Diabetes mellitus and peripheral artery disease

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Vascular Surgery

Background:

• Atherosclerotic peripheral artery disease (PAD) shares pathological roots with other cardiovascular diseases.
• Diabetes mellitus is a major risk factor for PAD, increasing the likelihood of developing chronic limb-threatening ischemia (CLTI).
• CLTI, characterized by rest pain, nonhealing ulcers, and gangrene due to chronic ischemia, significantly impacts patients with diabetes.

Purpose of the Study:

• To provide an overview of the intricate relationship between atherosclerotic PAD, specifically CLTI, and diabetes mellitus.
• To present the clinical impact, features, prognosis, and management of CLTI in diabetic patients.
• To highlight the distinct clinical profile of CLTI in individuals with coexisting diabetes and CLTI compared to the general diabetic population.

Main Methods:

• Review of existing literature and clinical data on atherosclerotic peripheral artery disease (PAD) and diabetes mellitus.
• Analysis of the clinical impact, features, prognosis, comorbidity, occurrence, and seasonality of chronic limb-threatening ischemia (CLTI) in diabetic patients.
• Discussion of current clinical management strategies for CLTI, including pre-revascularization measures.

Main Results:

• Diabetes mellitus significantly elevates the risk of PAD and subsequent CLTI.
• CLTI presents unique clinical features, prognosis, and comorbidities in diabetic individuals compared to non-diabetic patients.
• The interplay between diabetes and CLTI is bidirectional, with notable clinical implications for both conditions.

Conclusions:

• There is a substantial need for improved treatment and management strategies for CLTI, particularly in the context of diabetes.
• Proactive clinical measures, including risk assessment, timely diagnosis, and expedited referral to vascular specialists, are vital for enhancing CLTI outcomes.
• Further research is essential to generate more evidence and refine the clinical approach to CLTI in diabetic patients.