MetroHealth Heart & Vascular Center
Vascular Ulcer and Diabetic Wound Care
What causes diabetic
• 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
• 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?
• 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
• Medications to lower blood pressure include angiotensin-converting
enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, and
• 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.
• 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
• 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.