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Is Peripheral Vascular Disease Related To Diabetes?

Peripheral Arterial Disease (pad)

Peripheral Arterial Disease (pad)

Peripheral arterial disease, also called PAD, occurs when blood vessels in the legs are narrowed or blocked by fatty deposits and blood flow to your feet and legs decreases. If you have PAD, you have an increased risk for heart attack and stroke. An estimated 1 out of every 3 people with diabetes over the age of 50 have this condition. However, many of those with warning signs don't realize that they have PAD and therefore don't get treatment. If you have diabetes, you're much more likely to have PAD, a heart attack, or a stroke. But you can cut your chances of having those problems by taking special care of your blood vessels. How Do I Know Whether I'm at High Risk for PAD? Just having diabetes puts you at risk, but your risk is even greater under the following conditions: History of heart disease, or you've have had a heart attack or a stroke Family history of heart disease, heart attacks, or strokes You can't change your age or your family history, but taking care of your diabetes and the conditions that come with it can lower your chances of having 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, which disappears after a few minutes of rest Numbness, tingling, or coldness in the lower legs or feet Sores or infections on your feet or legs that heal slowly 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. An expert panel brought together by the Continue reading >>

Peripheral Arterial Disease (pad)

Peripheral Arterial Disease (pad)

Peripheral arterial disease (PAD) happens when buildup on the walls of blood vessels causes them to narrow. It commonly affects people with type 2 diabetes, who are also prone to high cholesterol and heart disease. According to the American Diabetes Association, about 1 in 3 people with diabetes over the age of 50 have PAD. Doctors most often diagnose PAD when it’s causing leg or foot problems. Since buildup and narrowing of the arteries occur in all arteries in the body, people with PAD are at high risk of heart attack and stroke. If you suspect you have PAD, it’s important to talk to your doctor. They can help you take steps to treat your symptoms and protect your heart and blood vessels. PAD affects millions of Americans, reports the National Heart, Lung, and Blood Institute. However, people often don’t notice it. Many doctors and patients overlook subtle signs of the condition. Possible signs of PAD include: a pain in your calves when you’re walking or exercising that goes away with rest, which is called “claudication” numbness, tingling, or a feeling of pins and needles in your lower legs or feet cuts or sores on your legs or feet that don’t heal or heal slowly Sometimes, the symptoms of PAD are so subtle that you may not suspect you have a problem. In some cases, you may dismiss mild leg pain from PAD as a sign of aging and nothing more. That’s why it’s so important to pay attention to your body and take potential symptoms of PAD seriously. Early treatment is essential to protecting your vascular system. If you have PAD, plaque builds up on your blood vessel walls and restricts the flow of blood and oxygen to your legs and feet. Depending on its severity, this can cause pain in your lower legs when you’re walking. It can also cause numbness, ti Continue reading >>

Peripheral Arterial Disease Among Adult Diabetic Patients Attending A Large Outpatient Diabetic Clinic At A National Referral Hospital In Uganda: A Descriptive Cross Sectional Study

Peripheral Arterial Disease Among Adult Diabetic Patients Attending A Large Outpatient Diabetic Clinic At A National Referral Hospital In Uganda: A Descriptive Cross Sectional Study

Peripheral Arterial Disease among Adult Diabetic Patients Attending a Large Outpatient Diabetic Clinic at a National Referral Hospital in Uganda: A Descriptive Cross Sectional Study Affiliations: Department of Medicine and Diabetes/endocrine clinic, St. Raphael of St. Francis hospital Nsambya, Kampala, Uganda, Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Nkozi, Uganda Affiliation: Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda Peripheral arterial disease (PAD) is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c) levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI) to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 510 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. The mean age/standard deviation of the study participants was 53.9/12.4 years with a male Continue reading >>

Diabetes And Peripheral Artery Disease: Know The Connection

Diabetes And Peripheral Artery Disease: Know The Connection

Tweet If you are one of the nearly 16 million Americans who have diabetes, you already know that it comes with its fair share of complications. Diabetics have an increased risk of a large number of health complications including heart disease, stroke, eye problems, kidney disease, and even some conditions that you may have never heard of before such as peripheral artery disease. What is Peripheral Artery Disease (PAD)? Peripheral artery disease (PAD) is a condition marked by narrowed arteries in the legs most often caused by the gradual build-up of plaque. As the path of blood flow becomes more restricted, the risk of complications such as heart attack, stroke, and even loss of limbs increases. Why are Diabetics at an Increased Risk for Peripheral Artery Disease? There often no symptoms associated with PAD which makes it all the more important that patients be aware if they are considered high risk. In the case of those with diabetes, monitoring and controlling their disease is of particular importance. When blood sugar is not well-controlled, the walls of the arteries can become damaged and plaque may build up more easily. This leads to some staggering numbers concerning complications and mortality: An estimated 50% of those with diabetes die from cardiovascular events More than 71% of diabetics also suffer from hypertension Diabetics account for more than 60% of non-traumatic amputations of lower limbs Preventing Limb Amputation in Diabetic Patients Protecting the vascular health in those with diabetes is crucial to preventing the development of PAD and potential limb amputation. This can be accomplished most effectively through careful monitoring and control of diabetes through regular doctor appointments, healthy lifestyle, and in some cases, medication or insulin. Continue reading >>

