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B Dharani: What Is the N1 Modifiable Cause of PAD in People With Diabetes?
B Dharani/LinkedIn
Dec 26, 2025, 04:59

B Dharani: What Is the N1 Modifiable Cause of PAD in People With Diabetes?

B Dharani, Diabetologist/ General Physician at Dharani Clinic, shared on LinkedIn:

”What Is the N1 Modifiable Cause of PAD in People With Diabetes?

Smoking.

Peripheral arterial disease (PAD) is a major driver of disability, limb loss, and mortality in people with diabetes.

While several factors contribute, smoking remains the most common and powerful modifiable risk factor.

In individuals with diabetes, smoking:

– Accelerates atherosclerosis

– Causes severe endothelial dysfunction

– Increases inflammation and thrombosis

– Further reduces blood flow to already compromised limbs

The combination of diabetes plus smoking leads to:

– Earlier onset of PAD

– Faster disease progression

– Higher risk of ulcers, critical limb ischemia, and amputations

Yes—glycemic control, blood pressure, and lipids are crucial.

But no single modifiable factor worsens PAD outcomes more consistently than smoking.

Key takeaway:
If we aim to prevent PAD progression and limb loss in diabetes, smoking cessation must be prioritized, not treated as an afterthought.

Sometimes, the most effective intervention isn’t a new drug or device—it’s addressing the risk factor doing the most harm.”

B Dharani: What Is the N1 Modifiable Cause of PAD in People With Diabetes?

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