Peripheral vascular disease

Peripheral vascular disease (PVD) is another major complication of diabetes. It is characterized by narrowing (or occlusion) of the blood vessels supplying the limbs (especially the lower limbs). The narrowing of the blood vessels results from the deposition of the fat on the arterial walls, which thereby, impedes the circulation in the limbs.

A person suffering from PVD may complain of pain in calf muscles, thighs and the buttocks on walking (claudication). Presence of claudication is an important sign that predicts involvement of blood vessels supplying the heart and the brain.

Taking rest or slowing down while walking decreases the pain as the demand for oxygen by the leg muscles is reduced. As the pain comes and goes (intermittent) and the person limps (claudication) while walking it is called “Intermittent claudication”.

If the condition is not managed the pain may become continuous and prevent the person from sleeping (rest pain). This pain often feels worse in the toes and may be relieved by hanging the legs down from the bed.

Presence of severe pain in lower limbs especially at night and non-healing foot ulcers indicate that PVD is getting worse, hence, immediately consult your doctor. 

Your doctor may advise you to get an ultrasound test or angiogram done to examine the blood vessels in the limbs.

The main risk factor for peripheral vascular disease is smoking. The other risk factors include:

  • Gender: Men are 6 times more likely to develop PVD as compared to females because of the associated smoking factor. Also female sex hormones prevent women from PVD till menopause.
  • High fat diet such as fried food and snacks, butter, whole milk and whole milk dairy products.
  • Sedentary lifestyle
  • Hereditary: Some genes may run in the family which increases their tendency to have high levels of cholesterol in the blood or have increased deposition of fat on the blood vessel wall.
  • High blood pressure  

Peripheral vascular disease can be prevented by:

  • Avoiding smoking
  • Doing regular exercises as it helps to promote the growth of new blood vessels (collateral circulation) and increases HDL cholesterol level in blood. Walking is the best exercise, start at a slow pace and continue till the pain comes on. Gradually increase the duration of walking to 30-minutes/ day.
  • Take a low-fat diet
  • Control your blood sugar, blood cholesterol levels and blood pressure
  • Lose weight if you are overweight or obese.

If suffering from PVD take proper care of your feet. Wash your feet daily and dry them properly especially between the toes to prevent any infection. Wear comfortable shoes and avoid any kind of injury.

Management of PVD may involve taking cholesterol-lowering medications, aspirin (to decrease the risk of clot formation in the blood vessels) and in advanced cases angioplasty (commonly used surgical intervention for clogged arteries) or bypass surgery may be done