Diabetes is a collection of conditions involving the hormone insulin and how your body uses glucose. Type 1 and type 2 diabetes are chronic forms of diabetes. These chronic forms of the disease can lead to various complications that could affect all parts of the body.
There is unease among the diabetic population because complications include toe, foot, and limb amputation. We aim to educate patients about how diabetes mellitus can progress to peripheral artery disease (PAD), the leading cause of amputation for people with diabetes.
How Does Diabetes Affect the Arteries?
Diabetes mellitus is a condition in which the hormone insulin, produced by the pancreas, is either lacking or ineffective. Insulin acts as the gatekeeper of sugar, also known as glucose, by allowing sugar to leave the bloodstream and enter other cells in the body to be used as energy. Without adequate insulin, the sugar stays in the bloodstream at increased levels. Chronic high blood sugar in turn leads to internal blood vessel walls that are rough and inflexible. Sticky plaques can easily build up on these damaged vessel walls in a condition called atherosclerosis and efficient blood flow is occluded.
The smallest blood vessels in the body, located at the extremities, are most likely to be affected by occlusion. This is why most peripheral extremities can experience the worst blood flow when blood sugars are consistently high. Known as peripheral artery disease (PAD), restricted blood flow prevents oxygen, nutrients, and healing cells from reaching the toes, feet, and legs. This makes them prone to numbness, infection, and poor wound healing. Sometimes a wound will go unnoticed by a patient due to a lack of nerve sensation in the wound; this is called neuropathy. Chronic wounds may cause tissue damage or infection that may become so severe that amputation is necessary.
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PAD Prevention for Diabetic Patients
It is important to prevent peripheral artery disease and detect it early to avoid amputations. To prevent peripheral artery disease, it is crucial to control blood sugar levels by adhering to an appropriate diet. Test blood glucose and A1C levels regularly, and take all medications as prescribed by your doctor. As discussed earlier, keeping blood sugar levels stable will prevent blood vessel damage and the subsequent effects of poor blood flow.
Other ways to prevent PAD are to exercise regularly, avoid smoking, and prevent or control other medical conditions such as high blood pressure and high cholesterol.
Detect Peripheral Artery Disease Early
Early detection of peripheral artery disease is both possible and crucial. One classic symptom of PAD is leg or foot pain that increases with activity such as walking or exercise. Other symptoms may include leg numbness and/or weakness. One leg or foot may feel cold, especially compared to the other foot or the rest of the body. Also, watch out for slowed hair or nail growth and sores that don’t appear to be healing well. You may notice discoloration of the skin on the legs or feet. Your doctor may notice other signs such as a weak pulse in an extremity. Take care to observe and care for feet daily by checking all skin surfaces, keeping feet and legs clean and dry, and wearing comfortable shoes that fit appropriately.
29 million Americans are affected by diabetes and 12 million are affected by peripheral artery disease. Fortunately, by taking the above measures and working closely with vascular experts, lower limb amputations have been reduced by half over the past 20 years. Vascular experts help educate patients about peripheral artery disease prevention, screen for it regularly and determine the best form of treatment. If peripheral artery disease is detected early, studies show that up to 90% of associated amputations can be avoided.
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How to Detect & Treat PAD
It is important to find a vascular team you trust. The interventional radiologists, interventional cardiologists, and vascular surgeons at Modern Vascular work with your endocrinologists, podiatrists, PCPs, and other physicians to provide the care that you need. The top priority of our physicians is to prevent unnecessary amputations. Modern Vascular is committed to utilizing state-of-the-art technology and modern, advanced techniques, such as minimally invasive outpatient endovascular procedures, for providing positive outcomes. Our vascular providers are committed to finding the best solutions to save your toes, feet, and limbs. Diabetic patients with PAD should seek providers with extensive training, a specialized focus, and plenty of experience diagnosing and treating those conditions. Consider seeking a second opinion if your doctor has indicated that amputation is your only option