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Complications of Diabetes

Circulatory Problems (Peripheral Vascular Disease)

What is peripheral vascular disease?

Peripheral Vascular disease (PVD) is a condition caused by furring-up of the blood vessels (atherosclerosis) which carry blood to the legs. People who have PVD also have a greater risk of having other complications of atheroma such as cornoary heart disease (CHD) and stroke. Build up of fatty deposits within the walls of the blood vessels affects the circulation.

Who is at risk of PVD?

  • smokers
  • elderly
  • high blood pressure
  • people with diabetes
  • family history of CHD, stroke or PVD

What are the symptoms?

  • cold feet
  • cramping pain or fatigue in the calves which occurs during walking and disappears at rest. This is known as intermittent claudication
  • burning pain in the feet or toes

How is it diagnosed?

Your doctor is likely to make a clinical diagnosis. Other tests such as ultrasound may be requested. Angiography is used for confirmation and for planning treatment.

What is the treatment?

The treatment of PVD depends on the severity of the condition. If your symptoms are severe and you have pain at rest or upon walking a short distance, you may benefit from a procedure to improve the blood flow to your legs. Whatever the treatment, the following are essential

  • lowering cholesterol
  • smoking cessation
  • regular exercise
  • control of high blood pressure

How can circulation be improved?

There are two main approaches to improving blood flow, angioplasty and bypass surgery. Angioplasty is done by passing a balloon along the blood vessel up to the area of obstruction. The balloon is then expanded which may partially relieve the blockage. A 'stent' which is a tubular shaped piece of wire mesh, may then be inserted in the narrowed blood vessel.

Bypass surgery involves a surgical operation and uses a vessel or artificial tube to get round the blocked artery.

Who is suitable for Angioplasty?

Not all blockages are suitable for angioplasty. This procedure is best suited for 'short blocks' of large blood vessels.

 

Dr Nishan Wijenaike, MD, FRCP
Consultant Diabetologist
West Suffolk Hospital Diabetes Service
October 2002
Updated November 2007