Diabetes & peripheral arterial disease and their increasing stress on the public health system

The prevalence of Diabetes Mellitus is on the rise in the United States. Today there are 18.8 million children and adults diagnosed in the United States suffering from diabetes and another 7.0 million undiagnosed. This is a staggering 8.3% of the population. Associated with this dramatic increase is also the cost associated with treatment of the disease and its complications. As a consequence of this dramatic increase in the prevalence of diabetes there has also been an associated increase in microvascular and macrovascular complications such as Peripheral Arterial Disease (PAD). PAD is characterized by narrowing and blockade of peripheral arteries and associated with an increased risk of death and ischemic events. The risk of diabetic patients to experience complications associated with PAD is increased fourfold when compared to the non-diabetic population. This has led to an increased incidence of vascular complications affecting the lower limb such as chronic foot ulcers which are an important risk factor for lower-extremity amputation. The early diagnosis of PAD in diabetic patients is necessary to reduce the high incidence of amputations as well as minimize the risk of cardiovascular morbidity and mortality. In 2007, the cost of diabetes in the Unites States was $174 billion. Aggressive management, along with early and proper diagnosis of diabetes within the public health system can minimize the long-term complications of PAD and necessarily reduce the costs associated with diabetes management and care.