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Diabetic vascular disease: characteristics of vascular disease unique to the diabetic patient

Gary W Gibbons1, Palma M Shaw

  • 1South Shore Hospital Center for Wound Care and Hyperbaric Medicine, South Weymouth, MA 02189, USA. gary_gibbons_MD@sshosp.org

Seminars in Vascular Surgery
|July 24, 2012
PubMed

Insights

Diabetes significantly impacts vascular health, increasing lower extremity complications due to arterial disease, neuropathy, and infection. Aggressive treatment of macrovascular disease is crucial for managing diabetic wounds and improving patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Diabetology
  • Vascular Surgery

Background:

  • Diabetes mellitus is a systemic condition with profound cardiovascular implications.
  • Diabetic vascular disease contributes significantly to lower extremity complications, alongside neuropathy and infection.
  • Peripheral arterial disease in diabetics often affects infrapopliteal arteries.

Purpose of the Study:

  • To highlight the multifactorial nature of diabetic lower extremity complications.
  • To emphasize the role of macrovascular disease in diabetic foot pathology.
  • To advocate for aggressive revascularization strategies in diabetic patients.

Main Methods:

  • Review of existing literature on diabetic vascular complications.
  • Analysis of the interplay between macrovascular and microvascular dysfunction.
  • Discussion of treatment paradigms for diabetic peripheral arterial disease.

Main Results:

  • Diabetic vascular disease predominantly affects small, below-knee arteries.
  • Microvascular dysfunction in the diabetic foot is non-occlusive.
  • Macrovascular atherosclerotic occlusive disease is a key factor in diabetic wounds.

Conclusions:

  • An aggressive approach to treating macrovascular disease is essential for diabetic wound healing.
  • Individualized, patient-centered treatment plans are necessary.
  • Comprehensive revascularization strategies, both endovascular and open, optimize outcomes and healthcare affordability.

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