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Circulation Savvy
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It’s confirmed: New data show that chronically high blood sugar levels create the greatest threat to healthy peripheral circulation. This often manifests itself as PAD (peripheral arterial disease)—the obstruction of blood flow, usually in the lower legs, that is indicative of a wide range of cardiovascular risks and can trigger pain and cramps. Johns Hopkins researchers reported recently that those with the highest blood sugars over time were 53 to 64 percent more likely to have PAD than people who kept their glucose levels at lower healthy levels. “Our results suggest that poor blood sugar control, as indicated by elevated A1C levels in people with diabetes, is associated with an increased risk of PAD independently of other known risk factors,” says Liz Selvin, M.D., from Johns Hopkins Bloomberg School of Public Health in Baltimore.
PAD associated with diabetes leads to problems with the vessel walls, blood flow and coagulation, making blood clots extremely likely. That happens because when glucose levels are high, blood platelets (responsible for coagulation) take up more glucose and tend to clump more. It is for these reasons that diabetes is a unique risk factor for cardiovascular disease. But symptoms of PAD for those with diabetes may be elusive, making it harder for doctors to offer treatment in time to avoid serious repercussions. According to the American Diabetes Association consensus statement on peripheral arterial disease in people with diabetes published in the journal Clinical Diabetes, over 5 years, 20 percent of people diagnosed with PAD will sustain nonfatal heart attack or stroke, and 30 percent will die, largely from cardiovascular disease—and people with diabetes fare much worse than those with PAD alone. Prevention is essential: “Ultimately, our results suggest that efforts to improve glycemic control in persons with diabetes may substantially reduce the risk of PAD,” Dr. Selvin said.
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