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Peripheral arterial disease in diabetes--a review
E B Jude1, I Eleftheriadou, N Tentolouris
1Tameside General Hospital, Ashton-Under-Lyne, Lancashire, UK. edward.jude@tgh.nhs.uk
Diabetic Medicine : a Journal of the British Diabetic Association
|February 4, 2010
Summary
Diabetic patients face high risks for peripheral arterial disease (PAD). Early diagnosis using ankle-brachial pressure index (ABI) and managing risk factors like smoking and high blood sugar are crucial for better outcomes.
Area of Science:
- Vascular Medicine
- Diabetology
- Cardiovascular Disease
Background:
- Diabetic patients have a high risk of peripheral arterial disease (PAD), presenting with intermittent claudication or critical limb ischemia.
- Clinical diagnosis of PAD in diabetics can be inconsistent, necessitating reliable diagnostic tools.
Purpose of the Study:
- To highlight the diagnostic utility of the ankle-brachial pressure index (ABI) in diabetic patients with PAD.
- To discuss current and emerging treatment strategies for PAD in the diabetic population.
- To emphasize the importance of risk factor modification and awareness in managing PAD outcomes.
Main Methods:
- Review of diagnostic methods for PAD in diabetic patients, focusing on the ankle-brachial pressure index (ABI).
- Analysis of established and novel risk factors contributing to PAD progression in diabetes.
- Evaluation of treatment modalities including lifestyle modifications, risk factor management, and therapeutic angiogenesis.
Main Results:
- Ankle-brachial pressure index (ABI) < 0.9 is diagnostic of PAD, even in asymptomatic diabetics, and predicts cardiovascular morbidity and mortality.
- Lifestyle modifications and management of hyperglycemia, dyslipidemia, smoking, and hypertension slow PAD progression.
- Outcomes of revascularization procedures are poorer in diabetic patients, with higher amputation rates.
Conclusions:
- The ankle-brachial pressure index (ABI) is a key diagnostic tool for peripheral arterial disease (PAD) in diabetic individuals.
- Intensive management of cardiovascular risk factors is essential to reduce morbidity and mortality in diabetic patients with PAD.
- While therapeutic angiogenesis shows promise, comprehensive risk factor control remains paramount for improving PAD outcomes in this high-risk group.
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