Effectiveness of Conservative Treatment on Chronic Venous Disease Symptoms and Quality of Life in Patients with Type 2 Diabetes: Results from a Subanalysis of the VEIN STEP Observational Study.

BACKGROUND

This post-hoc subanalysis of the VEIN STEP study assessed the effectiveness of conservative treatment, particularly venoactive drugs (VAD), in reducing chronic venous disease (CVD) signs and symptoms and improving quality of life (QoL) for patients with type 2 diabetes (T2D) in a real-life setting.

METHODS

VEIN STEP was an observational, prospective study conducted in adult outpatients who consulted for symptomatic CVD (NCT04574375). CVD symptoms (10-cm Visual Analog Scale and Patient Global Impression of Change), disease severity (Venous Clinical Severity Score), and QoL (Chronic Venous Insufficiency Questionnaire [CIVIQ-14]) were assessed.

RESULTS

Overall, 6084 patients were analyzed, of whom 702 (11.5%) had T2D. These patients were more likely to be older, present with a more advanced CEAP class, have a higher body mass index, greater symptom severity and reduced QoL scores than those without T2D (p<0.001 for all). Almost all patients with T2D (97.3%) received VAD-based treatment, mainly micronized purified flavonoid fraction (MPFF, 72.2%) or diosmin (24.6%). After 4 weeks, conservative therapy was associated with significant improvements in CVD symptoms and QoL (p<0.001). Physicians also noted a significant improvement in disease severity (p<0.001). The decrease in global symptom intensity was significantly greater among patients treated with MPFF than in those treated with diosmin (mean -2.7±1.8 vs -2.0±1.8, p=0.004). Greater reductions in symptom intensity were also observed in patients treated with MPFF for pain (p=0.011), leg heaviness (p=0.006), and swelling (p=0.014), with a tendency for greater improvement of cramps. QoL improved for patients receiving MPFF and those receiving diosmin, with changes in CIVIQ-14 global index score of -21.3±15.8 and -15.5±14.6, respectively.

CONCLUSION

These findings indicate that patients with concomitant CVD and T2D are more likely to have greater symptom severity and disease burden. In such patients, VAD-based conservative therapy, particularly MPFF, was associated with significant improvements in CVD-related symptoms and QoL.

© 2026 Ulloa et al.