Peripheral Vascular Disease in Diabetes

  • Jennifer K. Svahn


Diabetes mellitus is a ubiquitous disease which affects millions of Americans, incurs significant comorbidities and costs billions annually in healthcare dollars. The morbidities associated with diabetes mellitus include a substantial increase in both small vessel (microvascular) and large vessel (macrovascular) disease. The macrovascular effects of diabetes, causing serious morbidity and mortality, are found in the coronary, cerebral (extra and intracranial) and peripheral vascular circulation. The focus of this chapter’s discussion will be on the lower extremity peripheral vascular complications of diabetes.


Peripheral Vascular Disease Limb Salvage Great Saphenous Vein Rest Pain Major Amputation 
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  1. 1.
    Goldenberg SG, Alex M, Joshi RA, Blumenthal HT. Nonatheromatous peripheral vascular disease of the lower extremity in diabetes mellitus. Diabetes 8: 261–73, 1959.PubMedGoogle Scholar
  2. 2.
    Strandness DE Jr, Priest RE, Gibbons GE. Combined clinical and pathologic study of diabetic and nondiabetic peripheral arterial disease. Diabetes 13: 366–72, 1964.PubMedGoogle Scholar
  3. 3.
    Conrad MC. Large and small artery occlusion in diabetics and nondiabetics with severe vascular disease. Circulation 36: 83–91, 1967.PubMedCrossRefGoogle Scholar
  4. 4.
    Bamer HB, Kaiser GC, Willman VL. Blood flow in the diabetic leg. Circulation 43: 391–4, 1971.CrossRefGoogle Scholar
  5. 5.
    Current therapy in vascular surgery. Ernst-Stanley, Ed, 3`a edition, 1995.Google Scholar
  6. 6.
    Cohen RA. Dysfunction of vascular endothelium in diabetes mellitus. Circulation 87: 67–76, 1993.Google Scholar
  7. 7.
    Parving HH, Viberti GC, Keen H, Christiansen JS, Lassen NA. Hemodynamic factors in the genesis of diabetic microangiopathy. Metabolism 32: 943–9, 1983.PubMedCrossRefGoogle Scholar
  8. 8.
    Flynn MD, Tooke JE. Aetiology of diabetic foot ulceration: a role for the microcirculation? Diabetes Med 8: 320–9, 1992.CrossRefGoogle Scholar
  9. 9.
    Rayman G, Williams SA, Spencer PD, et al. Impaired microvascularhyperaemic response to minor skin trauma in type 1 diabetes. Br Med J 292: 1295–8, 1986.CrossRefGoogle Scholar
  10. 10.
    Parkhouse N, LeQueen PM. Impaired neurogenic vascular response in patients with diabetes and neuropathic foot lesions. N Engl J Med 318: 1306–9, 1988.PubMedCrossRefGoogle Scholar
  11. 11.
    Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 288: 373–6, 1980.PubMedCrossRefGoogle Scholar
  12. 12.
    Palmer RM, Ferrige AG, Moncada S. Nitric oxide release accounts for the biologic activity of endothelium-derived relaxing factor. Nature 327: 524–6, 1987.PubMedCrossRefGoogle Scholar
  13. 13.
    Baron AD. The coupling of glucose metabolism and perfusion in humanskeletal muscle. The potential role of endothelium-derived nitric oxide. Diabetes 45: S105–9, 1996.PubMedCrossRefGoogle Scholar
  14. 14.
    Wolff SP, Dean RT. Glucose autoxidation and protein modification: the role of oxidative glycosylation in diabetes. Biochem J 245: 234–50, 1987.Google Scholar
  15. 15.
    Timimi FK, Ting HH, Haley EA, Roddy M, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. J Am Coll Cardiol 31: 552–7, 1998.PubMedCrossRefGoogle Scholar
  16. 16.
    Vascular Surgery: A comprehensive review. Wesley S. Moore, Ed., 5th ed., W.B. Saunders Co., Philadelphia, PA.Google Scholar
  17. 17.
    Vascular disease: a multi-specialty approach to diagnosis and management Darwin Eton, Fred Weaver, Ed. Landes Bioscience, 1998.Google Scholar
  18. 18.
    Akbari CM, LoGerfo FW. Diabetes and peripheral vascular disease. J Vasc Surg 30: 373–84, 1999.PubMedCrossRefGoogle Scholar
  19. 19.
    LoGerfo FW, Gibbons GW, Pomposelli FB, et al. Trends in the care of the diabetic foot. Arch Surg 127: 617–21, 1992.PubMedCrossRefGoogle Scholar
  20. 20.
    Vascular, Medicine: A textbook of vascular biology and diseases Loscalzo J, Creager MA, Dzau VJ, Eds; 2nd ed., Little, Brown, 1996.Google Scholar
  21. 21.
    Baker WH, String ST, Hayes AC, Turner D. Diagnosis of peripheral occlusive disease: comparison of clinical evaluation and noninvasive laboratory. Arch Surg 113 (11): 138–10, 1978.CrossRefGoogle Scholar
  22. 22.
    Akbari CM, Gibbons GW, Habershaw GM, et al. The effect of arterial reconstruction on the natural history of diabetic neuropathy. Arch Surg 132: 148–52, 1997.PubMedCrossRefGoogle Scholar
  23. 23.
    Gloviczki P, Bower TC, Toomey BJ, et al. Microscope-aided pedal bypass is an effective and low-risk operation to salvage the ischemic foot. Am J Surg 168 (2): 76–84, 1994.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 2004

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  • Jennifer K. Svahn

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