Artériopathie diabétique des membres inférieurs

Lower limb arteriopathy is a common complication of diabetes mellitus, considered as an hallmark of macroangiopathy. In addition to hyperglycemia, smoking is a potent risk factor for the development of arteriopathy. In diabetic patients, clinical signs of the disease are not specific, but arteriopathy is rarely isolated and often combined with neuropathy and infection, leading to the aspect known as the “diabetic foot”. First-line non-invasive vascular investigations are always carried out, but lower limb arteriography is often required; this procedure should be cautiously used in diabetic patients. Therapeutic management requires at first assessment and treatment of infection. Then arterial restoration can be considered, using either percutaneous angioplasty or by-pass, but amputation can occur at any step. Anyway, this disease has to be managed by a trained multidisciplinary team to provide diabetic patients with the best prognosis in order to reduce the burden of arteriopathy.