Diabetics with peripheral arterial disease: Get up and get walking

Walk in the Park

Diabetics, take heed – you must do two things to protect your legs and feet:

  1. Ask your doctor to conduct a simple test for peripheral arterial disease
  2. Get up and get walking

Under control

More than 12 million Americans may have peripheral arterial disease (PAD), according to a report from the American Diabetes Association.

PAD is a painful condition caused by reduced blood flow to the legs due to arteries that have been narrowed by damage associated with diabetes. In advanced cases, ulcers and gangrene develop. ADA scientists estimate that about one-third of all diabetics over the age of 50 suffer from PAD.

The good news: Most patients may find it fairly easy to control PAD symptoms.

Researchers at Chicago’s Northwestern University recruited more than 150 PAD patients and divided them into three groups. One group received supervised treadmill exercise, one group received lower extremity resistance training, and the third group served as a control group, following no set exercise regimen.

Before and after the six-month intervention period, each subject was tested for physical endurance, treadmill walking performance, and brachial artery flow-mediated dilation – a measure of artery function used to evaluate cardiovascular risk.

Results showed that subjects in the treadmill group generally showed greater improvements compared to the resistance training group and control group. Brachial artery flow-mediated dilation was improved, as well as walking performance and physical functioning.

BP x 2

Unfortunately, many general practitioners are uninformed about the PAD-diabetes connection, so they don’t include PAD testing as a standard of diabetic care.

If you’re diabetic, ask your doctor about the ankle-brachial index test. It’s simple: Blood pressure is checked at the ankle and compared to a blood pressure reading from the arm. PAD is indicated if the ankle BP is significantly lower than the arm BP.

The ADA recommends regular PAD testing for all diabetics over 50, as well as anyone who finds their legs hurting or tiring easily after walking. Although PAD occurs mostly among older diabetics, young diabetics should also be checked if they’ve had diabetes for more than a decade, and especially if they smoke or have high blood pressure.

In advanced cases of PAD, surgery is sometimes needed to bypass obstructed arteries. For milder cases, exercise is recommended. You can find more information about the benefits of walking exercise in the e-Alert “Special Delivery” (11/9/06).

“Treadmill Exercise and Resistance Training in Patients With Peripheral Arterial Disease With and Without Intermittent Claudication” Journal of the American Medical Association, Vol. 301, No. 2, 1/14/09, jama.ama-assn.org