PAD & DIABETES
Peripheral arterial disease (PAD) and diabetes are the leading causes of non-traumatic, lower-limb amputations. Over 64,000 happen each year and up to 80% of these could likely be prevented. A podiatrist (foot and ankle specialist) can help you diagnose, treat and sometimes prevent conditions that can lead to foot pain and even amputation.
PAD affects 8 to 12 million Americans. One in every five people over the age of 70 has the disease. It is a common, yet serious disease. Men are more likely to have symptoms of PAD, but both men and women can develop the disease. PAD can impair physical health and diminish the ability to walk.
What is PAD?
"Atherosclerosis" or hardening of the arteries causes arteries to narrow or become blocked. When atherosclerosis affects the arteries of the heart it is called coronary artery disease (CAD). CAD can cause a heart attack. If atherosclerosis is in the limbs, it is called peripheral arterial disease (PAD). PAD has serious consequences for the legs, just as CAD has serious consequences for the heart.
PAD commonly affects blood flow to the legs. When blood vessels become too narrow, the pain, often described as muscle cramping, can be severe. It can also increase the chance of getting an infection while decreasing the ability to fight an infection if one occurs. In the advanced stages of PAD, known as critical limb ischemia (CLI), blood flow is blocked and legs are not receiving the oxygen or nutrition they need for cellular or tissue growth and repair. This can cause painful legs and foot sores. Eventually, it can lead to gangrene.
- High cholesterol/triglycerides
- High blood pressure
Many individuals with PAD do not experience typical leg symptoms so those at risk should undergo screening for PAD.
Your podiatric physician can do a simple test called ankle-brachial index (ABI). It compares the blood pressure in your ankles with the blood pressure in your arm. If your ABI is abnormal yet your feet are symptomatic of PAD, your podiatric physician may order other tests to determine the extent of your PAD. There are numerous treatments and surgeries available to correct PAD. The key is to diagnose it in its earliest stages.
Podiatrists not only treat patients with diabetes, they can be the first to discover signs of diabetes in your feet. Diabetes is a life threatening disease impacting over 24 million Americans and nearly 6 million additional people who don't even know they have it. Checking the feet for common symptoms of diabetes can help people at risk prevent serious complications. Since diabetic foot problems cause the highest percentage of non-traumatic lower-limb amputations in America, complications can be serious indeed.
Early detection will reduce amputation rates and improve the quality of life for people with diabetes. Your Washington State Podiatric Medical Association suggests checking your feet for warning signs of diabetes.
Once Diabetes is Detected
People with diabetes often develop "neuropathy" which affects the nerves making it difficult to feel cuts or wounds to the feet. Poorly fitted shoes, or even a stocking seam, can create a wound that may not be felt. Left unattended, such wounds can quickly become infected and lead to more serious consequences. Your podiatric physician knows how to treat and prevent these wounds and help keep your feet healthy and strong.
With more than 80 percent of patients with diabetes classified as overweight, exercise can play a key role in preventing and even treating the disease. Your Washington State Podiatric Medical Association can help you take strides toward better health by examining your feet and suggesting a walking regime.
Foot Tips For People With Diabetes
- Wash feet twice daily using mild soap, lukewarm water and dry with a soft towel.
- Inspect feet and toes daily for cuts, bruises, sores or changes to the toenails, such as thickening or discoloration. If age or other factors hamper self-inspection, ask someone to help you, or use a mirror.
- Lose weight. People with diabetes are commonly overweight, which nearly doubles the risk of complications.
- Wear thick, soft socks of an acrylic blend preferably without seams.
- Stop smoking. Tobacco can contribute to circulatory problems, which can be especially troublesome in patients with diabetes.
- Cut toenails straight across. Never cut into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners or snags. If your nails are hard to trim, ask your podiatric physician for assistance.
- Exercise. As a means to keep weight down and improve circulation, walking is one of the best all-around exercises.
- Never try to remove calluses, corns, or warts by yourself. Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreparable damage to the foot of a diabetic sufferer.
- See your podiatric physician. Regular checkups by your podiatric physician - at least annually - are the best way to ensure that your feet remain healthy.
PAD Warning Signs
- Cramping or pain in your legs, thighs, or buttocks that always occurs when you walk but that goes away when you rest.
- Foot or toe pain while idle that often disturbs your sleep.
- Skin wounds or ulcers on your feet or toes that are slow to heal (or that do not heal in a few weeks).
Diabetes Warning Signs
- Cold to the touch due to a lack of blood circulation
- Loss of hair
- Pain in legs