What causes diabetic vascular disease?

• If you have diabetes, it may increase the chances for the development of several vascular diseases.

• Your risk of vascular disease increases with the length of time you have had diabetes.

• You also increase your risk of developing diabetic vascular disease if you have high blood pressure, if you smoke, don't exercise, are overweight, or eat a high-fat diet.

What tests will I need?

• First your physician asks you questions about your general health, medical history, and symptoms. In addition, your physician conducts a physical exam.

• To confirm a diagnosis of diabetes, your physician will perform a blood test to measure your glucose level.

• Other tests that are often used to diagnose diabetic vascular disease involving the legs  include exercise treadmill testing, an ankle/brachial index (ABI), and a segmental arterial Doppler study.

• For the treadmill test, also called ECG stress testing, you walk or run on a treadmill while your physician measures your heart’s electrical activity. The test can detect poor blood flow.

How is diabetic vascular disease treated?

Medication

• Maintaining healthy blood sugar levels, controlling high blood pressure, and controlling lipid levels through medications all play an important part in diabetic vascular disease treatment.

• Insulin or glucose-lowering medications help control blood sugar levels.

• Medications to lower blood pressure include angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, and diuretics.

•  Cholesterol lowering medications include statins, which reduce the amount of cholesterol in your blood.

• To help keep your blood from clotting, your physician may prescribe antiplatelet medications, such as aspirin.

PAD treatment

• When peripheral arterial disease (PAD) causes sores to develop on your feet, your physician will use dressings and sometimes antibiotics to heal the sores before they become too extensive or deep.

• He or she will determine if enough blood is reaching the sores to allow them to heal. It is important to treat the sores promptly because, if the sores become so bad that the tissue of your foot dies, your surgeon may need to partially or completely amputate your foot or leg.

• To restore circulation to your leg and avoid amputation, your surgeon may need to perform bypass surgery. Bypass surgery creates a detour around any narrowed or blocked sections of your artery.

• Sometimes the blockage itself can be removed with a procedure called an endarterectomy. 

• Another treatment option for PAD is a minimally invasive procedure called angioplasty and stenting.

•  The location and extent of the blockage determines what procedure is likely to work best in your particular situation.