Diabetic Neuropathy vs. Peripheral Artery Disease: Understanding the Difference

It’s peripheral artery disease (PAD) awareness month, serving as a reminder of the importance of your vascular health. Among the various conditions affecting the peripheral arteries, PAD is often confused with diabetic neuropathy due to overlapping symptoms. 

Our team at New England Institute for Neurology and Headache is here to help you understand the distinctions between these two conditions, so you can know more about their effective management and treatment.

Understanding PAD

Peripheral artery disease is a common circulatory problem wherein narrowed arteries reduce blood flow to the limbs, most commonly the legs. This reduced blood flow can cause leg pain when walking (claudication), numbness, and other complications. 

PAD is primarily caused by atherosclerosis, where fatty deposits build up on artery walls, reducing blood flow.

Key symptoms of PAD include:

• Claudication: painful cramping in the hips, thighs, or calves after activities such as walking or climbing stairs
• Numbness or weakness: reduced blood flow can cause legs to feel numb or weak
• Coldness in the lower leg or foot: particularly when compared with the other leg
• Sores on toes, feet, or legs: non- or slow-healing wounds 
• Change in leg color: a noticeable difference in color between legs
• Hair loss or slower hair growth: reduced circulation can affect hair growth on legs and feet

PAD is a serious condition that can lead to limb amputation if untreated. It also increases the risk of heart attack and stroke.

Understanding diabetic neuropathy

Diabetic neuropathy is a type of nerve damage that can occur in individuals with diabetes. High blood sugar levels can injure nerves throughout the body, but diabetic neuropathy most often damages nerves in the legs and feet.

Key symptoms of diabetic neuropathy include:

• Pain and numbness: often starting in the toes or feet and gradually spreading upward
• Burning or tingling: a persistent burning sensation or tingling feeling
• Muscle weakness: reduced muscle strength, particularly in the lower extremities
• Loss of coordination: difficulty with balance and coordination due to nerve damage
• Ulcers and infections: nerve damage can result in unnoticed injuries, leading to ulcers and infections

Unlike PAD, diabetic neuropathy is directly related to blood sugar control. If you’re a diabetic, you need to manage your blood sugar levels to prevent and slow the progression of neuropathy.

How to distinguish between PAD and diabetic neuropathy

Although both PAD and diabetic neuropathy affect the legs and feet and share symptoms like pain, numbness, and ulcers, the underlying causes and treatments differ significantly. Here’s how:

Cause

PAD is primarily caused by atherosclerosis, but diabetic neuropathy is due to prolonged high blood sugar levels

Symptoms

PAD symptoms are more related to blood flow issues, such as claudication and coldness in the limbs, whereas diabetic neuropathy involves nerve-related symptoms like burning, tingling, and muscle weakness.

Diagnosis

PAD can be diagnosed through tests like the ankle-brachial index (ABI), which measures blood flow, whereas diabetic neuropathy is diagnosed through neurological exams and assessments of blood sugar control.

Treatment

PAD treatment focuses on improving blood flow through lifestyle changes, medications, or surgery. Diabetic neuropathy treatment emphasizes blood sugar management, pain relief, and protecting the feet from injury.

Understanding the differences between PAD and diabetic neuropathy is essential for appropriate treatment and management. During PAD awareness month, we’ll continue to share education about these conditions to ensure better vascular and neurological health.

If you have concerns about diabetic neuropathy or peripheral artery disease, don’t hesitate to reach out to our team in Stamford, Connecticut. We’re happy to help and answer any questions!