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Peripheral artery disease in diabetes

Circulatory disorders of the feet are more common in people with diabetes. The peripheral artery disease (PAD) is often the underlying factor of a chronic sore that does not heal well.

The vein on the left represents a narrowed artery and the one on the right a healthy blood vessel.

The narrowing of the vessels leading to the legs is a common manifestation of arterial disease. The aorta divides into two branches of common iliac arteries in the pelvic region, after which these turn into femoral arteries and continue into the lower legs as smaller arteries which again divide into the small arteries of the feet. A narrowing anywhere in these arteries stops the flow of blood, causing an oxygen deficiency. Mild oxygen deficiency is often asymptomatic if a person sedentary.

The peripheral artery disease (PAD) is more common in the elderly and people with diabetes. To some degree, this is because diabetes is common in the elderly. On the other hand, a person with diabetes is more likely to have medical conditions that predispose to PAD.

Intermittent claudication

The most common symptom of PAD is intermittent claudication. In intermittent claudication, moving causes pain in the lower limbs, forcing the person to stop. In addition to an arterial disease, intermittent claudication can result from a dysfunction of the back, hips, knees or peripheral nervous system, such as a trapped nerve.

Severe oxygen deficiency i.e. critical ischemia

Pain in the legs or feet at rest, an ulcer that is slow to heal or gangrene are signs of a severe lack of oxygen, risk of amputation and generalised arterial disease. Often, pain at rest occurs at night in a horizontal position. Dangling the feet, sitting up or standing up alleviates the pain.

For a person with diabetes, a severe lack of oxygen in the lower limbs can be painless due to a loss of sensation in the legs and feet. If a cut or sore in a leg or foot takes long to heal, the reason is often a lack of oxygen.

Each year, approximately 1,200 Finns need an amputation of a lower limb. Half of that number are people with diabetes.

Updated 30.9.2023