What You Need to Know About Peripheral Artery Disease

Peripheral artery disease (PAD) affects nearly 12 million people in the U.S., but it is people with diabetes who are at higher risk of developing this condition.

PAD is a condition similar to coronary artery disease. In coronary artery disease, the arteries that supply blood to the heart muscle close, while in PAD, it is the arteries that lead to areas outside the brain and heart, most commonly the legs and feet, that become clogged.

This occurs when fatty deposits build up in the inner linings of the artery walls of the legs and obstruct blood flow. PAD can lead to pain, specifically when walking, and in extreme cases could lead to limb amputation.

Symptoms of PAD

The most common symptom of peripheral arterial disease is intermittent pain, cramping or aching in the calves, thighs or buttocks, which can arise while walking or doing exercise. The more extreme symptoms of PAD are collectively called critical limb ischemia and can include rest pain, tissue loss and gangrene.

Rest pain is described as a continuous burning pain that begins or is aggravated by reclining and is relieved by sitting or standing. Signs of tissue loss and gangrene are things like open sores, skin infections or ulcers that will not heal, and dry gangrene, which is dry, black skin on the legs or feet.

However, PAD in people with diabetes will often go unnoticed or undiagnosed because many patients do not have any symptoms, do not report their symptoms, or the perception of pain is hampered by the presence of peripheral neuropathy. Another problem for diagnosing PAD is that there is no generalized method that has been agreed upon yet by physicians and researchers in the field.

Risk Factors for PAD

In people with diabetes, the risk of PAD is higher due to age, duration of diabetes and the presence of peripheral neuropathy. PAD and diabetes share in common other risk factors such as:

• - Irregular blood sugar levels
• - Smoking
• - Obesity/weight problems
• - Physical inactivity
• - High blood pressure
• - High LDL cholesterol, or “bad” cholesterol
• - Family history of cardiovascular disease, stroke or PAD
• - Previous history of coronary artery disease, heart attack, angina, bypass surgery or stroke

Prevention

Many of the risk factors mentioned can be controlled by minimizing the likelihood of developing PAD and slowing its progression. One of the most effective treatments for PAD is regular physical activity. It is suggested to start with a simple walking routine and leg exercises. Making changes in your diet can also help to prevent and control PAD.

Many patients with PAD have high cholesterol levels. Changing your diet to one that is low in saturated fats, trans fats and cholesterol can help to lower your cholesterol levels. Furthermore, it is strongly recommended that you not smoke as smoking can greatly increase your risk of PAD, heart attack and stroke.

It is also important to remember that all patients with diabetes and PAD should maintain regular foot care in order to minimize the risks of developing complications and limb loss.

Treatments

If you are diagnosed with PAD, your doctor will approach you about different treatment options available to you. It is possible that your doctor may recommended a program of supervised exercise training. This program could consist of at least three months of intermittent treadmill walking, three times per week.

The program usually takes into account the fact that walking can cause pain and consists of alternating activity and rest. This kind of therapy is usually carried out in a monitored environment in a rehabilitation center.

Additionally, you may also be prescribed high blood pressure and cholesterol-lowering medications as well as antiplatelet medication, which helps prevent blood clots.

Sources: American Heart Association and American Diabetes Association