Peripheral arterial disease (PAD) occurs in patients with diabetes at a higher percentage as compared to non-diabetic population, due to a higher incidence of risk factors of atherosclerosis, including abnormalities of glucose metabolism. Typically, PAD manifests in diabetic subjects at a younger age, the gender differences are blurred, and in such populations, predominately peripheral arteries are affected.
In addition to typical atherosclerotic lesions occurring as a part of macrovascular complications, we often see capillary chronic ischemia in diabetic subjects. It is necessary to pay attention to PAD in the high risk group of diabetic patients, since the symptoms and their clinical picture could be sometimes devoided of useful information and modified by many factors, most frequently by peripheral and autonomic neuropathy.
Instead of preventive approaches focused on controlling atherosclerosis risk factors and modified pharmacotherapy, we provide treatment of PAD using similar tools, including revascularization methods, as in patients without diabetes. So far it has not yet been clearly determined what kind of PAD therapy is preferable in diabetic patients endovascular, surgical or stem-cell therapy.