Peripheral Artery Disease and Diabetes

Medically Reviewed by Michael Dansinger, MD on April 23, 2020

When you have diabetes, you automatically have a higher risk of also having heart and blood vessel problems. One of these conditions is peripheral artery disease (PAD).

PAD causes blocked arteries in places outside your brain and heart. PAD usually blocks arteries in your:

  • Legs
  • Feet
  • Arms
  • Neck
  • Belly

When these arteries narrow, it can slow down or stop blood flow to these parts of your body. You may feel no symptoms at all, or you may have pain in the affected areas. PAD raises your risk of having a heart attack or stroke.

Around 20%-30% of people diagnosed with PAD also have diabetes. The real number may be even higher because some people don’t have symptoms. Diabetes not only raises your risk of getting PAD, it can make PAD get worse more quickly. It can also make the symptoms of PAD worse.

Some things that make it more likely you'll get PAD are out of your control. These include:

  • Age (Your risk jumps from 20% at age 40 to 29% at age 50)
  • How long you’ve had diabetes
  • Nerve damage
  • Race (Hispanic and African American people with diabetes are at higher risk than white people)
  • Family history of PAD or heart disease

But you do have some control over other things that can raise your chances for PAD. These include:

PAD and Diabetes in Your Body

Some of the things that cause PAD are related to the way diabetes works in your body. Doctors think this is why people with diabetes are at higher risk of getting PAD. These include:

  • Inflammation. The levels of certain proteins go up in your body when you have inflammation. These proteins are higher both when you have PAD and when you have diabetes.
  • Cell changes. Diabetes affects the lining around cells in your blood vessels. This means your blood vessels aren't as flexible as they need to be to help blood flow smoothly. That makes your risk of PAD go up.
  • Blood clotting. When you have diabetes, your blood platelets (disk-shaped cells that help with clotting) clump together more often. This speeds up the process that can cause PAD.
  • Insulin resistance. Diabetes means your body doesn't respond the right way to insulin. That throws off the balance of chemicals and other substances coming in and out of the cells that line your blood vessels. These cells can’t work as well as they should, which increases your chances of PAD.

Lower Your Risk

Steps you take to protect yourself from PAD are similar to those that help your overall heart health. They include:

  • Keep your blood sugar under control. Your goal should be an HbA1c under 7%.
  • Quit smoking. Find a system that works for you to kick the habit.
  • Lower your blood pressure and cholesterol. Ask your doctor if you need medicine to control your blood pressure and cholesterol. Diet and exercise can help, too.
  • Ask about aspirin. Your doctor may tell you to take aspirin to help keep your blood flowing well.
  • Get regular exercise. Physical activity boosts your overall heart health. Find a workout that works for you and get moving for at least 3 days a week. If you haven't exercised before, talk to your doctor first.
WebMD Medical Reference



American Heart Association: "Peripheral Artery Disease and Diabetes."

Mayo Clinic: "Arteriosclerosis /atherosclerosis."

World Journal of Diabetes: "Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes."

Diabetes Care: "Peripheral Arterial Disease in People With Diabetes."

Harvard Medical School: "The importance of exercise when you have diabetes."

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