Diabetes And Peripheral Vascular Disease.

Diabetes And Peripheral Vascular Disease.

Abstract The risk of peripheral vascular disease (PVD) is increased in diabetic patients, occurs earlier and is often more severe and diffuse. Endothelial dysfunction, vascular smooth muscle cell dysfunction, inflammation and hypercoagubility are the key factors in diabetic arteriopathy. The presence of PVD, apart from its increased risk of claudication, ischemic ulcers, gangrene and possible amputation, is also a marker for generalized atherosclerosis and a strong predictor for cardiovascular ischemic events. However, despite the recognition that PVD is associated with increased ischemic event rates and death, particularly in diabetic patients, this specific manifestation of systemic atherosclerosis is largely underdiagnosed and undertreated. In type-1 diabetes, early intensive insulin treatment reduces both microvascular (nephropathy, retinopathy and neuropathy) and macrovascular complications of diabetes (DCCT/EDIC study). In type-2 diabetes, UKPDS showed that tight glucose control reduces micro- and macrovascular complications, when therapy is started early after diagnosis and that early intervention has long lasting protective effects. However recently published trials (ADVANCE, ACCORD and VADT) pointed out that lowering glycemic targets to nearly normal glycaemia does not further reduce cardiovascular events in individuals with longstanding type 2 diabetes and that hypoglycaemia is to be avoided in individuals with ischemic heart disease. Finally, the small but important Steno-2 trial demonstrated that to significantly reduce peripheral vascular disease, ischemic events and mortality in type-2 diabetes, intensified multifactorial treatment of all modifiable risk factors is needed. Therefore, to prevent micro- and macrovascular complications, like PVD, in type-1 an Continue reading >>

Peripheral Vascular Disease And Type 2 Diabetes: What's The Connection?

Peripheral Vascular Disease And Type 2 Diabetes: What's The Connection?

When blood glucose (sugar) levels are too high for too long, or swing back and forth between highs and lows, people with diabetes put themselves at risk for serious complications and damage to their bodies. Peripheral vascular disease (PVD) is one of the medical complications that can strike when type 2 diabetes is not well managed. Peripheral vascular disease includes several conditions that affect the blood vessels. PVD occurs when peripheral blood vessels, those located away from the heart, become blocked or damaged in some way. Peripheral artery disease, or PAD, is one type of PVD; it affects arteries in the arms and legs. PVD Symptoms The main symptoms of peripheral vascular disease include: Pain in the buttocks or extremities, including the thighs or calves A blue tint to the toes Numbness in the legs or feet A heavy feeling in the limbs Cold feet Leg cramps, which often increase with more activity Skin redness Frequent infections Foot pain Wounds on the feet and toes that won't heal PVD Causes PVD occurs when plaque, which is composed of cholesterol and other fatty substances found in the blood, builds up and creates a blockage in the blood vessels, keeping blood from flowing properly. Peripheral vascular disease can be caused or worsened by: Smoking Having high blood pressure Having persistent high blood glucose levels African-Americans are at a significantly increased risk of developing PVD; people age 50 and older and people with diabetes are also at an increased risk for the condition. PVD Prevention and Treatment People with diabetes can do much to protect themselves against PVD and keep their blood vessels clear. Start by achieving good control over your diabetes with these steps: Take all diabetes medications as prescribed by your doctor. Keep blood pressu Continue reading >>

Association Between Peripheral Arterial Disease And Diabetic Foot Ulcers In Patients With Diabetes Mellitus Type 2 - Sciencedirect

Association Between Peripheral Arterial Disease And Diabetic Foot Ulcers In Patients With Diabetes Mellitus Type 2 - Sciencedirect

