On World Diabetes Day on 14 November, the spotlight falls on peripheral arterial disease, which often affects people with type 2 diabetes.

For many people with peripheral artery disease (PAD), the condition has few warning signs.

However, the sobering reality is that it can lead to gangrene, limb amputation and even death. Indeed, patients may not realise they have PAD until they find that a simple wound is taking a long time to heal or it develops complications.

PAD tends to affect people living with type 2 diabetes because, when it is poorly controlled, the condition can damage nerve endings, weaken the immune system and speed up atherosclerosis, or the buildup of fatty deposits on the walls of blood vessels.

Diabetes and PAD

- PAD occurs most commonly in the legs as the blood vessels are
the longest and furthest from the heart
- Symptoms include pain in the legs after walking; severe pain at night that disrupts sleep even with strong painkillers; wounds that develop at pressure points or from ill-fitting shoes; wounds that do not heal, become infected or turn gangrenous
- In severe cases, loss of blood circulation can lead to gangrene and even amputation

Impact of blocked arteries in other parts of the body

​	​Ischaemic heart disease, chest pain, heart attack — if the coronary or heart arteries are blocked
​	​Stroke — if the carotid arteries supplying blood to the brain, neck and face are blocked
​	​Renal failure — if the renal arteries are diseased
​	​Stomach pain — if the mesenteric arteries that supply blood to the intestines are blocked
​	​Finger pain or ulcers that cannot heal — when the vessels to the hands are diseased

Causes of blocked arteries 

	​High cholesterol
​	​High blood pressure
​	​​Smoking
​	​​Diabetes
​	​​Medicines
​	​​Injury
​	​​Genetics
​	​​Infections
​	​​Blood clots

Stay in control

• Take medications as prescribed
• Exercise regularly
• Maintain a healthy diet
• Quit smoking
• Put on appropriate footwear and carry out proper foot care
• Protect against injuries or wounds
• Check daily for cuts, redness, swelling, sores, blisters, corns and calluses, or other changes

Type 1 vs type 2

In patients with type 2 diabetes, the pancreas makes insulin but the body’s cells are unresponsive to the hormone. In type 1 diabetes, the pancreas does not make the hormone that helps the body convert glucose and sugar into energy. With both types of
diabetes, blood sugar levels and fats build up as a result.