People with diabetes are at increased risk for peripheral artery disease (PAD), which occurs when plaque builds up in the blood vessels that carry blood from the heart to the legs. More than 10 percent of people over the age of 65 have PAD.

PAD reduces blood supply to the tissues in the legs. Some people have no symptoms, while others have the classic symptom of pain in the calf while walking that subsides when resting (called "intermittent claudication"). Others experience changes in leg function that can affect their ability to walk.

In a new study, PAD was diagnosed with a test called the ankle brachial index (ABI), which compares blood pressure in the arm and lower leg. It is a simple, noninvasive way to identify PAD. Only about a third of the patients with PAD in the study had any leg pain. They did have signs of poor leg functioning, however, including slower walking speed and an inability to walk continuously. They also could not walk as far in a six-minute test than those without PAD. If these symptoms seem familiar to you, ask your doctor about an ABI test.

Untreated PAD can be dangerous, with high rates of mortality and development of other cardiovascular complications. It is usually treated with lifestyle changes including increased walking to stimulate the formation of new blood vessels around those that are blocked. Drugs to dilate blood vessels or thin the blood may be given; in severe cases, angioplasty or bypass procedures may be indicated.

Sources:

• McDermott MM, Greenland P, Kiu K, et al. The ankle brachial index is associated with leg function and physical activity: the walking and leg circulation study. Annals of Internal Medicine, June 18, 2002;136:873-883.
• American College of Cardiology. Peripheral vascular diseases and you. March 12, 2002. www.acc.org/media/patient/PVD.