Combined Clinical and Pathologic Study of Diabetic and Nondiabetic Peripheral Arterial Disease

The results of a combined clinical and pathologic study of large and small arteries in ihe diabetic and nondiabetic patient show that the diabetic has the same incidence of occlusion in the femoral-popliteal system but a higher incidence below the knee. A specific lesion of small arteries and arterioles which distinguishes the diabetic from the nondiabetic was not observed in this study. The results of this investigation provide no support for the concept that a specific disease of small arteries and arterioles in diabetic patients contributes to the ischemic process. We believe the ischemic lesions found in the diabetic patient can adequately be explained on the basis of arteriosclerotic obstruction of the major arteries, and those ulcers occurring in the absence of major artery disease are attributable to peripheral neuropathy.