Peripheral Arterial Disease and Diabetes Mellitus BT - The Diabetes Textbook: Clinical Principles, Patient Management and Public Health Issues

Abstract

Peripheral arterial disease (PAD) is the partial or total occlusion of peripheral arteries and is usually due to atherosclerotic disease. It can be diagnosed in a variety of ways; however it is objectively most commonly defined as an ankle-brachial index < 0.9. It results in a spectrum of manifestations ranging from asymptomatic disease, intermittent claudication, rest pain, tissue loss, to gangrene. Furthermore the presence of PAD is a coronary artery disease equivalent and puts patients at risk for cardiovascular and cerebrovascular complications and mortality. While PAD and diabetes share many risk factors, they also share the same endpoints; in fact the severity and progression of PAD are accelerated when associated with diabetes. Patients with diabetes are among those most vulnerable to developing PAD, and they suffer the most complications and worst outcomes, making early detection and risk factor modification paramount in their treatment.