diabetestalk.net

Why Are Diabetics At Increased Risk For Pad

Prevalence And Correlates Of Peripheral Arterial Disease In Nigerians With Type 2 Diabetes

Prevalence And Correlates Of Peripheral Arterial Disease In Nigerians With Type 2 Diabetes

Copyright © 2016 D. O. Soyoye et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background. Peripheral arterial disease (PAD) is a major risk factor for nonhealing foot ulcers in people with diabetes. A number of traditional risk factors have been reported to be associated with PAD; however, there may be a need to consider nontraditional risk factors especially in some vulnerable populations. This study determined the prevalence and risk factors associated with PAD in diabetics. Methods. One hundred and fifty type 2 diabetics and an equal number of age- and sex-matched apparently healthy controls were studied. Assessment of PAD was made using history, palpation of lower limb vessels, and measurement of ankle-brachial index (ABI). Statistically significant differences between categorical and continuous variables were determined using Chi square (χ2) and Student t-tests, respectively. Regression analysis was done to determine the associated risk factors for PAD. Results. Prevalence of PAD using ABI was 22.0% and 8.0% among diabetic and nondiabetic populations, respectively. Peripheral arterial disease was associated with age, male gender, waist circumference, and high-sensitivity C-reactive protein. Conclusion. This study highlights the high prevalence of PAD in people with type 2 diabetes mellitus and in apparently healthy controls; age, male gender, abdominal obesity, and high hs-CRP values were the associated risk factors. 1. Introduction Peripheral arterial disease (PAD) reflects systemic atherosclerosis and is associated with long-term disability and increased cardiovascular complication Continue reading >>

4 Why Do You Think Diabetics Are Also At Increased

4 Why Do You Think Diabetics Are Also At Increased

I would assume it’s because in general, diabetics (specifically type 2) are likely to be obese, 5. Explain why untreated PAD can lead to the loss of a leg. Make sure to mention the specific Loss of blood flow, or oxygen, to an extremity may lead to this extremity dying and literally decaying; if the body part is dead, why keep it? For instance, if the femoral arteries were blocked, or severely 6. Explain how the endocrine system and the kidneys help play a role in regulating blood pressure. 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 In Patients With Type 2 Diabetes Mellitus In South India: The Urban Vs Rural Divide

Peripheral Arterial Disease In Patients With Type 2 Diabetes Mellitus In South India: The Urban Vs Rural Divide

Background and Aims: Peripheral arterial disease (PAD) is a marker for macrovascular disease and a risk factor for lower limb amputations, in patients with diabetes. The extent and impact of PAD in the rural population in India has not been well studied. The aim of this study was to screen for asymptomatic PAD using ankle brachial index (ABI) in order to characterize and compare risk factors associated with it and to look for the presence of ischemic heart disease (IHD) in rural and urban populations. Materials and Methods: This was an observational, cross-sectional study involving type 2 diabetic patients attending the diabetes clinic in an urban and rural hospital, in South India. Two hundred rural (R) and 400 urban (U) patients were screened for PAD over a period of1 year. An ABI ≤0.9 or >1.3 was considered abnormal. Patients with known PAD and or claudication were excluded as the aim was to look for PAD in asymptomatic patients. Anthropometric measurements and investigations were carried out. Risk factors were analyzed and P values and odds ratio (OR) were calculated. Results: 17.8% of patients had an ABI suggestive of PAD (R 20% vs U 16.8%). 63.6% were male. Known risk factors of PAD were identified and included dyslipidemia (85%; R 92.5% vs U 80.6%; OR 1.61), obesity (84.1%; R 85% vs U 83.6%; OR 0.75), hypertension (59.8%; R 47.5% vs U 67.2%; OR 1.26), and age >50 years (64.5%; R 55% vs U 70%; OR1.24). Except for smoking (22.4%; R 32.5% vs U 16.4%; OR 1.03), none of the other risk factors were different between groups. Mean duration of type 2 diabetes mellitus (T2DM) was 7.95±7.50 (R 4.66±5.22 vs U 9.61±7.93; P<0.001). Electrocardiogram (ECG) changes consistent with IHD were found in 25.3% of patients with PAD (R 20% vs U 28.3%; OR 3.06; confidence interval ( 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 >>

