By Jill Buterbaugh, RN, MSN, CRNP, FNP-BC
Diabetes, even if well controlled, is an unpredictable disease. Sometimes there is no correlation between how good the diabetes is managed and the degree of complications. Common complications of diabetes that can effect venous health include poor healing and peripheral neuropathy. Treating venous insufficiency will reduce the potential for venous related skin rashes, ulcers and neuropathies, but not eliminate it. Venous insufficiency is a disease and as with any disease, it will need to be monitored and treated as it progresses.
So why does it take a person with diabetes longer to heal than someone who does not have the disease? There are many contributing factors to healing that are unique to people with diabetes. First of all, high levels of sugar in the blood vessels tend to make them stiff and narrow. Arteries deliver blood to the tissues and veins return the blood to the heart. Arteries deliver the oxygen and nutrients to the tissues to maintain good health and promote healing. Decreased delivery of blood to the tissues will decrease the delivery of the components necessary for efficient healing and prolongs the process.
Venous insufficiency can further impair circulation by decreasing the amount of blood that is being returned to the heart and lungs to eliminate cellular waste and replenish oxygen and nutrient supplies. The blood becomes stagnant in the diseased veins and the body will utilize all the oxygen and nutrients it can from what is in the vessels. Over time, this leads to changes in the skin like dryness, rashes or even ulcerations.
Elevated sugar levels also decrease the ability of the immune system to function. There are enzymes and hormones produced by the body when high sugar levels are present that prevent the immune cells from working correctly. This increases the risk of infection and illness to occur as well as prevents the healing of infection and illness that is already present. Venous insufficiency can lead to chronic ulcers even in a person without diabetes, but is very dangerous in people with diabetes. It can lead to overwhelming infection known as sepsis which can result in death or even gangrene which often results in amputation.
Diabetic neuropathy is when the high sugar levels damage peripheral nerves. It is sometimes described as a pricking or burning sensation initially. However, as the disease progresses it will eventually lead to a loss of feeling. This is especially concerning to diabetics because small injuries or wounds may not be noticed until after they become chronic or infected. Veins are located very close to nerves. When veins are diseased and chronically inflamed, this irritates the nerves that are near them making the neuropathy symptoms worse. Treating the veins will not eliminate the symptoms coming from diabetic nerve damage, but may make the symptoms somewhat better or easier to control.
Having diabetes should never prevent you from having your veins fixed. Ablation procedures and microphlebectomies, which are done to treat larger diseased veins, are done under sterile technique and only involve puncture wounds and needle sticks. The risk of infection from having these procedures done is very minimal. Sclerotherapy involves needle sticks using clean technique and also has a very low risk of infection. Treating the diseased veins is very beneficial to someone with diabetes because it may prevent complications that occur over time and improves the health of the surrounding tissues.
For more information on the treatment of venous insufficiency, feel free to review some of the archived articles previously posted on our website. If you would like an appointment for a consultation and evaluation, please call (814) 515-9919. We would be happy to evaluate you to see if treatment of venous insufficiency is right for you.