A recent study in the Journal of Vascular Surgery has found that patients who went to the hospital with lower extremity lesions were more likely to end up with a possibly preventable amputation if they had both diabetes and peripheral artery disease (PAD), compared to patients who only had one of these disorders. While this finding should be of note to any patients affected by either of these diseases it, unfortunately, is of particular significance to the African American community. One in four older African Americans has diabetes, and African Americans are twice as likely as non-Hispanic whites to have peripheral artery disease.
High blood pressure is also thought to contribute to an elevated risk of amputations—it is both a risk factor for PAD and more common in African Americans. According to a 2013 report from the American Heart Association, 43% of African American men and 47% of African American women had high blood pressure, compared to 33% of non-Hispanic white men and 31% of non-Hispanic white women. This does not mean that amputations or other complications of PAD and diabetes are inevitable for African Americans, however. It only means that greater awareness is needed to prevent them.
How Do PAD and Diabetes Lead to Amputations?
Diabetes and peripheral artery disease are a dangerous combination because together, they make it more likely that a patient will sustain injuries to their feet and legs that fail to heal properly, leading to infection. Neuropathy, which causes numbness, tingling, or pain in the legs and feet, is a common side effect of diabetes. Cuts, scrapes, and other minor wounds can go unnoticed because the patient literally doesn’t feel them, leaving them open for bacteria to enter. Poor control of blood sugar levels also slows healing and contributes to poor circulation.
PAD makes this situation even worse by clogging blood vessels and restricting blood flow to the extremities. Without sufficient blood flow and oxygen reaching the wounds, healing cannot take place. Amputation may be the only option when an untreatable infection threatens to turn to gangrene or sepsis. The key to avoiding this outcome is prevention.
Contributing Risk Factors
It makes sense that patients with both diabetes and PAD face an increased risk of complications that could potentially lead to amputation. But is there any reason to think African Americans might face an additional reason for susceptibility? Experts suggest that behavior, rather than any inherent cause, is a likely factor. Studies have shown that African Americans don’t go to the doctor as often, which means that the often-subtle early signs of PAD may go undiscussed with their medical provider. When PAD goes undetected until serious complications arise, the outcomes tend to be worse.
Early detection, diligent monitoring, and lifestyle changes can all help reduce the chances that an emerging case of PAD will progress to the point of causing severe complications. Therefore, if you are experiencing any symptoms that could signal PAD, such as leg pain brought on by activity, you should talk to your doctor right away. This is especially true if you have already been diagnosed with diabetes. Noninvasive tests can determine if you have PAD, which will allow you to seek the specialized care you need to remain healthy and active.
Whether you know you have PAD or only suspect you do, the Vein & Fibroid Treatment Center can help. We start with a thorough examination using advanced diagnostic techniques to identify any circulatory problems. Then we create an individualized treatment plan encompassing lifestyle recommendations, medication, and other interventions as needed to slow the progression of the disease and maintain a good quality of life. For patients already suffering from blocked blood vessels and reduced blood flow, we’ve successfully intervened with minimally invasive treatments that restore circulation without the necessity of a hospital stay. To learn more about peripheral artery disease and your risk factors for developing it, or to book an appointment, contact us here.