Specificities of primary and secondary prevention of lower extremity artery disease in patients with diabetes mellitus.
Int Angiol
; 43(3): 367-373, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-39041784
ABSTRACT
Diabetes mellitus (DM) is a major risk factor for lower extremity arterial disease (LEAD) and about 20% of symptomatic patients with LEAD have DM. In subjects with DM, LEAD is a cause of morbidity and mortality. DM typically causes complications in the form of macro- and microangiopathy. In these patients, macroangiopathy manifests as atherosclerosis like in non-diabetic patients. However, its course is accelerated due to accompanying risk factors like hyperlipidemia and hypertension, with cumulative effects. Other factors are also relevant such as inflammation, endothelial dysfunction, platelet activation, blood rheological properties, hypercoagulability, and factors stimulating vascular smooth muscle cell proliferation. Additionally, DM is a risk factor for restenosis and amputation. DM is strongly associated with femoral-popliteal and tibial LEAD, which manifests earlier in patients with DM and may progress more rapidly to critical limb ischemia. Diabetic microangiopathy is characterized by arteriolosclerosis and interstitial fibrosis which additionally affects progression and outcomes of angiopathy of lower limbs. Glycemic control particularly decreases microangiopathic complications, while prevention of macrovascular complications requires treatment of accompanying risk factors like hypertension and dyslipidemia.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Extremidade Inferior
/
Prevenção Secundária
/
Doença Arterial Periférica
Limite:
Humans
Idioma:
En
Revista:
Int Angiol
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
IT
/
ITALIA
/
ITALY
/
ITÁLIA