Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology.

Abstract

Peripheral artery disease (PAD) is prevalent among people with diabetes, and the combination is associated with high risk of cardiovascular events and adverse limb outcomes. Greater attention to this population is needed to mitigate the adverse consequences of this severe manifestation of atherosclerotic cardiovascular disease. Accordingly, the diagnosis and management of PAD in people with diabetes is an important public health concern, especially among vulnerable populations. Many people with diabetes do not experience typical symptoms of PAD, and PAD may go undetected at earlier stages in those with diabetes. The diagnosis is therefore often delayed until PAD is advanced to chronic limb-threatening ischemia. As a result, the rates of amputation are disproportionately high in this population. In addition, guideline-directed medical therapies for treatment of PAD in people with diabetes are underutilized. To address these concerns, this scientific statement provides an overview of current recommendations for screening, diagnosis, and management, including consensus recommendations that underscore evidence-based treatments. This scientific statement also outlines promising areas for future research, including use of electronic health records to support more timely diagnosis, optimal timing and methods for screening, and standardization of clinical trial endpoints.