Assessment and Diagnosis of Peripheral Artery Disease in Patients with Diabetes

Abstract

Peripheral artery disease (PAD) is a chronic circulatory condition that occurs when the arteries that supply blood to the legs and feet are narrowed or blocked, leading to reduced blood flow to these areas. PAD is a common complication of type 2 diabetes, affecting up to 1 in 3 individuals with the condition. Assessment of PAD in individuals with diabetes typically involves a physical exam, ankle-brachial index (ABI) measurement, and imaging tests such as Doppler ultrasound or angiography. The ABI is a noninvasive measure that compares the blood pressure in the ankles and arms, with a lower ABI indicating a higher risk of PAD. Management of PAD in type 2 diabetes involves a multifaceted approach, including lifestyle modifications, medication, and revascularization procedures. Lifestyle changes such as smoking cessation and regular exercise can improve PAD symptoms and reduce the risk of disease progression. Medications such as antiplatelet agents, statins, and blood pressure-lowering drugs help to manage PAD and its associated risk factors. Revascularization procedures such as angioplasty or bypass surgery may be necessary in severe cases of PAD to restore blood flow to the affected limbs. In addition, these procedures should be considered in the feet of patients with diabetes if there is evidence of ischemia. Early detection and management of PAD in type 2 diabetes are critical to preventing complications such as non-healing wounds, infections, and amputations. Individuals with type 2 diabetes should undergo regular screening for PAD and work with their healthcare providers to develop a personalized treatment plan.