Peripheral Artery Disease Case Studies

Approximately one third of the patients have Peripheral Artery Disease (PAD) with diabetes mellitus. Patients who have type 2 diabetes mellitus have a higher risk of developing Peripheral Artery Disease and macrovascular disease. When Peripheral Artery Disease has developed in a patient with diabetes, prognosis in a patient is very poor. Over a 5-year period approximately 4 % of the patients experience limb loss, 20 % have myocardial infarction or stroke and 30 % die. A huge majority of (75 % to be exact) of these deaths are cardiovascular-related. The prognosis is even pooper in patients who develop critical limb ischemia. Approximately 25 % of the patients undergo amputation and 25 % die as a result of cardiovascular causes within 12 months. (1) Besides the statistics mentioned
On the other hand, patients with diabetes can present later with more severe diseases. Treatment of patients with a Peripheral Artery Disease has 2 components: management of Peripheral Artery disease and cardiovascular risk reduction. Patients with PAD should receive treatment that include antiplatelet agents, lipid-lowering therapy, antihypertensives, smoking cessation therapy and improved glycemic control. On the other side, Patients who have both PAD and diabetes require the similar treatment but the difference is that patients with Type 2 Diabetes and PAD need to get special consideration because of the high-risk status. For example, LDL cholesterol and blood pressure targets are more aggressive in diabetic patients compared to other patients groups. In addition, patients with diabetes need to regularly get their foot checked/inspected and get the optimal foot care because diabetes increases the risk that critical limb ischemia will develop and severe lesions possibly could get remain undetected as a result of neuropathy.