Vascular and Microvascular Disease of the Foot in Diabetes

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Abstract
PROBLEMS of the foot in patients with diabetes mellitus are often ascribed to "small-vessel disease." In particular, there is a widespread misconception that patients with diabetes mellitus have arteriolar occlusive disease, which can cause ischemic lesions even in the presence of normal pedal pulses. This view often leads to inappropriate care of the patient and a hopeless attitude on the part of the physician.The prevailing view regarding the presence of microvascular occlusive disease probably originated in an early study by Goldenberg et al.1 Specimens obtained by amputation from patients with and without diabetes were studied retrospectively with light microscopy. . . .