Peripheral arterial disease (PAD) refers to diseases of blood vessels outside the heart and brain. It is a form of atherosclerosis, in which fatty substances build up inside the arterial walls and can, over time, create an obstruction that restricts proper blood flow. This may affect the legs, arms, stomach or kidneys’ arteries. PAD affects approximately 12 million people in the U.S.
People with diabetes are at greater risk for severe PAD. Those with diabetes and PAD are at higher risk of heart attack, stroke and are five times more likely to have an amputation. The doctors at Marion Heart Associates took some time to answer questions about PAD.
What is the link between diabetes and PAD? People with diabetes are at a higher risk for having PAD. Some studies have found that one out of three people with diabetes over age 50 has PAD. Those with both diseases are much more likely to have a heart attack or stroke than those who just have PAD.1
Why it is important to diagnose and treat PAD in diabetic patients? Many people with diabetes do not have feeling in their feet due to nerve disease. They may have severe PAD but cannot feel any symptoms. As a result, it takes a long time for a diagnosis.
How do I know whether I’m at high risk for PAD? Just having diabetes increases the risk for PAD, but the risk is even greater if the person is or has any of the following conditions, as well as diabetes: a smoker, high blood pressure, over age 50, abnormal blood cholesterol levels, overweight, history of heart disease, family history of heart disease, heart attacks or strokes
What are the symptoms of PAD? Many people with diabetes and PAD do not have any symptoms. Some people may experience mild leg pain or trouble walking and believe that it’s just a sign of getting older. Others may have the following symptoms:
Leg pain, particularly when walking or exercising
Numbness, tingling or coldness in the lower legs or feet Sores or infections on feet or legs that heal slowly
How is PAD diagnosed?
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 pressure in your arm, you may have PAD. Other tests such as an ultrasound, a CT (computed tomography) scan and an angiogram can also be used to diagnosis PAD.
How is PAD treated?
People with PAD are at a very high risk for heart attack and stroke, so it is very important to manage cardiovascular risk factors. Here are some steps you can take:
Aim for an A1C (blood glucose test) below 7 percent.
Lower your blood pressure to less than 130/80 mmHg.
Get your LDL cholesterol below 100 mg/dl.
Take aspirin or other antiplatelet medicines, which have been shown to reduce heart attacks and strokes in people with PAD.
Studies have found that exercise, such as walking, can be used both to treat PAD and to prevent it.
Angioplasty or stenting or surgery can be done to keep the artery open.
Clinicians at the Heart & Vascular Institute and Marion Heart Associates have expertise and a multidisciplinary approach in medical and endovascular interventions to diagnose, treat and prevent complications of peripheral arterial disease (PAD) in diabetic patients. Our clinicians also follow patients throughout their lives to ensure ongoing support and further treatment, if needed.
Marion Heart Associates, P.A.
1805 SE Lake Weir Avenue, Ocala