One check can save a limb, or your life

Vascular surgeon says diabetics should be sure to get this annual exam

November 30, 2021

Patients with diabetes are at significantly higher risk for vascular diseases, which—if left untreated—can lead to devastating consequences like blindness, amputation and even death.

Diabetes itself affects the blood vessels, which can lead to peripheral artery disease. Patients with type 2 diabetes often have other risk factors as well that impact vascular health, like high cholesterol, obesity and a history of smoking.

“Diabetes affects so many different parts of the body,” says Patricia Furey, MD, FACS, MBA, Chief of Vascular Surgery at CMC’s New England Heart & Vascular Institute. “It affects blood vessels in the heart, the eyes, and especially the lower extremities. It also causes something called neuropathy, or loss of sensation in the feet. When that happens, a person doesn’t get alerted to potential problems.”

Major warning signs of vascular disease include pain or itching in the legs and feet, while walking or at rest. Not only can patients with diabetes miss these symptoms because of decreased sensation in their legs and feet, they’re also more prone to foot injury and wounds.

“Wounds that go unnoticed and don’t heal can become infected. Severe wounds, as well as advanced vascular disease, could require surgery or amputation,” says Dr. Furey. “This is why it’s so important for diabetics to get good foot care. Patients with diabetes need to keep their feet clean, wear good socks and footwear, and be sure to get a diabetic foot exam every year.”

A diabetic foot exam will detect wounds and can help determine if a patient is showing signs of vascular disease. A patient’s primary care provider, their endocrinologist, or a wound specialist can do this exam.

Studies have shown that about 30-percent of diabetics and more than 80-percent of those who had a diabetes-related amputation have neuropathy. “If we can work with patients with neuropathy before they have wounds, there’s a much lower risk of amputation,” says Dr. Furey.

In addition, diabetics should have their eyes checked regularly. “The effect of diabetes on vision is profound,” says Dr. Furey. “Problems with the blood vessels in the eyes can lead to retinopathy, causing floaters, blurred vision, or blindness.”

The good news, says Dr. Furey, is that all of these diabetes-related complications are avoidable. Lifestyle changes can prevent many of them and, if caught early enough, some can be managed with medications. “But patients have to get in to see their doctors, so we’re asking patients with diabetes to commit to being seen on a regular basis.”