Skip to main content
Home
Browse topics
Cardiovascular disorders Chronic kidney disease Diabetes devices & technology GLP-1 receptor agonists Hyperglycemia Hypoglycemia Obesity, diet, & lifestyle interventions SGLT2 inhibitors Type 1 diabetes Type 2 diabetes Browse all topics
EN
EN
In focus
Novel clinical evidence in continuous glucose monitoring Fasting for religion and health in people with diabetes The challenge of type 2 diabetes in children HFpEF & diabetes: Diagnosis and management in the wake of EMPEROR-Preserved Addressing suicide risk in diabetes: Rates and risk factors, HCP fears, and practical advice The SURPASS trials: Summarizing efficacy data on tirzepatide Semaglutide for weight loss: STEP and SELECT trials: Results from the STEP and SELECT trials Why psychosocial care matters DiRECT: Type 2 diabetes remission through weight management
Congress coverage
EASD 58th Annual Meeting 2022 The American Diabetes Association 82nd Scientific Sessions
About us
Medicine Matters Diabetes
EXTENDED SEARCH
Top

10-04-2012 | Diabetic foot | Book chapter | Article

5. Clinical Features and Diagnosis of Peripheral Arterial Disease

Author: Cameron M. Akbari, MD, MBA, FACS

Publisher: Humana Press

Login to get access

Abstract

Peripheral arterial disease is a fundamental consideration in the patient presenting with a diabetic foot. Although broad in context, it is only part of the overall alteration in vascular structure and function characterized by two distinct pathologic processes: a nonocclusive microcirculatory impairment involving the capillaries and arterioles of the kidneys, retina, and peripheral nerves and a macroangiopathy manifesting as atherosclerotic lesions of the coronary and peripheral arterial circulation. The former is relatively unique to diabetes and is best described as an accelerated microangiopathy rather than an occlusive process. In addition to its well-recognized contribution to the development of diabetic neuropathy, retinopathy, and nephropathy, this microvascular dysfunction is also of paramount importance in the diabetic foot.
Literature
1.
Akbari CM, LoGerfo FW. Diabetes and peripheral vascular disease. J Vasc Surg. 1999;30:373–84.PubMedCrossRef
2.
LoGerfo FW, Coffman JD. Vascular and microvascular disease of the foot in diabetes. N Engl J Med. 1984;311:1615–9.PubMedCrossRef
3.
Parkhouse N, LeQueen PM. Impaired neurogenic vascular response in patients with diabetes and neuropathic foot lesions. N Engl J Med. 1988;318:1306–9.PubMedCrossRef
4.
Akbari CM, LoGerfo FW. Peripheral vascular disease in the person with diabetes. In: Porte D, Sherwin RS, Baron AD, editors. Ellenberg and Rifkin’s diabetes mellitus. 6th ed. New York: McGraw-Hill; 2003. p. 845–57.
5.
Flynn MD, Tooke JE. Aetiology of diabetic foot ulceration: a role for the microcirculation? Diabet Med. 1992;8:320–9.CrossRef
6.
Akbari CM, LoGerfo FW. The micro- and macrocirculation in diabetes mellitus. In: Veves A, editor. A clinical approach to diabetic neuropathy. 1st ed. New York: Humana; 1998. p. 319–31.CrossRef
7.
Veves A, Akbari CM, Primavera J, et al. Endothelial dysfunction and the expression of endothelial nitric oxide synthetase in diabetic neuropathy, vascular disease, and foot ulceration. Diabetes. 1997;47:457–63.CrossRef
8.
Ruderman NB, Haudenschild C. Diabetes as an atherogenic factor. Prog Cardiovasc Dis. 1984;26:373–412.PubMedCrossRef
9.
Brand FN, Abbott RD, Kannel WB. Diabetes, intermittent claudication, and risk of cardiovascular events. The Framingham Study. Diabetes. 1989;38:504–9.PubMedCrossRef
10.
Stokes J, Kannel WB, Wolf PA, Cupples LA, D’Agostino RB. The relative importance of selected risk factors for various manifestations of cardiovascular disease among men and women from 35 to 64 years old: 30 years of follow-up in the Framingham Study. Circulation. 1987;75:65–73.
11.
Tuomilehto J, Rastenyte D, Jousilahti P, Sarti C, Vartiainen E. Diabetes mellitus as a risk factor for death from stroke: prospective study of the middle-aged Finnish population. Stroke. 1996;27:210–5.PubMedCrossRef
12.
Dormandy J, Heeck L, Vig S. Predicting which patients will develop chronic critical leg ischemia. Semin Vasc Surg. 1999;12:138–41.PubMed
13.
Menzoian JO, LaMorte WW, Paniszyn CC, et al. Symptomatology and anatomic patterns of peripheral vascular disease: differing impact of smoking and diabetes. Ann Vasc Surg. 1989;3:224–8.PubMedCrossRef

Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform. 

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »

Image Credits