Difference in Clinical Presentation of Chronic Venous Disease Between a Diabetic and Non-diabetic Population in Mexico and Its Response to Conservative Treatment

Chronic venous disease (CVD) is a widespread, underdiagnosed, and progressive condition that reduces quality of life and increases healthcare costs. The relationship between CVD and type 2 diabetes (T2D) is complex, sharing multiple factors that contribute to development and progression. Despite the high prevalence of type 2 diabetes in CVD, there is a lack of evidence for the proper care for these patients. We aim to describe the relationship between CVD and T2D and the effectiveness of conservative treatment in a Mexican population as a sub-analysis of the Vein Step-Mexico Study.

Methods: The Vein Step study was an international observational prospective study conducted in real-world settings in adult patients consulting for symptomatic CVD. We are presenting data evaluated from a population recruited in Mexico. Patients underwent a clinical evaluation using the Clinical Etiology Anatomy Pathophysiology (CEAP) classification. Patients received initial treatment with venoactive drugs (VAD), compression, lifestyle change, etc. according to each physician’s judgment. Up to 8 weeks outcomes were evaluated using a 10cm visual analog score (VAS) and QoL using the CIVIQ-14 questionnaire and VCSS. Clinical changes over time were analyzed using a Wilcoxon test and between-group comparison using a ranked ANCOVA with baseline value as covariates adjusted on main baseline characteristics and relevant concomitant treatments.

Results:

From Jul 2021 to Sep 2022, a total of 803 patients were analyzed. A total of 609 (75.8%) were female, the average age was 52 years, with a BMI average of 28.4 kg/m², and 138 (17.2%) patients presented diabetes mellitus of which 127 (92%) were T2D. 53% of C0-C3 patients were non-DM vs 10.2% of DM, lower QoL, and more severe clinical symptoms in the T2D group. A VAD-based treatment was prescribed in 97.3% of patients with MPFF being used in 70.2%, compression was used in combination with VADs in 56%. Treatment with VAD was associated with a significant decrease over time in mean global symptoms intensity and in each symptom evaluated, a significant improvement in QoL was also observed. These improvements were similar in magnitude in non-T2D.

Conclusions:

In this sub-analysis of the Vein Step study, we observed that T2D patients exhibited greater severity of CVD. Results suggest that oral venoactive monotherapy or in combination with other conservative treatments, can lead to a significant reduction in CVD symptoms and therefore, an improvement in QoL in this population.