Volume 19, Issue 76 , JulySeptember 2017, Pages 123-126 Association between peripheral arterial disease and diabetic foot ulcers in patients with diabetes mellitus type 2 Author links open overlay panel M..Tresierra-Ayala Open Access funded by Universidad Autnoma de Nuevo Len Diabetic foot ulcer (DFU) is a chronic complication of diabetes mellitus. It is reported that diabetes is associated with a two to four-fold increase in the incidence of peripheral arterial disease (PAD) compared to non-diabetic subjects. Peripheral arterial disease (PAD) may play a role in the etiology of foot ulceration in patients with diabetes mellitus. To determine the association between peripheral arterial disease and diabetic foot ulcers in patients with type II diabetes mellitus. A cross-sectional study was carried out at Hospital Belen of Trujillo, which all patients with type 2 diabetes mellitus 50 years were included. Presence or absence of both variables was measured in our study. Three hundred twenty-two patients were included in the study. We found that 129 patients had peripheral arterial disease and diabetic foot ulcers (OR 3, 95% IC 1.0878.242 and p<0.001). In this study, peripheral arterial disease was associated with diabetic foot ulcer in patients with type 2 diabetes mellitus. Continue reading >>

Peripheral Artery Disease And Diabetes

Peripheral Artery Disease And Diabetes

People with diabetes are at higher risk of developing atherosclerosis, the most common cause of peripheral artery disease (PAD) . And individuals with PAD have a much higher risk ofheart attack or stroke. PAD is a condition similar to coronary artery disease (blockage in arteries that supply blood to the heart muscle) and carotid artery disease (blockage in arteries leading to the brain). However, with PAD, it's the arteries leading to areas outside the brain and heart that become blocked, including the neck, arms and belly, butmost often in the legs and feet. Fatty deposits build up in the inner linings of the artery walls of the legs, making them narrower,hindering blood flow and can even stop blood flow to the legs and feet completely. This condition can lead to pain, especially when walking, as well as a number of other symptoms like foot wounds that are slow to heal, one foot being much colder than the other, or gangrene. In severe cases, foot or leg amputation may be needed. Why does diabetes increase the risk for developing PAD? Individuals with diabetes are already at an increase risk for PAD. Add to that another of therisk factors listed here, and there's an even greater chance of developing the condition. Previous history of coronary artery disease ( heart attack , angina , angioplasty or bypass surgery ) or stroke A number of the risk factors mentioned here can be controlled to minimize the likelihood of developing PAD and to slow its progression. For people with diabetes, it's especially important to keep blood glucose levels as normal as possible. Also, regular physical activity is important, and special footwear and medications may be needed. Learn more about how to prevent and treat PAD . Taking steps to reduce the risk of PAD also helps reduce the chanc Continue reading >>

Diabetes And Peripheral Arterial Disease (pad)

Diabetes And Peripheral Arterial Disease (pad)

Diabetes is a condition in which your body has trouble using a sugar called glucose, for energy. As a result, the sugar level in your blood becomes too high. Diabetes is a chronic (lifelong) condition. It puts you at high risk for peripheral arterial disease (PAD). This is a disease of arteries in the legs. If you have PAD, arteries in other parts of your body are likely diseased, too. That puts you at high risk for other serious health problems. Read on to learn how diabetes can lead to PAD and affect your health. How diabetes can lead to PAD Diabetes can hurt your arteries. If diabetes is not controlled well, blood sugar levels will be high. High blood sugar can make the artery walls rough. A waxy substance in the blood called plaque can then build up on the artery walls. This plaque contains cholesterol. This makes it harder for blood to flow through your arteries. This limits blood flow to your arms and legs, which causes damage in the tissues. The feet are most at risk of tissue damage. If tissue damage is very bad, then toes, feet, or even legs may need to be removed (amputated). But blood sugar and cholesterol levels can be controlled. This is done with nutrition and exercise. Weight loss and medication may also help. And proper foot care is very important for people with PAD. If diabetes is not controlled Uncontrolled diabetes can cause many complications, including: Heart disease Stroke Kidney damage or kidney failure (nephropathy) Liver disease Digestion problems Nerve damage (neuropathy) Eye damage (retinopathy) Sexual dysfunction Periodontal (gum) disease Needing a toe, foot, or leg amputated (if you also have PAD) If diabetes is controlled Controlling diabetes can reduce your risk for serious health problems, including: Heart disease and stroke Kidney disea Continue reading >>

Peripheral Artery Disease In Patients With Diabetes: Epidemiology, Mechanisms, And Outcomes

Peripheral Artery Disease In Patients With Diabetes: Epidemiology, Mechanisms, And Outcomes

