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Diabetic Arterial and Vascular Disease

People with diabetes face unique health challenges, including an increased risk for cardiovascular conditions such as diabetic arterial or diabetic vascular disease. Diabetic arterial and vascular disease increases your risk for heart attack, stroke, nonhealing wounds in the legs and feet, and high blood pressure.

At UPMC, our vascular surgeons are experts in treating diabetic arterial and vascular disease and its complications.

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What Is Diabetic Arterial and Vascular Disease?

People with diabetes are at much greater risk for heart and vascular disease compared to people who do not have diabetes.

Conditions associated with diabetic arterial disease include:

How common is diabetic arterial and vascular disease?

Arterial and vascular disease is more common in people with diabetes compared to the general population.

What causes diabetic arterial and vascular disease?

People with diabetes have too much sugar in their blood. This can damage your blood vessels and the nerves that control your heart and blood vessels. It may also cause your blood vessels to narrow — a process known as atherosclerosis.

Atherosclerosis is also called hardening of the arteries. It happens when plaque — which is made up of cholesterol and other fats, calcium, and fibrous tissue — builds up in the walls of arteries.

What are diabetic arterial disease risk factors and complications?

Diabetic arterial disease risk factors

Factors that can increase your risk for diabetic vascular disease include:

  • How long you have had diabetes.
  • How well your diabetes is controlled.
  • If you have high blood pressure or high cholesterol levels.
  • If you use tobacco.
  • If you do not exercise.
  • If you are overweight or obese.
  • If you eat a high-fat diet.

These factors can also worsen diabetic arterial disease that already exists.

Complications of diabetic arterial disease

People with diabetes are more likely to have a heart attack or stroke, or experience kidney disease.

Diabetic arterial disease typically affects smaller arteries — including those that lead to the eyes, kidneys, fingers, feet, and toes — causing nerve and circulation problems.

If enough plaque builds up to narrow or block an artery for a prolonged period, it can cause damage to tissue and organs. The health problems that result depend on the location of any narrowing or blockage.

For example:

  • Narrowing or blockage of an artery that supplies blood to the heart can result in a heart attack.
  • Blocked carotid arteries in the neck can result in a stroke.
  • Blockages in the blood vessels to the legs may lead to difficulty walking or wounds in the feet.
  • The same circulation problems often occur in the arteries that supply the eyes and kidneys.

Because many people with diabetes develop nerve problems, they may not notice that their feet are injured, which can lead to:

  • Sores (ulcers) that heal slowly or do not heal.
  • Infection.
  • Tissue death (gangrene), in the worst cases, which can lead to amputation.

How can I prevent diabetic arterial disease?

You may not be able to control some of your risk factors for diabetic arterial disease. However, you may be able to reduce your risk of developing diabetic arterial disease by:

  • Avoiding smoking.
  • Eating a diet that is rich in fruits, vegetables, and whole grains.
  • Exercising and maintaining a healthy weight.
  • Maintaining normal blood pressure and cholesterol levels.
  • Making sure your diabetes is well-controlled.
  • Limiting alcoholic beverages.

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What Are the Signs and Symptoms of Diabetic Arterial and Vascular Disease?

People with diabetic arterial disease can experience symptoms such as:

  • Blurry vision.
  • Spots in the vision (called floaters).
  • Swelling of the face, fingers, or toes.
  • Weight gain.
  • Foot ulcers caused by blood vessel narrowing in the feet.
  • Loss of feeling or a sense of burning in the hands or feet.
  • Leg pain when walking (called claudication).

When should I see a doctor about my diabetic arterial disease symptoms?

If you are having symptoms of diabetic arterial disease, you should schedule an appointment with your doctor or discuss the issue at your next checkup.

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How Do You Treat Diabetic Arterial and Vascular Disease?

Treatments for diabetic arterial disease focus on helping you control your blood sugar and the risk factors that contribute to the disease. These include lifestyle changes and medication, if necessary.

If your vascular surgeon discovers a narrowed or blocked artery, he or she may also recommend a minimally invasive or surgical procedure to clear the blockage or open the artery.

We also use a number of techniques to treat nonhealing wounds — a common health challenge for people with diabetic arterial disease.

Treatment options include:

Lifestyle changes

Your doctor may recommend lifestyle changes to help you manage diabetic arterial disease, including:

  • Controlling blood sugar.
  • Decreasing the levels of LDL (bad) cholesterol in your blood and increasing the levels of HDL (good) cholesterol.
  • Lowering high blood pressure.
  • Eating a low-fat diet.
  • Avoiding tobacco use.
  • Exercising.
  • Losing weight.
  • Limiting alcohol intake.

Medicine to treat diabetic arterial disease

Your doctor may prescribe medications to control:

  • Blood sugar.
  • Cholesterol levels, such as statins.
  • Blood pressure, such as diuretics and beta blockers.
  • Clotting, such as aspirin and warfarin (Coumadin).

Minimally invasive procedures for diabetic arterial disease

When diabetic arterial disease causes severe foot or calf pain, or when nonhealing foot wounds develop, your UPMC vascular surgeon may recommend minimally invasive interventions to restore circulation to your legs. During a minimally invasive procedure, your vascular surgeon will:

  • Insert a long flexible tube called a catheter into a blood vessel in your leg through a tiny incision.
  • Guide the catheter to the site of the blockage.
  • Use different devices, such as angioplasty balloons and stents, to open blocked arteries and keep them open.

Surgery for diabetic arterial disease

If your vascular surgeon cannot perform a minimally invasive procedure, he or she may recommend leg bypass surgery. Your vascular surgeon makes an incision in your leg near the blocked artery. Using a part of one of your own veins or a synthetic blood vessel, your surgeon will attach one end to the artery above the blockage and the other end below the blockage. This allows blood to bypass the blockage.

Wound care for diabetic arterial disease

UPMC's vascular surgeons are experts in assessing and treating diabetic foot wounds and offer a range of treatments, including:

  • Wound debridement (removing tissue that will no longer heal).
  • Vacuum-assisted closure.
  • Systemic hyperbaric oxygen therapy.
  • Surgery.

How effective is treatment?

Treatment for diabetic arterial disease may reduce symptoms, improve quality of life, and prevent your condition from getting worse. Although there is no cure for diabetic arterial disease, early treatment can reduce the chances of complications.


Last reviewed by a UPMC medical professional on 2024-10-01.