By: Dr. Krishna Chaitanya, Lead Consultant – Vascular and Endovascular Surgery, Aster RV Hospital

Peripheral Vascular Disease (PVD) is a common complication for those with diabetes, significantly impacting blood flow and increasing the risk of severe complications like infections, ulcers, and in some cases, amputation. This blog will explore the connection between diabetes and PVD, shedding light on risk factors, early symptoms, and treatment options to help manage and reduce the impact of this condition.

Why Diabetics are Prone to PVD

Diabetes is an illness that impacts blood glucose but is also associated with changes in blood vessels and circulation throughout the body. Diabetes causes high blood glucose, which leads to damage within vessel walls to form plaques and narrowing of the arteries. Also, in diabetics, the duration of blood vessel inflammation is likely to be higher than in patients without diabetes, which increases the risk of PVD.

Though diabetes itself is a significant risk factor, other elements can contribute to the development and progression of PVD:

• Smoking: Smoking is found to contribute to worsening atherosclerosis and also damages blood vessels, hence posing serious risks for diabetics
• Hypertension (High Blood Pressure): High blood pressure raises the stress on the arterial walls, which in turn worsens blood vessel deterioration
• Dyslipidemia: Plaque builds up if the patient has high levels of bad cholesterol (LDL) and low levels of good cholesterol (HDL)
• Age and Gender: People who are 50 and above, and men are more susceptible to developing PVD than women

Symptoms that Indicate PVD in Diabetics:

Some of the PVD symptoms are not prominently noticeable or are even different from the common features traditionally associated with the disease, which worsens this situation for diabetics. Common symptoms include:

• Claudication: Pain, cramping, or heaviness in the legs or buttocks that occurs during walking and is relieved by rest.
• Coldness in the Extremities: One may feel cold due to reduced blood flow to the feet or legs.
• Poor Healing of Sores and Ulcers: There is poor circulation in the feet, thus it takes longer for injuries to heal fully.
• Shiny Skin or Loss of Hair on the Legs and Feet: When circulation is reduced, it changes skin texture and also the rate of hair growth.
• Reduced Pulse in the Legs and Feet: Lack of or weak pulse in the legs indicates limited blood circulation.

How to Treat Peripheral Vascular Disease in Diabetic Patients?

Managing PVD in diabetic patients typically requires a combination of lifestyle changes, medications, and in some cases, surgical intervention. The primary goal of managing SLE is the relief of symptoms, promotion of circulation, and avoiding further advancement of the illness.

Lifestyle Modifications

Smoking Cessation: You need to quit smoking to stop the progression of PVD. Smoking acts as a barrier to blood flow and also affects blood vessels.

Exercise Therapy: In more chronic cases, supervised exercise programs such as walking are suggested as they improve circulation, hence alleviating patients’ symptoms.

Dietary Changes: Low fat, high fiber, fruits, and vegetable diets lower cholesterol and balance blood glucose concentrations.

Medications

Several medications may be prescribed to help manage PVD in diabetics:

Antiplatelet Agents: Drugs such as aspirin or clopidogrel thin the blood so that it flows more easily through the arteries and limits clot formation.

Cholesterol-Lowering Medications: Statins for cardiac care reduce cholesterol values in the blood and lower the rate of atherosclerotic plaque formation.

Blood Pressure Medications: Controlling blood pressure reduces arterial stress and helps prevent PVD progression.

Blood Sugar Control: Ensuring the patient’s blood sugar is well-controlled is another way to avoid worsening of blood vessels.

Surgical and Interventional Procedures

In cases of advanced PVD, lifestyle changes and medication might not be enough; surgical options may be necessary:

Angioplasty and Stenting: A minimally invasive procedure in which the artery is expanded by the inflation of a balloon, with a stent put in the artery to maintain its open state.

Atherectomy: A process where plaque is removed to open the arteries and allow regular blood flow.

Bypass Surgery: In more severe cases, bypass surgery can be an option, creating an alternate pathway for blood flow around narrowed or blocked arteries.