Go to: Peripheral artery disease (PAD) is the atherosclerosis of lower extremity arteries and is also associated with atherothrombosis of other vascular beds, including the cardiovascular and cerebrovascular systems. The presence of diabetes mellitus greatly increases the risk of PAD, as well as accelerates its course, making these patients more susceptible to ischemic events and impaired functional status compared to patients without diabetes. To minimize these cardiovascular risks it is critical to understand the pathophysiology of atherosclerosis in diabetic patients. This, in turn, can offer insights into the therapeutic avenues available for these patients. This article provides an overview of the epidemiology of PAD in diabetic patients, followed by an analysis of the mechanisms by which altered metabolism in diabetes promotes atherosclerosis and plaque instability. Outcomes of PAD in diabetic patients are also discussed, with a focus on diabetic ulcers and critical limb ischemia. Keywords: Peripheral artery disease, Epidemiology, Pathophysiology, Outcomes, Diabetes Core tip: Diabetes mellitus (DM) is a major risk factor of peripheral artery disease (PAD), leading to increased morbidity and mortality as well as an accelerated disease course. As such, a more thorough understanding of the multi-factorial mechanisms underlying disease etiology for both DM and PAD is justified. This review provides clinical insight into the current state of research in the pathophysiology of PAD in diabetic patients, as well as highlights the progress of endovascular interventions for PAD, with a focus on techniques that have shown promise for treatment of critical lower limb ischemia. Go to: INTRODUCTION Over 170 million people worldwide have diabetes mellitus (DM) and the worldwide Continue reading >>

Peripheral Artery Disease

Peripheral Artery Disease

Rachael L Morley, academic foundation doctor1 2, Anita Sharma, general practitioner, clinical director in vascular care Oldham CCG, GP member of NICE Quality Standards Advisory Committee3, Alexander D Horsch, consultant interventional and diagnostic radiologist1, Robert J Hinchliffe, professor of vascular surgery1 2 1North Bristol NHS Trust, Bristol, Bristol, UK 2Bristol Centre for Surgical Research, NIHR Bristol BRC, University of Bristol, UK 3South Chadderton Health Centre, Oldham, UK Correspondence to: R J Hinchliffe robert.hinchliffe{at}bristol.ac.uk Most people with peripheral artery disease are asymptomatic Peripheral artery disease is associated with a high risk of vascular complications such as myocardial infarction, stroke, vascular dementia, renovascular disease, and mesenteric disease Few patients with intermittent claudication develop limb-threatening complications (1-3% in 5 years) Management of risk factorsincluding smoking, diabetes, and dyslipidaemiais key to reducing the risk of vascular complications Patients with critical limb ischaemia are at high risk of limb amputation and premature death Peripheral artery disease affects around 13% of the Western population who are more than 50 years old.1 It is most commonly due to atherosclerosis, where an atherosclerotic plaque causes arterial stenosis or occlusion. This results in a reduction in blood flow to the affected limb. Most patients are asymptomatic, but many experience intermittent claudication (pain on walking). Critical limb ischaemia occurs when the reduction in blood flow is so severe that it causes pain on rest or tissue loss (ulceration or gangrene).1 Atherosclerosis is a systemic disease. Some 60% of patients with peripheral artery disease will have ischaemic heart disease, and 30% have cereb Continue reading >>

Diabetes And Vascular Disease

Diabetes And Vascular Disease

Diabetics have a high incidence of stroke. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. There are several types of diabetes: Type 1 diabetes (previously called “juvenile diabetes”) is an autoimmune disorder, in which the insulin producing beta cells are destroyed by the body’s immune system. As a result, the body cannot produce insulin, the hormone that allows glucose to enter and fuel the cells. To survive, individuals with type 1 diabetes must take insulin every day. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Type 2 diabetes (previously called “adult onset diabetes”) is the most common type of diabetes, accounting for 90-95% of all diabetes. In type 2 diabetes, the body does not produce enough insulin and/or the body’s cells become resistant to insulin. Gestational diabetes occurs in some women who have high blood glucose levels during pregnancy but have never had diabetes. It affects about 4% of all pregnant women, with about 135,000 cases in the United States each year. Women who have gestational diabetes have a 20-50% chance of developing type 2 diabetes in the next five to ten years. Prediabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 41 million Americans who have prediabetes, in addition to the 20.8 million with diabetes. If you do not manage your diabetes or maintain healthy habits, you could develop serious health conditions, including blindness, severe kidney disease, stroke, heart attack, sores in your feet, or gangrene (dead tissue) th Continue reading >>