Peripheral Arterial Disease

Peripheral Arterial Disease

Peripheral arterial disease, or PAD, is a condition in which arteries leading to the legs, feet, and sometimes arms become narrowed, blocking blood flow and causing symptoms such as cramping, pain, or tiredness in the legs when walking or climbing stairs. Having diabetes puts a person at increased risk of developing PAD. This video interview with diabetes expert Enrico Cagliero, MD, MPH, addresses common risk factors for and symptoms of PAD, approaches that can be used to reduce the risk of developing PAD, and treatment options that are available for those who are dealing with this painful condition. Cramping, pain, or tiredness in the legs when walking or climbing stairs – these may not sound like symptoms of a serious condition. In fact, many people believe that they are normal signs of aging. But they can be signs of peripheral arterial disease, a severe condition that can lead to gangrene and amputation if left untreated. So if you have these symptoms, be sure to tell your doctor. If you have peripheral arterial disease, or PAD, you are likely all too familiar with the leg pain and cramping that is characteristic of this condition. But according to new research from Japan, exercises that strengthen the hips may reduce calf cramps for people with PAD. In PAD, the arteries that lead to the legs, feet, and sometimes arms, become clogged with fatty deposits, which reduce or block blood flow to the affected areas. Causing symptoms such as cramping, pain, or tiredness in the legs when walking or climbing stairs, the condition affects between 8 million and 12 million Americans, with those who have diabetes more likely to develop PAD than the general population. Peripheral arterial disease (PAD) is a condition in which arteries become narrowed, blocking circulation and po Continue reading >>

Understand The Connection Between Diabetes And Peripheral Artery Disease (pad) During American Diabetes Month

Understand The Connection Between Diabetes And Peripheral Artery Disease (pad) During American Diabetes Month

Americans living with diabetes are at an increased risk for developing PAD, which disproportionately affects minority and underserved communities WASHINGTON – The CardioVascular Coalition (CVC), a leading group of community-based cardiovascular and endovascular care providers, physicians, and manufacturers created to advance community-based solutions designed to improve awareness, prevention, and intervention of vascular disease, is highlighting the clinical link between peripheral artery disease (PAD) and diabetes this month during American Diabetes Month. PAD is a life-threatening circulatory condition, which causes narrowing or blockage of the vessels that carry blood from the heart to the legs and affects an estimated 18 million Americans. Diabetics are among the patient groups most likely to receive a PAD diagnosis. According to the American Diabetes Association, an estimated one out of every three people with diabetes over the age of 50 may also have PAD. “Patients living with diabetes are one of the most at-risk patient populations for developing PAD, however many patients are unaware of this correlation. While diabetes is a chronic condition that most Americans understand and recognize, PAD is much different,” said Jeffrey G. Carr, MD, FACC, FSCAI, an Interventional Cardiologist and Endovascular Specialist and the physician lead on the CardioVascular Coalition. “Unfortunately, too many diabetic patients are simply not aware of PAD symptoms, which increases a patients’ risks for lower limb amputation. If diabetic patients are able to identify the signs of PAD, more timely interventions can help to reduce limb loss among this vulnerable population.” If not properly managed, both diabetes and PAD can lead to non-traumatic lower limb amputations, which d Continue reading >>

Diabetic Leg Pain And Peripheral Arterial Disease

Diabetic Leg Pain And Peripheral Arterial Disease

Cramping, pain, or tiredness in the legs when walking or climbing stairs — these may not sound like symptoms of a serious condition. In fact, many people believe that they are normal signs of aging. But they can be signs of peripheral arterial disease, a severe condition that can lead to gangrene and amputation if left untreated. So if you have these symptoms, be sure to tell your doctor. Peripheral arterial disease (PAD) is a condition in which arteries leading to the legs and feet (or in some cases the arms) become clogged with fatty deposits called plaque, resulting in reduced or blocked blood flow to these areas. It affects between 8 million and 12 million Americans, and people with diabetes are more likely to develop PAD than the general population. PAD is also known as peripheral vascular disease (PVD), leg atherosclerosis, or simply poor circulation. PAD and diabetes Anyone can develop PAD, but people with diabetes, especially those with Type 2 diabetes, have a higher risk of developing it because of a series of bodily changes associated with diabetes, including insulin resistance, a higher level of blood fats, and an increase in blood pressure. All of these contribute to arteries becoming clogged with fatty deposits, leading to the hardening and narrowing of these blood vessels. Having diabetes also increases the risk of developing neuropathy, or nerve damage, as a result of high blood glucose. Neuropathy can cause decreased sensation in the feet and legs, which can cause a person not to notice small injuries to the foot, such as blisters or cuts. If a person continues to walk on an injury, it is likely to enlarge and get infected. The combination of PAD and neuropathy is particularly dangerous because when blood flow to the feet is reduced, the body has a har Continue reading >>

