Abstract
Diabetes mellitus is an important risk factor for the development of cardiovascular diseases. Peripheral arterial disease affecting lower limb arteries is one of the clinical manifestations of atherosclerosis. The frailty syndrome (Frailty) is a problem associated with diminution of physiological reserves. The ankle-brachial index is a commonly used tool for diagnosing peripheral arterial disease (PAD). The usefulness of the ankle-brachial index (ABI) is limited in people with diabetes because of calcification of the middle layer of arteries. In this population, toe-brachial index should be measured. Frailty may be associated with worse prognosis for patients undergoing revascularization. Amputation may be an important factor leading to the development of Frailty. The risk of amputation and the prognosis after revascularization may be modified by some medications and blood glucose levels. The purpose of this paper is to review the literature about the association between PAD, especially in patients living with diabetes and Frailty.
Highlights
The increasing prevalence of type 2 diabetes mellitus is one of the most important problems for public health worldwide, especially in developed countries
Maddaloni et al presented an interesting commentary elucidating the crucial role of taking into consideration the presence of features of frailty syndrome (Frailty) in patients living with type 2 diabetes in therapeutic strategy
They noted that clinical trials for frail patients living with diabetes and the preparation of a specific scale for the assessment of Frailty in patients living with diabetes are needed [33]
Summary
The increasing prevalence of type 2 diabetes mellitus is one of the most important problems for public health worldwide, especially in developed countries. As a result of atherosclerosis, to which diabetes predisposes, ischemic heart disease, stenosis of the carotid and vertebral arteries, chronic ischemia of the lower limbs, chronic intestinal ischemia, or narrowing of the renal arteries may develop, among others [9]. Chronic lower extremity ischemia is a manifestation of peripheral arterial disease (PAD) affecting arteries responsible for blood supply of lower limb. It may result from stenosis (narrowing) or occlusion (complete blockage) of vascular lumen [10]. We described how Frailty in patients with chronic lower limb ischemia affects the prognosis and the effectiveness of treatment
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