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Source: The Associated Press, January 22, 2004
Author: Lauran Neergaard
        
There’s grim news on the diabetes front: Nearly two-thirds of diabetics aren’t properly controlling their blood sugar. And one in three older diabetics likely also has a serious leg disease that could cost their limb – or their life.

This year, specialists for the first time are urging every diabetic over age 50 to get tested for the leg disease, called peripheral arterial disease or PAD.

Testing is simple – just check blood pressure in the ankle. If it’s significantly lower than blood pressure in the arm, PAD may be narrowing leg arteries and slowly choking off blood flow.

Severe PAD can lead to amputation. Worse, if your leg arteries are clogged and stiff, your heart arteries are too. Having PAD quadruples your risk of a heart attack or stroke, important to know so you can seek protective treatment.

Anybody can get PAD. At least 12 million Americans are thought to have it, most of them undiagnosed. But diabetes damages the blood vessels in ways that make patients especially susceptible to cardiovascular disease, meaning diabetics are most at risk, concludes an expert panel brought together by the American Diabetes Association.

Studies suggest one in three diabetics over age 50 may have PAD. So the diabetes association panel wants all diabetics that age to get screened for PAD. If results are normal, get rechecked every five years, say the recommendations, published last month in the journal Diabetes Care.

“This is news to a lot of people, even within the diabetes community, that this is really a very prevalent condition that to this point has been under-addressed,” says Dr. Peter Sheehan, director of the Diabetes Foot & Ankle Center at New York University School of Medicine, who authored the testing recommendations.

Consider testing younger diabetics if they have other risk factors for PAD: smoking, high blood pressure, high cholesterol, or they’ve had diabetes for more than a decade, the recommendations say.

Anyone with symptoms of PAD – legs that hurt or tire easily while walking – should seek testing, too. But most PAD sufferers never report symptoms, plus diabetes causes nerve damage that can blunt those patients’ ability to feel the warning pains.