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​Diabetic Arterial and Vascular Disease

People with diabetes face special health challenges, including an increased risk for cardiovascular conditions such as diabetic arterial or diabetic vascular disease.

At the UPMC Heart and Vascular Institute, our vascular surgeons are experts in treating diabetic arterial disease and its complications.

Contact the UPMC Heart and Vascular Institute

To request an appointment, contact the UPMC Heart and Vascular Institute:


What Is Diabetic Arterial Disease?

People with diabetes are at much greater risk for heart and vascular disease compared to people who do not have diabetes.

Conditions associated with diabetic arterial disease include:

  • Heart attacks
  • Strokes
  • Nonhealing wounds in the legs and feet
  • High blood pressure

Causes of diabetic arterial disease

People with diabetes have too much sugar in their blood. This may change blood chemistry and cause blood vessels to narrow. Or, it can damage blood vessels — a process known as atherosclerosis.

Atherosclerosis is also called hardening of the arteries. It results when plaque — which is made up of cholesterol and other fats, calcium, and fibrous tissue — builds up in the walls of arteries.

If enough plaque builds up to narrow or block an artery for a prolonged period, it can cause damage to tissue and organs. The health problems that result depend on the location of any narrowing or blockage.

For example:

  • Narrowing or blockage of an artery that supplies blood to the heart can result in heart attack.
  • Blocked carotid arteries in the neck can result in a stroke.
  • Blockages in the blood vessels to the legs may lead to difficulty walking or wounds in the feet. The same circulation problems often occur in the arteries that supply the eyes and  kidneys.

Diabetic arterial disease risks

Factors that can increase your risk for diabetic vascular disease include:

  • How long you have had diabetes
  • How well your diabetes is controlled
  • If you have high blood pressure or high cholesterol levels
  • If you use tobacco
  • If you do not exercise
  • If you are overweight or obese
  • If you eat a high-fat diet

These factors can also worsen diabetic arterial disease that already exists.

Diabetic arterial disease complications

People with diabetes are more likely to have a heart attack or stroke, or experience kidney disease.

Diabetic arterial disease typically affects smaller arteries — including those that lead to the eyes, kidneys, fingers, feet, and toes — causing nerve and circulation problems. This combination can create a number of health issues, such as loss of feeling in the feet.

Because many people with diabetes develop nerve problems, they may not notice that their feet are injured, which can lead to:

  • Sores (ulcers) that heal slowly or do not heal
  • Infection
  • Tissue death (gangrene), in the worst cases, which can lead to amputation

Why choose UPMC for diabetic arterial disease care?

  • Vascular surgeons at the UPMC Heart and Vascular Institute treat more than 1,000 people with diabetic arterial disease each year.
  • We pioneered wound care in western Pennsylvania, starting the first wound clinic in the area and providing expertise in evaluating and treating diabetic foot wounds.
  • Our comprehensive, team-based approach includes vascular, orthopaedic, plastic, and general surgeons — as well as podiatry and internal medicine professionals — all working together to provide an effective treatment plan that is right for you.

Learn More About Diabetic Arterial Disease 

From the Society for Vascular Surgery

From our Health Library at UPMC.com:

Diabetic Arterial Disease Symptoms and Diagnosis

People with diabetic arterial disease can experience symptoms such as:

  • Blurry vision
  • Spots in the vision (called floaters)
  • Swelling of the face, fingers, or toes or weight gain
  • Foot ulcers caused by blood vessel narrowing in the feet
  • Loss of feeling or a sense of burning in the hands or feet
  • Leg pain when walking (called claudication)

Diagnosing diabetic arterial disease

Tests your doctor at the UPMC Heart and Vascular Institute may use to diagnose diabetic arterial disease of the legs include:

  • Ankle/brachial index (ABI): This test compares the blood pressure in your ankle with the blood pressure in your arm. Normally, the two blood pressures are about the same. But, if the blood pressure in your ankle is lower than that of your arm, your leg arteries have narrowed.
  • Duplex ultrasound: This is a painless test that uses sound waves to create images of the arteries in your legs. It also enables your doctor to measure blood flow through the arteries.

Learn More About Diabetic Arterial Disease Symptoms 

From the Society for Vascular Surgery

From our Health Library at UPMC.com:

Diabetic Arterial Disease Treatment

Treatments for diabetic arterial disease focus on helping you control your blood sugar and the risk factors that contribute to the disease. These include lifestyle changes and medication, if necessary.

If your vascular surgeon at UPMC's Heart and Vascular Institute discovers a narrowed or blocked artery, he or she may also recommend a minimally invasive or surgical procedure to clear any blockage or open the artery.

We also use a number of techniques to treat nonhealing wounds — a common health challenge of people with diabetic arterial disease.

Lifestyle changes and medication

Lifestyle changes that can control the factors for diabetic arterial disease include:

  • Controlling blood sugar
  • Decreasing the levels of LDL (bad) cholesterol in your blood and increasing the levels of HDL (good) cholesterol
  • Lowering high blood pressure
  • Eating a low-fat diet
  • Quitting tobacco use
  • Exercising
  • Losing weight
  • Limiting alcohol intake

Your doctor may prescribe medications to control:

  • Blood sugar
  • Cholesterol levels, such as statins
  • Blood pressure, such as diuretics and beta blockers
  • Clotting, such as aspirin and warfarin (Coumadin)

Minimally invasive procedures and surgery for diabetic arterial disease

When diabetic arterial disease causes severe foot or calf pain, or when wounds develop on feet, your UPMC vascular surgeon may recommend minimally invasive interventions or surgery to restore circulation to your legs.

  • Minimally invasive treatments: In minimally invasive treatments, your vascular surgeon inserts a long flexible tube — called a catheter — into a blood vessel in your leg through a tiny incision. The surgeon guides the catheter to the site of the blockage. The catheter can carry different devices, such as angioplasty balloons and stents. These devices help open blocked arteries and keep them open.
  • Leg bypass surgery: If your vascular surgeon cannot perform a minimally invasive procedure, he or she may recommend leg bypass surgery. Your vascular surgeon makes an incision in your leg near the blocked artery. Using a part of one of your own veins or a synthetic blood vessel, the surgeon attaches one end to the artery above the blockage and the other end below the blockage.

Wound care

UPMC's vascular surgeons are experts in assessing and treating diabetic foot wounds.

We offer a range of treatments, including:

  • Wound debridement (removing tissue that will no longer heal)
  • Vacuum-assisted closure
  • Systemic hyperbaric oxygen therapy
  • Surgery

Learn more about lifestyle changes and other treatments for diabetic arterial disease 

From the Society for Vascular Surgery

From our Health Library at UPMC.com