Peripheral Artery Disease and Diabetes

Medically Reviewed by Michael Dansinger, MD on April 09, 2022
3 min read

Peripheral artery disease is when a sticky plaque made of cholesterol and fats builds up on artery walls. “Peripheral” means it forms in blood vessels outside the area of your heart or brain -- closer to your arms and legs. But it can also be in your feet, neck, hands, and 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.

Diabetes is a disease that causes too much sugar in your blood, which, over time, can damage your heart and blood vessels (cardiovascular disease), nerves (neuropathy), kidneys, and other organs.

PAD raises your risk for diabetes, and diabetes raises your risk for PAD. Even certain symptoms of each disease raise your risk for the other. Some of these symptoms 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.

About 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 also can worsen symptoms and bring them on more quickly. 

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:

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.