Prevalence of deep venous incompetence and microvascular abnormalities in patients with diabetes mellitus

The involvement of venous disease in the diabetic neuropathic foot is widely accepted. This article reports the result of prevalence of venous incompetence, impaired calf vein hemodynamics, and loss of microvascular control in the skin over the dorsum of the foot in an effort to document whether increased retrograde pressure caused by venous incompetence or loss of sympathetic regulation of the microcirculation is present in the diabetic patient who is at risk of foot disease. It was found that 64% and 70.7% of diabetic patients had deep venous incompetence in their right and left legs, respectively, which was statistically significantly greater than what was found in a previous report on the general population (P < .05); 42.7% and 49.3% of patients had a reduced venous refilling time in the right and left legs, respectively, and 30.7% and 33.3% of patients had loss of the arteriovenous response in the right and left legs. Some previous reports have suggested evidence of hemodynamic and morphological changes in patients with diabetic foot disease. The outstanding contribution of this report is the finding of venous incompetence in patients with diabetes but not foot disease. Because some 15% of the population with diabetes develop foot complications, the reported observations offer hope of alleviating symptoms if not preventing ulcers.