DIABETES-ASSOCIATED PERIPHERAL ARTERY DISEASE: PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT

Diabetes mellitus-associated peripheral artery disease (PAD) is a severe complication driven by hyperglycemia-induced vascular damage. This overview covers its pathophysiology, diagnosis, and management based on recent guidelines. Peripheral artery disease (PAD) is one of the major cardiovascular diseases that afflicts a large population worldwide Peripheral arterial disease (PAD) represents a progressive manifestation of systemic atherosclerosis, affecting more than 200 million individuals worldwide and primarily occurring in older adults and those with a smoking history, or chronic kidney disease. Peripheral arterial disease (PAD) refers to partial or complete occlusion of the peripheral vessels of the upper and lower limbs. It usually occurs as part of systemic atherosclerosis in the coronary and cerebral arteries. "Diabetes mellitus in peripheral artery disease (PAD)” goes beyond being just a risk factor, acting as a major accelerator of disease, worsening severity, and dramatically increasing risks of amputation, cardiovascular events, and mortality through mechanisms like inflammation, endothelial dysfunction, and abnormal blood flow, requiring aggressive, multi-faceted management. It's a complex interaction where hyperglycemia and insulin resistance promote atherosclerosis and impair healing, making PAD more aggressive and harder to treat, often leading to silent progression or severe diabetic foot complications.