Interview With Dr. Michael Conte: Peripheral Artery Disease

Interview With Dr. Michael Conte: Peripheral Artery Disease

Hear a Patient Power interview with Dr. Michael Conte, who talks about the importance of early diagnosis and treatment of peripheral artery disease (PAD). Peripheral artery disease is a progressive narrowing of the blood vessels that affects up to 20 percent of those over age 55. Diabetics in particular are two to four times more likely to develop the condition. Still, it is under diagnosed and under treated, leading to limb amputation, heart attack and stroke. Interview Transcript Introduction Andrew Schorr: Hello and welcome to Patient Power. I'm Andrew Schorr. This is where we tackle significant medical topics with leading experts from UCSF Medical Center. One of the conditions that affects so many millions, maybe 23 million Americans and many millions more around the world, is diabetes. Now people know you want to control your blood sugar, and they may know that you're at higher risk for heart problems and even stroke, but of course another condition that can go with it is diabetic neuropathy, circulation problems, and certainly peripheral artery disease, and we're going to learn more about that with Dr. Michael Conte, who is chief of Vascular and Endovascular Surgery at the UCSF Heart and Vascular Center. Dr. Conte led the largest multi-center clinical trial to date examining the outcomes of leg bypass surgery in patients with severe peripheral artery disease, and we're also going to learn about the whole range of treatments and evaluation that's so important for people with diabetes. Dr. Conte, thank you so much for being with us. Let's talk about diabetes. People may know that they're at risk for problems in their feet, but they may not understand the risks related to peripheral artery disease for diabetics and also how it could even be a signal that they have ev Continue reading >>

Why Does America Think China Has Such Bad Air Quality When They Are At A 30 Percent Increased Risk Of Stroke Just For Being A New Yorker?

Why Does America Think China Has Such Bad Air Quality When They Are At A 30 Percent Increased Risk Of Stroke Just For Being A New Yorker?

Why does America think China has such bad air quality when they are at a 30 percent increased risk of stroke just for being a New Yorker? This question does not sound right, but I looked into it anyway. All I've been able to confirm is that China is currently experiencing a smog crisis: New York City does not have smog. It might not even be possible to have smog in New York as it is a coastal city and is not located in a valley. I don't expect New York City air quality to hold a candle to the Yukon, but comparing it to a region currently experiencing an air quality crisis does not make sense. I'm unaware of any correlation between being a New Yorker and suffering a stroke, but for good measure, here is a list of the highest risk factors for stroke: Environment is not listed as a top factor. Continue reading >>

Are Diabetics More At Risk Of Getting Cancer?

Are Diabetics More At Risk Of Getting Cancer?

Sugar makes cancer grow faster (activates oncogenes) in fruit flies In this study from the Icahn School of Medicine at Mount Sinai in New York City fruit flies were used as an animal model. You may ask, why fruit flies; we are not fruit flies, we are humans! As incredible as it sounds, on a cellular level our cell metabolism and the cell metabolism of fruit flies is identical. But the generation time of fruit flies is much shorter and results can be seen in days and weeks. To achieve the same in human trials would take months and years. Also, researchers could breed a strain of fruit flies that was susceptible to develop tumors. When they were fed sugar, the fruit flies developed insulin resistance within a short time. This model was chosen by the researchers as it is known for some time that in humans insulin resistance from diabetes, obesity, and other metabolic diseases leads to a higher risk of developing breast cancer, liver cancer, colon cancer and pancreatic cancer. The researchers wanted to sort out what the metabolic advantage of the cancer cells was under these conditions. The researchers found that the sugar in the diet activated silent cancer causing genes (called “oncogenes)” in the fruit flies that in turn helped to promote insulin resistance and the development of tumors. Because of the insulin resistance sugar could not enter into the normal body cells, but the tumor was using up all of the sugar allowing the tumor cells to multiply at a rapid rate. The end result was that the sugar from the diet fed the cancer cells directly making them grow faster. Interestingly, when these flies that had developed tumors on a high sugar diet were switched to a high protein/low sugar diet, the tumors stopped growing and were contained. In this fruit fly example the 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 >>

