As diabetes affects every vascular bed in the body and increases the risk for accelerated atherogenesis-the formation of plaque build-up in the lining of the arteries, diabetics are especially susceptible to PAD. In real terms this means that 18.2 million Americans with diabetes are at risk of PAD.

Because atherosclerosis is a systemic disease, people with PAD are likely to have blocked arteries in other areas of their body. Over time, the plaque builds up in the arteries and blocks the smaller arteries first, such as in the legs. This causes decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation.

Eventually the larger arteries, such as those in the heart or the carotid artery to the brain, become blocked as well, so PAD in the legs is in fact an early warning for future life-threatening vascular disease.

If undetected, peripheral arterial disease can lead to amputation and increase a person's risk of having a heart attack and stroke. Apparently this progression of PAD results in death for about one-third of patients.

Due to the vascular damage caused by the progression of diabetes, more than 50 percent of diabetic PAD patients are asymptomatic and cannot feel the classic warning sign of PAD - intermittent claudication, or leg pain that occurs when walking or exercising and disappears when the person stops the activity.

This makes screening essential as one-third of diabetics have peripheral arterial disease. By the time they do notice they have a problem, they are often facing amputation, kidney damage, or stroke. That diabetics and their doctors need to get into the habit of an annual ABI test to look for PAD.

During the Legs For Life screening, an ankle brachial index (ABI) test is used to detect PAD. This quick, painless test compares the blood pressure in the legs to the blood pressure in the arms to determine how well the blood is flowing and whether further tests are needed.

Additionally during Legs For Life, interventional radiologists screen for related vascular diseases, including abdominal aortic aneurysm, and carotid artery disease that can lead to stroke.

Screening is recommended if you:-
· Have diabetes
· Have ever smoked or smoke now
· Are over age 50
· Have a family history of vascular disease, such as PAD, aneurysm, heart attack or stroke
· Have high cholesterol or a high lipid blood test
· Are overweight
· Have an inactive lifestyle
· Have a personal history of high blood pressure, heart disease, or other vascular disease
· Have cramping or tiredness in the muscle when walking or exercising, which is relieved by resting
· Have pain in the legs or feet that awakens you at night

PAD can often be treated with lifestyle changes, and sometimes stopping smoking, a structured exercise program, and medication are all that is needed to alleviate symptoms and prevent further progression of the disease.
Early detection could slow the progression of the disease, and avoid much less invasive treatment options, saving patients from amputation, says Dr. Wiener.

More information can be found at http://www.LegsForLife.org or http://www.SIRweb.org.