Vnitr Lek 2003, 49(12):911-915

[Diabetic peripheral arterial disease].

I Hofírek, B Vojtísek: I. interní kardio-angiologická klinika Lékarské fakulty MU a FN u sv. Anny, Brno.

Macrovascular impairment of peripheral arteries in diabetes mellitus corresponds with such an impairment in atherosclerosis. Furthermore, peripheral angiopathy, microangiopathy, and polyneuropathy resulting from microangiopathy develop in diabetes. Impairment of microcirculation worsens peripheral blood flow. Infection and insufficient trophism worsen state. A wide range of factors participate in development of vascular disease in diabetes with adverse influence both on veins and reactions coming under rheology, haemocoagulation, and immune reactions. In type II diabetes an average interval of arterial impairment is 9-10 years, in type I diabetes approximately 17-22 years. A relative risk of non-traumatic amputation of a lower limb in diabetics is several times higher than in non-diabetics. A prevention of lower limbs impairment in diabetics is the most efficient method of reducing risk of amputation. An intervention therapy, endovascular intervention or angiosurgery are indicated in patients with clinical problems. A state of distal bed is an important factor for success of interventions. As a pivotal drug treatment in intervention and traditional methods is considered an effective antiaggregation treatment. A diabetic peripheral arterial disease is a complex disease requiring a wide view and considering various and changing pathophysiological mechanisms.