Varicose veins and diabetes – A complete guide

To successfully manage diabetes you need to manage not only the disease itself but also any complications that it can cause. Varicose veins are a common problem, but if you have varicose veins and diabetes you need to pay even more attention to your vein health. And by understanding the connection between varicose veins and diabetes, you’ll know how to take proactive steps to manage your symptoms and maintain your overall health.

So let’s look into varicose veins and explore what they are, their link with diabetes, and how to manage them.

Here’s everything you’ll need to know:

• What are varicose veins?
• What’s the link between varicose veins and diabetes?
• How to reduce the risk of and manage varicose veins with diabetes
• How to treat varicose veins in diabetes
• Conclusion: Varicose veins and diabetes – A problem that you can address and successfully treat

What are varicose veins?

Before we dive into the connection, management, and treatment of varicose veins and diabetes, let’s first look at what varicose veins are.

• Varicose veins are veins that are swollen or enlarged.
• They often appear dark blue or purple in colour.
• They typically form in the legs and feet but can also appear in other parts of the body.
• They may look twisted or bulging, giving them a knotted or rope-like appearance.

Varicose veins form when the valves within the veins that control blood flow (and prevent backflow) are weakened or damaged. When these valves are damaged, blood can flow backwards and pool in the veins. This leads to increased pressure and the enlarged and twisted appearance of varicose veins.

Varicose veins aren’t just a cosmetic problem. They can also cause aching, throbbing, pain, discomfort, and a heavy sensation.

Common causes of varicose veins and risk factors

Varicose veins are usually caused by several factors:

• Age – As you get older, the valves in your veins become less effective and the veins lose elasticity. This increases the risk of varicose veins.
• Gender – Women more often develop varicose veins compared to men. This is because hormonal changes during pregnancy, menopause, and hormonal contraception can all increase the risk of varicose veins.
• Genetics – Family history is a significant factor in the development of varicose veins. If your parents or close relatives have had varicose veins, you are likely at a higher risk of developing them as well.
• Long periods of sitting or standing – If you sit or stand for long periods, you may be at higher risk of varicose veins. This is because sitting or standing for long periods can lead to increased pressure on your veins.
• Obesity – Excess weight places added strain on veins, making it harder for them to move blood efficiently. This increases the chance of developing varicose veins.

How to identify the signs and symptoms of varicose veins

Varicose veins are usually easy to recognise, as they often present noticeable signs and symptoms.

• Visible veins – Varicose veins are visible beneath the skin and may appear twisted, bulging or enlarged.
• Discomfort or pain – If you have varicose veins you may feel aching, throbbing or a heavy sensation in the affected area (usually the legs). This pain may get worse if you continue to stand or sit.
• Swelling and inflammation – The affected area may become swollen, particularly after long periods of inactivity or during warm weather.
• Skin changes – Skin around varicose veins may discolour or get irritated. In severe cases, skin ulcers or sores may develop.

While varicose veins can be uncomfortable and unpleasant to look at, they’re typically not a significant health risk. However, when you have varicose veins and diabetes it’s a different matter, and more important for you to monitor and maintain your vein health.

What’s the link between varicose veins and diabetes?

Having diabetes contributes to the development and progression of varicose veins in several ways. Let’s look into how diabetes increases your risk and why:

How diabetes contributes to varicose veins

• Impaired circulation – Diabetes can affect your blood circulation, weakening your blood flow. This can increase the risk of blood pooling in your veins and the development of varicose veins.
• Weakened vein walls – Diabetes can also cause damage to the walls of blood vessels, including veins. This damage weakens the vein walls and increases the risk of them becoming varicose.

The impact of high blood sugar levels on blood vessels

High blood sugar levels are a major factor in why diabetes contributes to varicose veins. Here’s how:

• Inflammation and oxidative stress – High blood glucose levels can cause inflammation and oxidative stress (when your body has too many unstable molecules (a.k.a. free radicals) and not enough antioxidants to get rid of them). Inflammation and oxidative stress can damage blood vessels (including veins) and reduce their elasticity. Damaged veins can’t function as efficiently as they’re supposed to. This means they can’t move blood effectively and increases the risk of developing varicose veins.
• Endothelial dysfunction – The endothelium is a layer of cells lining the inner surface of blood vessels. It secretes chemicals that cause the blood vessel to relax or contract, which helps move blood through the body. However, high blood sugar levels over a long period can interfere with the endothelium, causing endothelial dysfunction. This is when the endothelium can’t function as effectively as it’s supposed to and properly control the relaxation and contraction of the blood vessel. This again impacts the vessel’s ability to move blood, increasing the risk of varicose veins.

The role of insulin resistance in varicose veins

Insulin resistance, commonly experienced by type 2 diabetics, is another key reason why diabetes can contribute to varicose veins.

• Impaired vein function – Insulin resistance can affect the smooth muscle cells within veins. These cells play a key role in maintaining the vein’s tone and ability to contract. When they’re not functioning properly, the vein can’t move blood around the body as effectively as it should and the risk of developing varicose veins increases.
• Increased inflammation – Insulin resistance can also cause inflammation. And again, inflammation can weaken and damage blood vessels, including veins, increasing the risk of varicose veins.

