Fast Five Quiz: Type 2 Diabetes and Peripheral Artery Disease

Romesh Khardori, MD, PhD

Disclosures

February 22, 2023

According to the 2023 American Diabetes Association Standards of Medical Care, the initial evaluation for PAD should include an assessment of the pedal pulses as well as a history of leg fatigue, claudication, and rest pain relieved with dependency. Patients who exhibit signs and symptoms of PAD should be referred for further arterial studies.

Although ankle-brachial index testing is indicated in patients with symptoms or signs of PAD, results may be inaccurate in patients with T2D owing to noncompressible vessels. Toe systolic blood pressure < 30 mm Hg is more accurate and suggestive of PAD.

Skin perfusion pressure (≥ 40 mm Hg), toe pressure (≥ 30 mm Hg), and/or transcutaneous oxygen pressure (TcPO2 ≥ 25 mm Hg) are tests that should be performed in patients with a diabetic foot ulcer and PAD.

According to guidelines by the Society for Vascular Surgery and the American Podiatric Medical Association, all individuals with diabetes who are > 50 years of age should undergo screening via noninvasive arterial studies.

Learn more about the workup for PAD.

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