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If you’re living with type 2 diabetes symptoms and notice changes to how your veins look, you may worry about whether the condition is harming your heart and blood vessels. While more visible veins are usually harmless, they may also point to problems with vein health that could require medical attention.
Here’s what to know about why blood vessels may become more noticeable with diabetes, when to be concerned, and how to keep your circulation healthy.
Type 2 diabetes affects the way your body processes glucose (sugar), leading to higher-than-normal blood sugar levels. Over time, high blood glucose can damage the lining of your blood vessels, including both veins and arteries. This can reduce their ability to appropriately get wider and narrower, making it harder for blood to move smoothly through your body.
Diabetic angiopathy — poor circulation caused by diabetes-related blood vessel damage — can lead to symptoms such as:
Diabetes can also affect the smallest arteries in the body, which feed important organs and systems like the eyes, nerves, and kidneys. This leads to complications like diabetic retinopathy (eye disease), diabetic neuropathy (nerve damage or disease), and diabetic nephropathy (kidney disease).
There are several reasons why people with diabetes may notice their blood vessels becoming more visible. In many cases, these changes are related to shifts in skin, fat, or hydration, rather than the veins themselves.
Unintentional weight loss may occur when diabetes is advanced and blood sugar levels aren’t under control. As the layer of fat under your skin thins out, veins may appear darker or more pronounced. This may first become noticeable in the arms, hands, and lower legs.
High blood glucose levels can cause the body to lose excess fluids through frequent urination. When you’re dehydrated, your skin may appear less plump and more transparent, revealing veins more easily.
When blood flow slows down due to damaged vessels or narrowed arteries, veins may become more prominent, particularly in the lower legs. This can sometimes be a sign of a condition called chronic venous insufficiency (CVI).
Chronically high blood sugar can damage small vessels that supply the skin, leading to slower healing and less elasticity. As a result, your skin can become thinner and more fragile, making veins appear more visible under the surface.
While visible veins are sometimes harmless, they can also be a sign of an underlying issue with your circulation. Here are some situations to watch out for.
Varicose veins are large, twisted, ropy veins that often appear on the legs. They occur when vein valves, which normally help push blood back to the heart, become weak or damaged. This causes blood to pool where gravity takes it, usually in the veins of the lower legs.
Diabetes doesn’t directly cause varicose veins, but poor circulation and inflammation from high blood sugar levels can make them worse.
If varicose veins are itchy, painful, or accompanied by leg swelling, talk to your doctor. They may recommend treatment options such as wearing compression stockings, reaching a healthy weight, and doing exercises to improve blood flow. There are also newer treatment options like laser ablation (using a laser to remove damaged veins), sclerotherapy (injecting a solution into the veins to close them), or radiofrequency ablation (using heat to close veins). Ultimately, some cases require surgery.
If your leg suddenly becomes swollen, painful, warm, or discolored, you may have a deep vein thrombosis (DVT), which is a blood clot in a deep vein. DVT is a real medical emergency because the clot can travel to the lungs and cause a pulmonary embolism (blocked artery in the lungs). This may be life-threatening. Go to the emergency room if you have:
People with diabetes are at higher risk for blood clots due to injury to the walls of blood vessels caused by chronically high blood sugar.
CVI is a vein disease that occurs when the veins in your legs can’t efficiently return blood to your heart. Blood pools in the lower legs, leading to:
If you notice these changes, see a healthcare provider. Treating CVI early can prevent complications such as skin infection or ulcers, which are more difficult to heal in people with diabetes.
Diabetes doesn’t only affect your veins; it can also harm your arteries and capillaries (tiny blood vessels). Over time, high blood sugar contributes to atherosclerosis, or the buildup of fatty deposits inside arteries. This can lead to heart disease, stroke, and peripheral artery disease (PAD).
In PAD, arteries in the legs become narrowed, reducing blood flow. Symptoms may include leg pain when walking, slow-healing sores, or shiny, hairless skin. PAD increases the risk of infection and amputation in severe cases.
Keeping your blood sugar, cholesterol, and blood pressure within target ranges is key to protecting your arteries and veins. Smoking also increases the risk of severe PAD, so stopping smoking is a priority.
There are steps you can take every day to promote good blood flow and vascular health.
Contact your doctor or a vein specialist if you notice any of the following changes:
More visible veins aren’t always a sign of trouble, but they can be a clue that your circulation or skin health is changing. Paying attention to how your skin looks is an important part of diabetes care.
On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.
Have you noticed more visible veins with diabetes due to any risk factors or causes? Let others know in the comments below.
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