How to reduce the risk of and manage varicose veins with diabetes

While diabetes can contribute to the development of varicose veins, there are ways you can reduce your risk of developing them and manage them:

Lifestyle modifications

For diabetics, adopting healthy lifestyle habits can help you avoid varicose veins and manage the symptoms if you do have them. You can:

• Maintain a healthy weight – If you’re carrying excess weight, it puts an additional strain on your veins which can lead to varicose veins. Aim for a healthy weight by following a balanced diet and exercising regularly.
• Stay physically active – Not only does being physically active help you reduce excess weight, but also improves circulation, strengthens leg muscles, and improves overall vein health. Consult with your doctor to see what exercises might be right for you, and try to include walking, cycling, swimming or low-impact exercises in your daily routine.
• Follow a healthy diet – Similarly, a healthy diet not only helps you reduce excess weight but also helps with blood sugar control and blood vessel health. Focus on whole, nutrient-rich foods. Include plenty of fruits, vegetables, lean proteins, whole grains, and healthy fats. And limit the amount of processed foods, sugary snacks and high-sugar beverages you eat and drink.
• Elevate the legs and avoid sitting or standing for long periods – By periodically elevating your legs above your heart throughout the day, you can improve your blood circulation and relieve pressure on your veins. You should also avoid sitting or standing for long periods, as this can increase your risk of varicose veins and make existing symptoms worse.

Blood sugar control

As poor blood sugar control can contribute to the development of varicose veins, maintaining good blood sugar control can help reduce your risk and manage them. Here’s how good blood sugar control can improve your vein health:

• Improved circulation – Stable blood sugar levels help promote healthy blood circulation. This reduces the risk of vein damage and varicose veins.
• Reduced inflammation – Keeping your blood glucose level in control reduces the risk of inflammation (which weakens blood vessels). Avoiding inflammation gives you a better chance of keeping your veins strong and healthy.

Regular check-ups

One of the key ways to reduce your risk of developing varicose veins and manage the symptoms if you do get them is to have regular check-ups with your doctor.

They can monitor your blood sugar control, check your vein health, and provide advice tailored to your specific needs. And if they find you have varicose veins and they’re severe enough to need treatment, they can help you consider your options.

How to treat varicose veins in diabetes

There are several ways to treat varicose veins in diabetics. These range from conservative to medical.

Conservative treatments

• Compression stockings – Compression stockings are a non-invasive way to treat varicose veins. The stockings are designed to provide varying pressure, applying the most at the ankles and gradually decreasing higher up the legs. This helps improve blood flow and reduce swelling.
• Weight management – Just as maintaining a healthy weight can reduce your risk of developing varicose veins, it can also help treat them. Losing weight can lessen the burden on your veins and reduce the symptoms of varicose veins.
• Exercising and stretching – Again, regular exercise (particularly activities that promote leg movement and muscle contraction) can improve circulation and not only reduce your risk of varicose veins but also help treat them. As well as exercising, do leg stretches to further improve blood flow and relieve pressure on your veins.
• Elevate the legs and avoid sitting or standing for long periods – Likewise, regularly raising your legs above your heart throughout the day can improve blood flow, reduce swelling, lower your risk of developing varicose veins, and help treat them.

Medical treatments

• Sclerotherapy – Sclerotherapy is a commonly used, minimally invasive procedure for treating varicose veins. A sclerosing agent (a chemical compound that acts as an irritant) is injected into the affected vein. This causes the vein walls to swell, stick together and cut off blood flow. Without blood flow, the vein eventually fades away. Sclerotherapy is a simple and typically safe procedure.
• Endovenous laser treatment – Endovenous laser treatment (EVLT) involves using a laser to close off and seal varicose veins. A thin laser fibre is inserted into the affected vein, and the laser is activated. This causes the vein to shrink and eventually disappear. EVLT is an effective and relatively painless procedure (you receive anaesthesia).

Surgical procedures

In more severe cases, or when conservative treatments or minimally invasive medical treatments have been determined insufficient, surgery may be necessary. Surgical options include vein ligation, stripping or ambulatory phlebectomy. This is when a surgeon makes an incision, then ties the affected vein off and may remove it.

Surgery is usually a last resort and should only be considered after you’ve discussed with your doctor and reviewed the alternative treatments.

Treatment considerations for diabetics

When considering or undergoing treatment for varicose veins, diabetics need to take additional precautions. It’s important to:

• Talk to your doctor – Your doctor can review your diabetes history and provide advice tailored to you. Tell them about any concerns or considerations you have, and they can help you choose the right treatment option.
• Monitor your blood sugar level – Certain treatments, such as sclerotherapy or surgery, may affect your blood glucose level. If you have these treatments, monitor your blood sugar level closely during and after, discuss with your doctor, and adjust your diabetes medication if needed.
• Follow post-treatment care instructions – As a diabetic, after undergoing a treatment you are at higher risk of complication than a non-diabetic. Follow post-treatment care instructions closely to reduce your risk. This may include wearing compression stockings, taking prescribed medications, or making lifestyle adjustments.

By addressing varicose veins quickly and with the right treatment you can reduce the symptoms and improve your vein health.

Conclusion: Varicose veins and diabetes – A problem that you can address and successfully treat

Varicose veins can be concerning for diabetics. But by understanding them and treating them quickly you can reduce their impact.

Managing varicose veins requires a holistic approach. Maintaining good blood sugar control and making lifestyle adjustments can help reduce your risk of developing varicose veins. Staying physically active, following a balanced diet, monitoring your blood glucose level, and regularly taking your diabetes medication are all key.

If you do develop varicose veins, the same lifestyle adjustments and proactive diabetes management measures can help you treat them. And if needed there are additional treatment options, ranging from conservative to medical and surgical.

Remember, everyone’s personal situation is unique. And what works for someone else may not be right for you. Talk to your doctor to get personalised advice and guidance. By staying proactive and working closely with your doctor you can effectively manage varicose veins and enjoy good vein health.