Diabetes and varicose veins are two diseases that often coexist. If you are a diabetic, you should know that vein doctors perform varicose vein treatment on type 2 diabetics every day. However, because diabetic high blood sugar also tends to damage blood vessels, you should take extra care to select a vein doctor who has a great deal of expertise and experience, such as those you’ll find at Metro Vein Centers, in dealing with type 2 diabetics. There are can also be complications due to neuropathy, i.e. damage to the nerves that should be taken into consideration before, during, and after the procedures.
Italian researchers, Francesco Ferrara and Giovanni Ferrara, published a paper entitled, “Sclerotherapy in the Patient with Diabetes: Indications and Results,” which sheds light on this important question often posed by type 2 diabetics as they converse with their vein doctor. Sclerotherapy has become on of the most popular methods of varicose vein treatment so this is a good place to start examining this question. Their paper was published in a journal called “Phlebolymphology” which is a fancy word for the study of venous and lymphatic diseases (diseases involving veins and the lymphatic tissue).
If you’re one of those people who like to read the last page of a book first so you’ll know in advance how it all ends up, you’ll like what we’re about to do! The conclusion of the research paper about was that sclerotherapy was just as successful in type 2 diabetics as it was in non-diabetics IF the blood sugar in diabetics was controlled through medication and other means. Notice that big “IF.” Diabetics have controlled blood sugar if their A1C is 6.5 percent or below. Don’t be surprised if your vein doctor orders an A1C test before he or she advices you on the best way forward. It’s possible, they may recommend that you get your blood sugar under control before any type of varicose vein treatment including sclerotherapy.
Now let’s explore some of the other details in the paper.
The Italian researchers studied the effects of sclerotherapy on sixty legs. In most cases, the sclerotherapy varicose vein treatment was performed on the greater saphenous vein, forty-seven cases in all. Another eight legs received sclerotherapy varicose vein treatment on the small saphenous vein and five legs received sclerotherapy on veins other than the saphenous vein. This is a good sample distribution because varicosities in the saphenous vein is most frequent cause of varicose veins throughout the whole leg.
Sclerotherapy is a minimally invasive varicose vein treatment. A small incision is made in the skin over a varicose vein. A chemical is then injected into the vein that displaces the blood and causes the vein wall to close and collapse upon itself. Essentially, the injected fluid (or foam) is a chemical irritant that causes the vein tissue to disintegrate through an series of events proceeding from inflammation, next thrombosis, and then fibrosis of the old vein material. This process triggers the body to reabsorb the old vein materials.
It turns out that foaming sclerosants are better than liquid sclerosants when performing sclerotherapy varicose vein treatment on type 2 diabetics. This is because less of a foaming sclerosant is needed than a liquid sclerosant. This is important because the vein walls in a diabetic tends to be more sensitive to a sclerosant and more easily ruptured. Foaming sclerosants are also better seen by duplex ultrasound during the procedure which makes the procedure more accurate, which is more important in a diabetic patient due how fragile the veins may be. Finally, if the sclerosant was to escape the vessel during the procedure, a rare occurrence but a higher risk in diabetics, it would cause less complications than a liquid sclerosant.
Diabetics are also at a much higher risk of infection during varicose vein treatment of any type, including sclerotherapy. Therefore, it’s important you choose a highly skilled and highly experienced vein doctor, like you’ll find at Metro Vein Centers, who has performed sclerotherapy on many diabetics and understands the need to take extra precautions. For example, the skin near the tiny incision should be sterilized in all patients, but in diabetics, there may be special precautions to sterilize the area even more than normal since the risk of infection is so much higher. There may also be an extra effort to drain the area of any excess fluid to make it easier to insert the needle without as much compression, which can introduce infection, and to prevent the easy spread of infection.
The best part of the study is that they followed up not only at six, eight, and twelve months after the procedure but also at two and then four years after the procedure. So, they determined how well the procedure worked in both the short term AND in the long term on type 2 diabetic patients. Even after four years, there were no cases of deep vein thrombosis in these diabetics who had received sclerotherapy. Since this is the most serious complication that can develop, this is very good news for diabetics considering varicose vein treatment.