctor's OK.

Minimally invasive treatments:

• Radiofrequency ablation: Uses heat from radio waves to close a diseased vein.
• Endovenous laser treatment: Uses heat from a laser to close off a varicose vein.
• Sclerotherapy: A vein specialist injects a medicine into a damaged vein to close it off.
• VenaSeal: Uses a medical-grade adhesive to seal a diseased vein.
• Varithena: Uses an injectable foam to close a diseased vein.
• Microphlebectomy: Removes bulging surface veins through tiny incisions.

How to Prevent Vein Problems in Diabetics

The best way to catch vein problems early is a regular evaluation. During an evaluation, a vein specialist examines your legs and feet for signs of vein damage or disease. Learn what to expect at your appointment. It's also a good idea to check your legs and feet yourself between visits. Look for:

• Pain or tenderness when you press on your leg
• An ulcer or open sore
• Skin changes, such as darkening or thickening
• A temperature difference between your legs
• Visible blue or dark veins
• Bulging veins
• Swelling in your legs or ankles

If you have any concerns about diabetes and your vein health, schedule a free vein health evaluation with Metro Vein Centers.

Chief Medical Officer

Dr. Philip LoPresti

Meet Dr. Philip LoPresti, DABVLM, FACS, a board-certified surgeon and vein specialist and surgeon with over 20 years of experience. Schedule an appointment with him in Queens, NY today.

Meet Dr. Philip LoPresti

Trusted insight from the nationally accredited, board-certified vein doctors at Metro Vein Centers.