Topographic distribution of peripheral arteriopathy in non-diabetics and type 2 diabetics

Peripheral arteriopathy (PA) in type 2 diabetics carries a worse prognosis compared to non-diabetics likely related to a more aggressive course of the macroangiopathy, presence of a prominent microangiopathy and worse results following revascularizations. In addition, the presence of Monckeberg's di sease in diabetics has an additional negative impact. Interestingly, PA in diabetics compared to non-diabetics is redistributed towards periphery invo lving predominantly the lower leg arteries. Based on the evidence we sugges t that diabetic PA represents a distinct form of a systemic vascular diseas e characterized by myointimal thickening of macro- and microvascular beds a ssociated with acceleration of the common variety atherosclerosis and in so me cases Monckeberg's media sclerosis. Despite the systemic involvement spe cific localizing factors determine the severity and clinical relevance of t he diabetic PA in individual vascular beds. In this paper some of the poten tial localizing factors for diabetic PA are presented and briefly discussed .