The Link Between Diabetes and Peripheral Arterial Disease (PAD)
Peripheral Arterial Disease, or PAD, occurs when blood vessels in the legs are narrowed or blocked by fatty deposits, causing a decrease of blood flow to the feet and legs. PAD is a condition where many of the arteries that lead to areas outside the brain and heart become blocked. The neck, arms, belly, legs, and feet can have fatty deposits that build up in the inner linings of the artery walls, making them narrower and hindering blood flow. This condition can lead to pain, slow-healing wounds, gangrene, and even foot or leg amputation in severe cases.
If you have diabetes, you’re much more likely to have PAD and also you have an increased risk for heart attack and stroke. An estimated one out of every three diabetics over the age of 50 has PAD. However, many of those with warning signs do not realize that they have PAD, so they do not get treatment. But you can cut your chances of having those problems by taking special care of your blood vessels and talking to your doctor as soon as possible.
Many people with diabetes and PAD do not have any symptoms. Some may experience mild leg pain or trouble walking and believe that it is just a sign of getting older. But this pain and other warning signs you should pay attention to, especially as a diabetic, include the following symptoms:
- Leg pain, particularly when walking or exercising, that disappears after a few minutes of rest
- Numbness, tingling, or coldness in the lower legs or feet
- Leg or feet sores or infections that heal slowly
Diabetics also are at higher risk of developing atherosclerosis, the most common cause of peripheral artery disease (PAD). And since individuals with PAD have a much higher risk of heart attack or stroke, other risk factors such as obesity, physical inactivity, smoking, and high blood pressure, there is an even greater chance of diabetics developing the condition.
There are several ways to tests used to diagnose PAD. The ankle-brachial index (ABI) is one test used to diagnose PAD. This test compares the blood pressure in your ankle to the blood pressure in your arm. If the blood pressure in the lower part of your leg is lower than the blood pressure in your arm, you may have PAD. An expert panel brought together by the American Diabetes Association recommends that people with diabetes over the age of 50 have an ABI to test for PAD.
Diabetics younger than 50 may benefit from testing if they have other PAD risk factors.
Once diagnosed with PAD, there are many steps you can take to manage the cardiovascular risk factors that exist for those with PAD. Some of the steps include:
- Quitting smoking (Ask your doctor for help!)
- Lowering your blood pressure to less than 140/80mmHg
- Getting your LDL cholesterol below 100 mg/dl
- Talking to your doctor about taking aspirin or other antiplatelet medications
- Aiming for an A1C below 7% (The A1C test measures your average blood glucose (sugar) over the past two to three months.)
- Increasing physical activity (Your doctor may recommend a program of supervised exercise training for you, also known as cardiac rehabilitation. You may have to begin slowly, but simple walking regimens, leg exercises, and treadmill exercise programs can ease symptoms. Exercise for poor circulation in leg arteries due to buildup of plaque takes into account the fact that walking causes pain. The program consists of alternating activity and rest in intervals so that you can build up the amount of time you can walk before having pain.)
In some cases, surgical procedures are used to treat PAD. Angioplasty, also called balloon angioplasty, is a procedure in which a small tube with a balloon attached is inserted and threaded into an artery; then the balloon is inflated, opening the narrowed artery. A wire tube, called a stent, may be left in place to help keep the artery open. An artery bypass graft is a procedure in which a blood vessel is taken from another part of the body and is attached to bypass a blocked artery.
Minimizing the PAD risk factors and keeping blood glucose levels as normal as possible can help to minimize the likelihood of developing PAD and to slow its progression. Steps taking to reduce the risk of PAD also will help reduce the chances of attack or stroke – and will help to avoid surgery and even help to enhance your quality of life!
If you have any question please talk to your doctor or give us a call. We can Help.