Peripheral vascular disease and Type 2 diabetes mellitus

Patients with Type 2 diabetes mellitus frequently have peripheral vascular disease, with a predilection for the lower legs. In this review potential m echanisms for this high prevalence and altered distribution are explored. I t is hypothesised that the metabolic abnormalities in the prediabetic phase predispose to a more distal and aggressive atherosclerosis. Once diabetes has developed this process is accelerated due to chronic hyperglycaemia. Fu rthermore, endothelial damage, non-enzymatic glycosylation and polyneuropat hy could lead to impaired vascular remodelling and collateral formation. Co pyright (C) 2000 John Wiley & Sons, Ltd.