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Peripheral Vascular Disease
A condition in which the arteries in the legs, and sometimes the arms, are narrowed by fatty plaque buildup (atherosclerosis). Peripheral vascular disease is 20 times more common in people with diabetes than in the general population. Along with diabetes, other risk factors for peripheral vascular disease are smoking, inactivity, and high blood lipid levels (cholesterol and triglycerides). In people with diabetes, chronic high blood glucose raises the risk of developing peripheral vascular disease.
The most common symptom of peripheral vascular disease is intermittent claudication, which is cramping leg pain brought on by walking (and usually relieved by rest) as a result of an inadequate blood supply. As the arterial blockage progresses, the pain may occur after walking less than one city block and may interfere with daily life, necessitating treatment. Another sign of peripheral vascular disease is that minor cuts or abrasions on the feet don’t heal.
Peripheral vascular disease can eventually become a very serious problem. People with poor circulation in their legs tend to develop foot ulcers that don’t heal, gangrene, and the need for amputation. If you experience intermittent claudication or very slow healing of wounds on your feet, be sure to consult your health-care team.
Severe, limb-threatening peripheral vascular disease is sometimes treated with surgery or endovascular techniques. Bypass surgery involves grafting a blood vessel from another part of the body to bypass the blockage in the affected vessel to restore blood flow. Endovascular (meaning “inside the blood vessel”) techniques include percutaneous transluminal angioplasty (also called balloon angioplasty), atherectomy (cutting away plaque deposits), and use of lasers to clear out blood vessels. In people with diabetes and peripheral vascular disease, endovascular procedures have only limited success and a high complication rate, so bypass surgery is often the best option.
In addition to tight blood glucose control, there are steps people can take to help prevent peripheral vascular disease. They include following a healthy diet that is low in cholesterol and saturated fat, stopping smoking, taking a blood-thinning drug such as aspirin (but only under the supervision of a doctor), and taking a walk every day to promote better circulation in the legs and feet.
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