If you have diabetes and you've started feeling pain or aches in your calves while walking, which eases up when you rest, it could be a sign of peripheral artery disease (PAD). PAD happens when the arteries in your legs narrow, cutting down blood flow.
Mitri Khoury, MD, vascular surgeon with HonorHealth Heart Care – Vascular, provides expert insights on the relationship between diabetes and PAD.
“Diabetes worsens plaque buildup in your arteries like how it raises your risk of heart attacks and strokes,” says Dr. Khoury. “This plaque narrows your vessels and reduces blood flow.”
Key signs and symptoms
- Pain with walking (claudication).
- Rest pain you notice in your foot while you are inactive, typically at night when lying flat.
- Diminished hair growth on the legs, due to a reduced blood supply to the skin.
- Development of ulcers or wounds on the feet that won’t heal.
Understanding the risk factors
While PAD can affect anyone, it’s more common in people with diabetes and other risk factors, including:
- Current smoker or history of smoking
- Age – especially if you’re older than 50
- High cholesterol
- High blood pressure
- History of heart disease
- Obesity – generally defined as a BMI over 30
- Chronic kidney disease
Methods of diagnosing PAD
If your doctor suspects you have PAD, here are some of the tests you may undergo:
- A six-minute walk test to gauge the distance you can walk before symptoms develop
- An ankle brachial index test, where blood pressure is measured on your arm and at the ankle, to determine the difference between the two. In people with PAD, blood pressure in the legs is typically lower than in the arms.
- An arterial ultrasound and/or another imaging test called a CT scan to visualize the degree of narrowing of the vessels
Exploring treatment options
Treatment for claudication centers on several key strategies:
- Walking: Regular physical activity helps develop new blood vessels to bypass blockages.
- Healthy eating: A balanced diet supports overall vascular health.
- Optimizing medical management: Proper medical care is essential for managing symptoms.
Dr. Khoury explains, “By staying active, many patients can alleviate symptoms,” Dr. Khoury explains. “If issues persist, we may prescribe cilostazol, a medication that helps improve blood flow.”
Additionally, surgical options are available, which may include:
- Stent placement: Inserting a stent to widen a narrowed artery.
- Bypass surgery: Creating a new path for blood flow around blocked arteries.
"The most important thing for people with diabetes and PAD to remember is to be active, and walk and exercise regularly," Dr. Khoury says. "Protect your feet and be mindful about injuries that could lead to non-healing wounds, keep your blood sugar under control and take your medications regularly."
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