How does diabetes affect claudication?

Can you please tell us how diabetes affects claudication? Certainly, so diabetes is a risk factor for peripheral vascular disease, that's for sure. But interestingly, claudication in diabetes can often be masked by the effect of diabetes on the nerves. So the nerves applied to the leg and your ability to feel pain in your leg is also significantly affected by diabetes, what we call neuropathy, and neuropathy can cause pain, so painful neuropathy, and it can also cause numbness, the lack of feeling from the foot and from the leg. So it is very possible that you have peripheral vascular disease with diabetes, but you're not getting the typical claudication symptoms that another person would have they not have diabetes. In particular with diabetes it's important to be vigilant with regards to whether you're developing peripheral vascular disease because a we should do everything we can to prevent any tissue damage or trauma to the tissue of your foot to prevent ulceration but also it's really important to modify your risk factors for cardiovascular disease generally if you do have peripheral vascular disease in diabetes to improve your overall long-term outcome.