Peripheral Vascular Disease

When the large blood vessels are damaged due to high blood fat levels and high blood pressure, they become narrow, stiff„ and less flexible. As fats and other materials (plaque) build up within the walls of the blood vessels, blood flows at a much slower rate and disease begins. When the hands and feet have reduced circulation, it is called peripheral vascular disease (PVD). People with diabetes are at an increased risk for PVD. Early detection of PVD is critical in reducing leg and foot problems.

What are the risk factors leading to PVD?

  • High blood sugar - Can do damage to the blood vessels and nerve endings
  • Diabetes - Leads to an increase in blood fats and build up in the arteries
  • High blood fats - Causes blood vessel walls to thicken and become narrow
  • High blood pressure - Damages blood vessels, kidneys and makes the heart work harder
  • Smoking - Narrows the blood vessels
  • Inactivity - Promotes obesity and may cause fats to build up in the blood vessels
  • Obesity - Makes it harder for the body to use insulin and places stress on legs and feet

Important things to remember:

  • People with type 1 or type 2 diabetes are at risk for PVD, heart disease and stroke.
  • Prevention of these problems is more likely to occur when you take good care of yourself.
  • You can do this by decreasing risk factors. You also need to keep your diabetes under control.

Steps to stay healthy:

  1. If you smoke, stop.
  2. Treat high blood fat levels by eating foods low in fat, losing weight and exercising. If blood fats remain high, there are medicines available. Keep your blood sugar levels under the goals established by your doctor.
  3. Lose weight. By losing 10 to 20 pounds, blood sugar, blood fat levels and blood pressure will often improve.
  4. Control high blood pressure by losing weight, exercising and taking blood pressure medicine.
  5. Meet with a dietitian to modify your meal plan. Eating the right foods can help to lower blood sugar, decrease blood fats and blood pressure. Decreasing portion sizes can also help with weight loss.
  6. Get regular exercise. Start slow and work up to 30 minutes daily.
  7. Check with your doctor before starting an exercise program.
  8. Check your feet daily for sores, redness, calluses, cracks, blisters and red spots. Trim your toenails straight across and file the edges with an emery nail file.
  9. Have an annual visit with a foot doctor who is familiar with foot problems for people with diabetes.
  10. Check with your doctor about taking a daily aspirin. This may help to decrease problems with your blood vessels.

How can your doctor help you? Your doctor should do the following:

  1. Check your feet and pulses at each visit.
  2. Evaluate your blood sugar results at each visit. This will help you to reach your blood sugar goals.
  3. Have A1c levels checked at least twice a year and inform you of the results.
  4. Prescribe medicines and/or treatment to relieve the symptoms of PVD.
  5. Depending on your risk factors, your doctor may recommend a stress test before prescribing an exercise program.
  6. Check for protein in the urine yearly.
  7. Perform a blood fat check yearly. This will need to be done more often if your levels are high.
  8. Refer you to a foot doctor yearly for a foot exam.
  9. Refer you to a diabetes educator and dietitian