November is Diabetes Awareness Month, an important time to focus on how this chronic disease impacts millions of Americans daily. Diabetes affects how the body uses glucose (sugar) for energy. This condition doesn’t just affect blood sugar but can also have widespread effects throughout the body, including the vascular system.
“Because diabetes raises blood sugar and causes insulin resistance, it causes injury to the lining of blood vessels,” said Dr. Jordan Knepper, vascular surgeon and medical director at MSU Health Care Heart and Vascular Center, who performs procedures at McLaren Greater Lansing. “The damage accelerates plaque buildup in the arteries and stiffens small vessels, driving inflammation. This can narrow and block arteries faster and at younger ages, causing small problems to snowball into bigger ones, such as infections and limb-threatening wounds.”
Some of the most common vascular conditions associated with diabetes are peripheral artery disease (PAD), which is a narrowing in leg arteries, causing pain with walking; foot ulcers and infections; and microvascular disease — damage to tiny vessels in the eyes, kidneys, and nerves that compounds wound-healing challenges.
“Controlling your blood glucose and managing your diabetes is essential in reducing your chances of developing serious complications,” said Dr. Knepper. “A good way to remember what to do is the ABCDE + Feet framework.”
- A1C; aim for individualized glucose controls (often around 7%).
- Blood pressure under 130/80 mmHg for most people.
- Cholesterol control or statin therapy if needed.
- Don’t smoke or vape.
- Exercise and eat well. Regular walking (goal – 150 minutes/week) and a heart-healthy, lower-refined-carb diet.
- Feet; daily inspection (top, bottom, and between toes). Wear well-fitted shoes and seek prompt care for any sores.
Dr. Knepper advises keeping close tabs on your body. Any changes or symptoms should be discussed with your doctor immediately. Some red flags that could be vascular conditions include leg pain near the calf, thigh, and buttocks with walking that improves with rest; cold feet, color changes in the legs or feet; shiny skin or hair loss in the legs; non-healing cuts, ulcers, or blackened tissue on toes. For feet, any kind of blisters, calluses, or drainage you didn’t feel happen; or welling redness; or foul odor that should be checked out immediately.
“If you had a previous heart attack or stroke, have kidney disease or known neuropathy, you should also be seen by a vascular surgeon for a screening, even if you don’t have any symptoms, to rule out any other conditions,” said Dr. Knepper.
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