Peripheral Vascular Disease - Symptoms

Peripheral Vascular Disease - Symptoms

A A A Peripheral Vascular Disease (cont.) Peripheral vascular disease (PVD) is a circulation disorder that causes narrowing, blockage, or spasms of blood vessels to parts of the body other than the brain and heart. The most common cause of peripheral vascular disease is atherosclerosis, or hardening of the arteries, a gradual process by which cholesterol plaques (material) builds up and causes inflammation in the inner walls of the arteries. This cholesterol plaque builds up over time and may block, narrow, or weaken the blood vessel walls, which results in restricted or blocked blood flow. Other causes of peripheral vascular disease include: Diabetes: Over the long-term, the high blood sugar level of persons with diabetes can damage blood vessels. This makes the blood vessels more likely to become narrowed or weakened. Plus, people with diabetes frequently also have high blood pressure and high fats in the blood, which accelerates the development of atherosclerosis. Inflammation of the arteries: This condition is called arteritis and can cause narrowing or weakening of the arteries. Several autoimmune conditions can develop vasculitis, and, besides the arteries, other organ systems are also affected. Infection: The inflammation and scarring caused by infection can block, narrow, or weaken blood vessels. Both salmonellosis (infection with Salmonella bacteria) and syphilis have been two infections traditionally known to infect and damage blood vessels. Structural defects: Defects in the structure of a blood vessel can cause narrowing. Most of these cases are acquired at birth, and the cause remains unknown. Takayasu disease is a vascular disease affecting the upper vessels of the body and affects usually Asian females. Injury: Blood vessels can be injured in an accident Continue reading >>

Review Article The Prevalence And Management Strategies For Peripheral Artery Disease Associated With Diabetes Mellitus In The Arab World

Review Article The Prevalence And Management Strategies For Peripheral Artery Disease Associated With Diabetes Mellitus In The Arab World

Introduction Diabetes mellitus (DM) is a major health challenge that explains a significant contribution to morbidity and premature mortality worldwide.1 The projected number of global diabetic patients is estimated to rise from 135 million in 1995 to 300 million in 2025.2 The number of people with undiagnosed T2DM is rapidly increasing, and there is a proportionately increased risk of developing complications in this group, many of whom have unidentified disease.3 In congruence with the global prevalence of DM, the Asia Pacific region is considered to be on the brink of an epidemic of DM.4 Several studies have reported a high prevalence of DM in various countries of the Middle East region such as Bahrain (25.7%),5 the KSA (23.7%),6 the Al Ain region of the United Arab Emirates (17.1%),7 and Jordan (16.9%).8 DM is a growing health problem in the Middle East region including KSA.9 In 1982, Bacchus RA published the first estimated prevalence of 2.5% of DM in KSA.10 This report showed that the prevalence of DM begins to rise at 35 years with a peak at 45–54 years. In 1987, Fatani et al. reported a prevalence of 4.3% in the rural areas,11 followed by a subsequently reported prevalence of 9.7% by El-Hazmi MA et al., in 1996.12 Another survey showed that “the age adjusted prevalence of DM was significantly higher in urban populations (males 12%, 95% CI = 11–13 and females 14%, 95% CI = 13–15) than in rural populations (males 7%, 95% CI = 7–8 and females 7.7%, 95% CI = 7–9), which is among the highest in the world”.13 Later, in 2004, Nozha et al. showed an estimated prevalence of DM in KSA of 23.7%.6 A changing lifestyle,14 increased longevity,15,16 lack of physical activity,17 change in dietary habits, and increasing urbanization18 are major reasons for this ups Continue reading >>

Diabetes & Pad: Diagnosis, Prevention, And Treatment Paradigms

Diabetes & Pad: Diagnosis, Prevention, And Treatment Paradigms

Peripheral artery disease is common in patients with diabetes. Proper prevention and early diagnosis can help patients avoid painful neuropathies and lower-extremity amputations. Page 1 of 2 The epidemic of diabetes shows no signs of abating. It is estimated that 347 million people worldwide have diabetes. In 2008, the World Health Organization (WHO) projected that diabetes will be the 7th leading cause of death by the year 2030.1 The prevalence of diabetes in the United States may affect 10% to 14% of the population by 2025, with obesity likely the biggest risk factor. The prevalence of diabetes varies worldwide—it is greater in middle-aged people in developing countries and people >/65 years of age in developed countries, such as the US.2 As the population ages, the incidence of peripheral artery disease (PAD), a common comorbidity in patients with diabetes, also increases. Currently, the prevalence of PAD in persons aged >40 years is 4.3%,3 whereas this increases to as high as 29% in those aged >70 years (or 50-69 years with a history of diabetes or smoking).4 These two diseases do not just independently increase the risk for each other, but diabetes is synergistic with PAD. In the Framingham Study, there was a 3.5% to 8.6% increase in developing PAD if the patient has diabetes.5 As both diseases continue to increase in prevalence, clinicians on the front line will be faced with treating the combination of these two comorbidities. For example, the Hoorn study showed the prevalence rate of an ankle brachial index (ABI) of <0.9 in individuals with normal glucose tolerance was 7%, which increased to 20.9% in patients with diabetes.6 Recent research efforts show that these diseases do share a common pathological pathway—insulin resistance.7 Hence, it is essential tha Continue reading >>

More in diabetes