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Diabetes and Peripheral Arterial Disease

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Updated December 14, 2011

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Diabetes and Peripheral Arterial Disease

Peripheral arterial disease can weaken blood flow to the legs if not caught early.

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What you should know about PAD:

Peripheral arterial disease (PAD) is a condition where the blood vessels in your legs narrow or become blocked, reducing blood flow to your legs and feet. It is estimated that one out of every three people with diabetes over the age of 50 has PAD.

How does diabetes affect the development of PAD?

Over time, High blood glucose levels can cause a number of health complications. These diabetes-related problems may involve the eyes, kidneys, nerves and blood vessels.

It has been well established that high blood sugar levels increase the risk of these complications and, in particular, the narrowing of blood vessels in your legs. Narrowing of the blood vessels puts you at greater risk of a heart attack or stroke.

Are there additional PAD risk factors?

In addition to having diabetes, there are other factors that may increase your risk of PAD. These include:
  • Smoking
  • High blood pressure
  • Being overweight
  • Being over age 50
  • History of heart disease
  • Sedentary lifestyle

Are there symptoms of PAD?

Some people experience no symptoms. The first symptoms are typically some mild discomfort or pain when walking, which you may attribute to aging or some other unrelated situation. Additionally, there may be:
  • Numbness, tingling or a cold sensation in the legs or feet
  • Infections, blisters or sores on the feet that are slow to heal

How is PAD diagnosed?

One of the best ways to diagnose PAD is using a test called the ankle brachial index (ABI). This test compares the blood pressure in your ankle with the blood pressure in your arm. Ideally, the blood pressure in each area should be the same. But if the blood pressure in your ankle is lower than the pressure in your arm, it shows that there is either blockage or a narrowing of the blood vessels to the leg, an indication of PAD. The American Diabetes Association recommends that every person with diabetes over age 50 have an ABI test.

Other tests include:

  • Injection of a dye into the blood vessels (called an angiogram). The vessels are then viewed with an X-ray to determine if there is a blockage or a narrowing.

  • Use of ultrasound waves to detect a blockage or narrowing.

  • An MRI scan to detect any blockage or narrowing.

Treatments

The good news is that you can significantly reduce your risk of PAD and other health problems that can stem from this condition by:
  • Not smoking.

  • Working to keep your blood glucose levels in good control. Most people set a goal for their hemoglobin A1c test to be below 7%. Talk with your doctor about the target range that is appropriate for you.

  • Lowering your blood pressure to less than 130/80.

  • Possible use of aspirin or antiplatelet medications, which have been shown to reduce heart attacks.

  • Improving circulation in your legs and feet through exercise, especially walking.

In some cases, surgery is needed to effectively treat PAD. Angioplasty, for example, involves inserting a small tube with an attached balloon into the artery. When the balloon reaches the collapsed portion, it is inflated to expand the vessel. A wire tube (stent) is then inserted to keep the blood vessel open so that blood can easily flow through the previously blocked area.

Another procedure, called artery bypass graft, involves taking a blood vessel from another part of the body and rerouting the blood flow around the blocked or collapsed artery.

Sources:

American Diabetes Association. "Peripheral Artery Disease (PAD).”

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