Periphere arterielle Verschlusskrankheit bei Diabetes mellitus

Zusammenfassung

Unter den klassischen Risikofaktoren der Atherosklerose spielt neben dem Nikotinkonsum der Diabetes mellitus (DM) eine besondere Rolle für die Pathophysiologie der peripheren arteriellen Verschlusskrankheit (pAVK), englisch Peripheral Artery Disease (PAD). Zur Abgrenzung einer pAVK der Arterien der unteren Extremitäten wurde im englischen Sprachraum zusätzlich der Begriff LEAD (Lower Extremity Arterial Disease) etabliert.

Morphologische Besonderheiten von Diabetikern mit pAVK erschweren die Diagnostik und führen zu einer schlechteren Prognose. Um die Entwicklung einer pAVK früh zu erkennen und adäquat behandeln zu können, wird in den aktuellen Leitlinien ein regelmäßiges Screening empfohlen. Die Sekundärprävention mit konsequenter Einstellung der Gefäßrisikofaktoren und Lifestylemaßnahmen wie Gehtraining und Selbstkontrolle der Haut der unteren Extremitäten ist bei diesem Patientenkollektiv besonders wichtig.

Abstract

Beyond classical risk factors nicotin abuse and diabetes are of special importance for the development of atherosclerosis in peripheral artery disease (PAD). In addition, the term “LEAD” characterizes lower extremity arterial disease. Due to specific anatomical aspects, diagnosis is often more difficult and prognosis poor when compared to non-diabetics. To diagnose PAD at an early stage, current guidelines recommend regular PAD screening of diabetic patients. Secondary prevention with consequent treatment and control of vascular risk factors as well as life style measures such as walking training and control of the skin of the lower extremities is of utmost importance in this group of patients.

Was ist wichtig?

• Diabetes ist einer der Hauptrisikofaktoren der peripheren arteriellen Verschlusskrankheit (pAVK), die Koinzidenz beinhaltet eine besonders schlechte Prognose.

• Es gibt morphologische Besonderheiten.

• Regelmäßiges Screening wird in beide Richtungen empfohlen.

• Eine konsequente Sekundärprävention ist entscheidend für die Prognose.

Schlüsselwörter

pAVK - Diabetes - Koinzidenz - periphere arterielle Verschlusskrankheit - PAD - diabetes - coincidence - peripheral arterial disease

Publication History

Received: 04 March 2024

Accepted: 07 May 2024

Article published online:
31 July 2024

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