State-of-the-art Paper Peripheral Arterial Disease In Patients With Diabetes

State-of-the-art Paper Peripheral Arterial Disease In Patients With Diabetes

Atherosclerosis is a progressive process affecting multiple vascular beds; its clinical consequences, which include coronary artery disease (CAD), cerebrovascular disease, and peripheral arterial disease (PAD), are potentially life-threatening (1). Atherosclerotic disease in one vascular bed indicates possible disease in others (2). The risk of atherosclerotic disease is markedly increased among individuals with diabetes. The increased risk is independent of, and additive to, other cardiovascular risk factors. Atherosclerosis causes most of the death and disability in patients with diabetes, particularly in the type 2 diabetic patient population (3). The Verona Diabetes Study showed that cardiovascular disease is responsible for 44% of all-cause fatalities in the diabetic patient population (4). The duration of diabetes increases the risk of death from cardiovascular disease, independent of co-existing risk factors (5). Insulin resistance is a key factor in the pathogenesis of diabetes. Insulin resistance and its attendant metabolic abnormalities may cause much of the increased cardiovascular risk of diabetes (6). Epidemiological studies have confirmed an association between diabetes and an increased prevalence of PAD (7,8). Peripheral arterial disease is usually characterized by occlusive arterial disease of the lower extremities. Although many patients are asymptomatic, or have atypical exertional symptoms, approximately one-third experience intermittent claudication, described as aching, cramping, or numbness in the affected limb, occurring with exercise and relieved at rest (9). Peripheral arterial disease in patients with diabetes adversely affects quality of life (10) and is associated with substantial functional impairment (11). The reduced walking speed and dist Continue reading >>

Peripheral Vascular Disease

Peripheral Vascular Disease

Peripheral Vascular Disease Overview Peripheral vascular disease, also called PVD, refers to any disease or disorder of the circulatory system outside of the brain and heart. The term can include any disorder that affects any blood vessels. It is, though, often used as a synonym for peripheral artery disease. PVD is the most common disease of the arteries. The build-up of fatty material inside the vessels, a condition called atherosclerosis or hardening of the arteries, is what causes it. The build up is a gradual process. Over time, the artery becomes blocked, narrowed, or weakened. When a blockage occurs in the arteries of the heart, it's called coronary heart disease or coronary artery disease. Most often, atherosclerosis is thought of in terms of its effect on arteries of the heart and of the brain. But atherosclerosis can affect any other blood vessel throughout the body. Blood vessels in the legs are the ones most often affected. Other arteries frequently affected include those that supply blood to the kidneys and those in the arms. When an artery is blocked or narrowed, the part of the body it supplies doesn't get enough oxygen. The condition is called ischemia. Ischemia can cause a variety of symptoms, depending on the organ or system that's affected. Symptoms range from pain, cold feet, and bluish discoloration to stroke or gangrene. If the condition is not reversed, the affected body part is injured and eventually starts to die. It's important to find narrowed arteries before damage occurs. Who Gets PVD About 8.5 million people in the United States have PVD. It occurs mostly in people over age 60, affecting about 12% to 20% of people in that age group. It's also common among people with diabetes. Men are slightly more likely than women to have PVD. The disease Continue reading >>

Peripheral Arterial Disease In People With Diabetes

Peripheral Arterial Disease In People With Diabetes

ABI, ankle-brachial index CABG, coronary artery bypass graft CAPRIE, Clopidogrel versus Aspirin in Patients At Risk of Ischemic Events CLI, critical limb ischemia CRP, C-reactive protein eNOS, endothelial cell nitric oxide synthase FDA, Food and Drug Administration FFA, free fatty acid MI, myocardial infarction MRA, magnetic resonance angiogram NF-κB, nuclear factor-κB PAD, peripheral arterial disease PAI-1, plasminogen activator inhibitor-1 PI, phosphatidylinositol PKC, protein kinase C PVR, pulse volume recording RAGE, receptor for advanced glycation end products UKPDS, U.K. Prospective Diabetes Study VSMC, vascular smooth muscle cell Peripheral arterial disease (PAD) is a condition characterized by atherosclerotic occlusive disease of the lower extremities. While PAD is a major risk factor for lower-extremity amputation, it is also accompanied by a high likelihood for symptomatic cardiovascular and cerebrovascular disease. Although much is known regarding PAD in the general population, the assessment and management of PAD in those with diabetes is less clear and poses some special issues. At present, there are no established guidelines regarding the care of patients with both diabetes and PAD. On the 7–8 of May 2003, a Consensus Development Conference was held to review the current knowledge regarding PAD in diabetes. After a series of lectures by experts in the field of endocrinology, cardiology, vascular surgery, orthopedic surgery, podiatry, and nursing, a vascular medicine panel was asked to answer the following questions: 1) What is the epidemiology and impact of PAD in people with diabetes? 2) Is the biology of PAD different in people with diabetes? 3) How is PAD in diabetes best diagnosed and evaluated? 4) What are the appropriate treatments for PAD in peo Continue reading >>

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