What's the Link Between Diabetes and Peripheral Artery Disease?

What's the Link Between Diabetes and Peripheral Artery Disease?

Diabetes and Peripheral Artery Disease Graphic

Two of the most common side effects of diabetes are poor circulation and vascular issues. Over time, diabetes can lead to a serious vascular disease known as Peripheral artery disease (PAD). 

Here’s how these two conditions are connected, and how people with diabetes can decrease their risk of serious complications.

Diabetes Increases the Risk of Peripheral Artery Disease

Peripheral artery disease is a vascular disease that causes circulatory issues. It is characterized by narrowed blood vessels and reduced blood flow in the extremities. PAD affects the arteries serving the head, stomach, arms and legs, with the legs commonly experiencing the most severe symptoms.

According to the American Heart Association, PAD can be an indicator of other serious cardiovascular conditions like atherosclerosis and heart diseases like coronary artery disease. It also increases a person’s risk of having a heart attack or stroke. 

Studies show that the two strongest risk factors for developing peripheral artery disease are diabetes and smoking1. In fact, studies have shown that 20% to 30% of people with diabetes mellitus also have PAD2. Type 2 diabetes is more commonly associated with PAD than Type 1.

The main link between diabetes and PAD is the effect that high blood sugar has on the blood vessels.

Poorly-controlled diabetes causes blood sugar levels to remain high for long periods of time. This can cause serious damage to the arteries, including plaque buildup that reduces normal blood flow to the extremities. 

Many diabetic people have PAD but experience no signs or symptoms. As the condition gets worse, they may develop nerve damage, muscle pain and weakness, non-healing wounds (ulcers), and skin changes. Many people with PAD experience severe pain during physical activities like walking, climbing stairs or standing for long periods of time.

PAD is also a main risk factor for lower-limb amputation among diabetic people3. 

Diabetes Causes PAD to Get Worse More Quickly

Diabetes doesn’t just increase a person’s risk of developing PAD; it also accelerates the severity of the disease and its symptoms.

In addition to painful nerve damage and potentially infectious non-healing ulcers, severe PAD can have life-limiting consequences. One study showed that individuals with symptomatic PAD are more likely to die during a cardiovascular event than individuals without PAD4. 

Additional Risk Factors for Developing PAD

Diabetes and smoking are the two biggest risk factors for developing PAD. 

Other risk factors include:

1. High blood pressure

2. High cholesterol

3. Obesity

4. Not exercising enough

5. Increasing age (being 50 years of age or older)

For diabetics who have additional risk factors for PAD, it is important to visit a vascular specialist to assess your vascular health. Simple lifestyle changes and certain medications can help you reduce your likelihood of developing serious vascular issues like PAD. 

Dr. Sendhil Subramanian at Georgia Vascular Institute is a renowned vascular specialist and radiologist serving the Atlanta, Georgia area. Dr. Subramanian specializes in the diagnosis and treatment of peripheral artery disease and provides surgical treatment methods like stenting and angioplasty. 

If you’re concerned about your risk factors for developing PAD, contact Georgia Vascular Institute to make your appointment today. 



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"Peripheral artery disease in patients with diabetes ... - NCBI." 10 Jul. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499529/.
"Peripheral Arterial Disease in People With Diabetes ...." https://care.diabetesjournals.org/content/26/12/3333.
"Peripheral artery disease and risk of cardiovascular events in ...." 8 Jul. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207208/.