DR RAVUL JINDAL DR.TARANVIR KAUR
VASCULAR AND ENDOVASCULAR SURGEON FORTIS HOSPITAL
MOHALI
Diabetes and peripheral vascular disease
MAGNITUDE OF DIABETES
42 million Indians are diabetics Estimated number of diabetics by 2025- 70 million
By 2030, every fifth person with diabetes will be an Indian
Real burden of the disease is due to its associated complications
Major Clinical Manifestations
Transient ischemic
attack
Angina: • Stable
• Unstable
Ischemic
stroke
Myocardial
infarction
Peripheral arterial
disease: • Intermittent claudication
• Rest Pain
• Gangrene
• Necrosis
MAGNITUDE OF PROBLEM……….
Foot ulceration – Affects almost 20% of all diabetic patients
Limb amputation: Most feared consequence - 80% follow foot ulcer.
Associated risk factors
> age 50
Smoke
Hypertension
High cholesterol
Family history of heart attack, or stroke
What is my first line of treatment?
PREVENTION
Daily inspection by patient – cheapest + most effective + easiest method
Soft leather or athletic foot wear
Patient education
Prophylactic skin and nail care
White cushion stockings – easy identification with weak eyes
Strict sugar control
Take home message
Prevention is better than cure
Most of the ischemic foot in diabetics can be treated
Must evaluate both for neuroathy and PVD in all patients with diabetes