Diabetes and Risk of PVD-Causing Foot Ulcers

Posted: January 27, 2021 | Revised: January 27, 2021

People with diabetes are prone to diseases of the nerves, such as foot ulcers. These often leave them unable to feel pressure points, fight off and heal from infections, and avoid peripheral vascular disease (PVD) — also called peripheral arterial disease (PAD). Infected ulcers can lead to amputation and arterial blockages, so it is important to have your feet evaluated by a podiatrist on a regular basis and to have a foot ulcer evaluated by a vascular surgeon. But first, you’ll need to know how to identify symptoms of PAD and foot ulcers as well as the treatments you can expect when seeking professional analysis.

Risks of Diabetic Foot Ulcers

While anyone with diabetes is vulnerable to a foot ulcer, there are key risk factors that increase the likelihood of this condition. Examples include footwear that does not fit or is of poor quality — as poor circulation hinders blood flow —  and feet that are not cleaned and maintained regularly — as dry skin leads to cracking, calluses, corns and bleeding wounds. Other risk factors range from alcohol, tobacco and obesity to diseases of the eyes, heart and kidneys. Obesity is one of the more obvious risks, since high glucose levels prevent recovery from infections.

Signs of a Foot Ulcer

A foot ulcer may cause drainage that stains your socks or shoes. This will be substituted by or accompany unusual swelling, irritation, redness and odors from one or both feet. While symptoms of foot ulcers are not always obvious, one of the more visible signs is black tissue that surrounds the ulcer, potentially leading to odorous discharge, pain and numbness. This indicates that the ulcer is infected, and you need medical treatment immediately.

Risks of Peripheral Arterial Disease

Every diabetic patient with an ulcer is vulnerable to PAD — the narrowing of arteries to the arms or legs that occurs when atherosclerotic plaque sticks to the lining of the arteries and blocks blood flow. Just like an untreated foot ulcer itself, this can result in nonhealing infections or wounds that lead to amputations, in addition to a heart attack.

Signs of PAD

Many people do not realize that PAD develops for up to two decades, possibly beginning without symptoms. If and when symptoms start, they may be pain or cramping in the calves, thighs, buttocks or arm muscles when exercising, as well as a burning ache in the feet during rest, fatigue of the legs or arms, numbness or tingling, difference in blood pressure from one arm to the other, and even impotence. If one of your symptoms is an ulcer, you’ll notice a shallow wound that is painful and takes a long time to heal or gradually gets worse.

Diagnosis and Treatment of PAD

When you schedule an appointment with a vascular surgeon to diagnose PAD, he or she will start with a thorough history and physical exam. That exam, coupled with your symptoms, may lead to further evaluation via relatively simple, noninvasive tests of blood pressure ratios, arterial pressure measurements and blood flow resistance of blockages. Detections of significant blockage may lead to invasive testing via an angiogram (medical imaging technique) for customized treatment plans.

From there, PAD is treated with an angioplasty, stenting or bypass surgery.


If you have a foot ulcer that has been diagnosed by a podiatrist, please turn to Vascular & Vein Center at Gulfcoast Surgeons for PAD testing and potential treatment as well as additional information — (239) 939-1767.