Peripheral arterial disease in patients with diabetes.J Am Coll Cardiol 2006; 47(5):921-9JACC
Peripheral arterial disease (PAD) is a chronic, lifestyle-limiting disease and is an independent predictor of cardiovascular and cerebrovascular ischemic events. Despite the recognition that PAD is associated with a marked increase in the risk of ischemic events, this particular manifestation of systemic atherosclerosis is largely underdiagnosed and undertreated. The risk of PAD is markedly increased among individuals with diabetes, and ischemic event rates are higher in diabetic individuals with PAD than in comparable non-diabetic populations. Consequently, early diagnosis and treatment of PAD in patients with diabetes is critically important in order to reduce the risk of cardiovascular events, minimize the risk of long-term disability, and improve quality of life. A diagnosis of PAD in patients with diabetes mandates a multi-faceted treatment approach, involving aggressive risk-factor modification, antiplatelet therapy, and revascularization procedures. The American Diabetes Association recently issued a consensus statement on the epidemiology, pathophysiology, diagnosis, and management of PAD in patients with diabetes. This article will review the clinical implications of the consensus statement and highlight the treatment options available in order to help prevent future ischemic events in diabetic individuals with PAD.