PERIPHERAL ARTERIAL DISEASE AND DIABETES MELLITUS: ENDOCRINOLOGICAL TREATMENT AND CLINICAL COMPLICATIONS

Abstract

Introduction The combination of diabetes mellitus and peripheral arterial disease (PAD) represents a significant challenge for clinical practice due to the interrelated complications that both conditions cause. Diabetes mellitus contributes to the progression of atherosclerosis and aggravates PAD, resulting in impaired peripheral circulation and increased risk of ulcers, infections and amputations. Effective management of these conditions requires a multidimensional approach, including tight glycaemic control, targeted pharmacological treatment and prevention strategies for additional complications.ObjectiveThe aim of this systematic literature review was to compile and evaluate current evidence on the impact of endocrine treatment on peripheral arterial disease and associated complications in patients with diabetes mellitus. The review aimed to provide a comprehensive overview of best management practices and to identify gaps in existing knowledge. MethodologyThe systematic review followed the PRISMA checklist and used the PubMed, SciELO and Web of Science databases to search for articles. Five main descriptors were used: "Diabetes Mellitus", "Peripheral Arterial Disease", "Endocrinological Treatment", "Clinical Complications" and "Disease Management". Inclusion and exclusion criteria were applied to select relevant studies published in the last 10 years. The inclusion criteria were: clinical studies and systematic reviews, published in English, Portuguese or Spanish, and that addressed patients with diabetes mellitus and PAD. Non-empirical studies, such as editorials and conference abstracts, studies of low methodological quality and research focused on conditions not directly related to the two diseases were excluded. Results The results revealed that strict glycemic control and adequate pharmacological treatment are essential for the management of PAD in diabetic patients. Control of blood pressure and lipids was also identified as a crucial factor for the prevention of PAD progression. The review highlighted the importance of regular foot monitoring to prevent ulcers and infections, and highlighted the vital role of ongoing patient education and a multidisciplinary approach to treatment. Conclusion The systematic review confirmed that an integrated and coordinated approach is essential for the effective management of patients with diabetes mellitus and PAD. The combination of glycemic control, pharmacological treatment, blood pressure and lipid management, and ulcer prevention contributes to the reduction of complications and improvement in the quality of life of patients. Collaboration between different health professionals and patient education are key elements for successful treatment.