Diabetics get their feet checked every time they see their doctor, but the fact is that everyone should do that, too. Your doctor should look for discoloration anywhere on your foot, unusual nail growth, and should also take your pulse in your foot.

What they are looking for are signs of peripheral artery disease (PAD), a narrowing of the arteries to your limbs. Most people have heard of coronary artery disease (CAD), which is caused by a narrowing of the major blood vessels to the heart. But PAD and CAD go hand-in-hand. If someone has CAD, they probably have PAD as well, and vice versa. It makes sense: if your arteries are narrowed in one part of your body, they’re probably narrowed in other parts as well.

One of the problems with PAD is that approximately half of people with this disease have no symptoms, especially at the early stages. Yes, their legs may hurt when they walk, but they are unlikely to think of it as anything other than normal aging. Often, however, it is PAD, and puts the person at greater risk of a cardiac event such as a heart attack or a stroke.


Not everyone with PAD has symptoms, but, if they do, these are the most common:

  • Cramping, fatigue, or a sense of “heaviness” in the lower body upon exertion. Though this usually occurs in the calves, it may also occur in one or both hips or thighs. This feeling is called claudication, and is the single most common symptom of PAD. The sensation sometimes goes away after a few minutes of rest, but not always.
  • A feeling of numbness in one or both legs
  • A feeling of weakness in one or both legs
  • Decreased temperature in one calf or foot, compared to the rest of the body or to the other calf or foot
  • Changed skin color in the legs, feet, or toes
  • Leg skin that appears “shiny”
  • Slower-than-normal toenail growth
  • Decreased hair growth on legs, feet, or toes
  • Sores or wounds on the leg, foot, or toe that heal very slowly, or don’t heal at all
  • Dead tissue, also known as gangrene

Risk Factors

Do the symptoms listed above bring diabetes to mind? It’s no coincidence. One of the greatest risk factors for PAD is diabetes, with more than 25% of diabetics suffering from PAD. The other greatest risk factor: smoking.

Other risk factors for PAD include:

  • Age over 65
  • Any age with:
    high cholesterol,
    high blood pressure,
    obesity, or
    history of smoking,
    family history of PAD


Complications from PAD put a person at risk of:

  • Critical limb ischemia. Decreased blood flow to the legs can cause chronic sores or infections. Left untreated, this can cause gangrene, and may even require amputation of the affected part of the leg.
  • Heart attack or If the blood vessels in your legs are narrowed, the blood vessels to your heart and brain are probably narrowed as well, increasing your risk of these events.


Most people with PAD can be treated with life changes, such as a monitored exercise program and weight control. They may also be put on a statin if they have high cholesterol. Of course, if they are diabetic, it is imperative that their blood sugar is under control.

Patients with advanced PAD may require a stent in the affected artery. Even if they undergo this procedure, they will need to change their lifestyle in order to prevent progression of the disease.

PAD is a serious condition, but with appropriate care, it can be stopped in its tracks.

Beacon of LIFE, in Oceanport, NJ, is a government-approved PACE program created to provide seniors, their family, caregivers and professional health care providers the flexibility to meet their health care needs while continuing to live in their community.

Beacon of LIFE maintains an interdisciplinary team of professionals who give each client the coordinated care they need. Our staff specialize in working with older people, and work with each client and their family to develop the most effective plan of care.

Our care and services allow people who would otherwise need to live in a nursing home to live where they want — in their own communities, in their own homes.

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