Type 2 Diabetes – Preventing Critical Limb Ischemia in Diabetics

Anyone who has been diagnosed with Type 2 diabetes is at risk for developing what is known as critical limb ischemia, a condition in which arteries supplying blood to the limbs form plaques inside their walls. When this happens not enough oxygen can reach the cells, and the cells develop ischemia, which can lead to cell death. Various medical people consider it an advanced form of peripheral artery disease (PAD), while others consider it a separate condition.

With enough dead cells in the limbs, the limbs are then subject to infection. The immune system is unable to fight infections effectively if blood flow is sluggish. Critical limb ischemia is not always diagnosed until serious problems such as gangrene, develop. Scientists at the Huazhong University of Science and Technology in Hubei, China, have found a molecule that could be used to diagnose critical limb ischemia before it progresses to a critical level. Their work was reported in September of 2017 by the journal Scientific Reports.

A molecule called Siglec-5 was found in cases where Type 2 diabetics had been diagnosed with ischemia. The molecule was seen in samples of plaque taken from the limbs of those with ischemia but not in the arteries of diabetic patients without plaque. The investigators concluded Siglec-5 levels could be used for the prevention of or treatment planning in critical limb ischemia.

In the United States, there are about 500 to 1000 cases of chronic limb ischemia diagnosed for every million people every year, with approximately 8 to 10 million cases existing at any one time. Worldwide statistics are unavailable.

The following can raise the risk of critical limb ischemia…

  • being aged over 60 or post menopausal,
  • being a smoker,
  • having Type 2 diabetes,
  • being overweight or obese,
  • leading a sedentary lifestyle,
  • having high cholesterol levels,
  • having high blood pressure readings,
  • a family history of blood vessel disease.

Anyone diagnosed with critical limb ischemia can have foot pain at rest. Muscle pain described as burning or cramping may be felt in the muscles and is relieved at rest. In more severe cases there can be ulceration or gangrene. The condition is diagnosed with a technique known as pulse volume recording or by ultrasound, a technique used to show blood flow, or lack thereof, throughout the legs and feet.

In mild cases, treatment can consist of…

  • controlling blood sugar levels,
  • taking medications to lower cholesterol levels,
  • reducing high blood pressure,
  • losing weight, and by
  • quitting smoking.

In other cases, angioplasty can be used. A tube with a small balloon may be inserted into the affected arteries. The balloon is inflated to aid in eliminating the plaque.

Surgery is another option. Jammed vessels may be replaced with artificial arteries.

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