The effect of diabetes on lower extremity arteries is unique, and it differs from non-diabetic lower extremity atherosclerosis mainly in the following aspects: 1. Age of onset Normal endothelial cells are important in maintaining coagulation homeostasis. In addition to serving as a barrier to prevent thrombus formation and prevent vasoactive substances from contacting smooth muscle cells, endothelial cells also have secretory functions and antiplatelet aggregation, causing vascular diastole, systole, and anti-thrombotic formation. Diabetes impairs the function of endothelial cells on the intimal surface of arteries, triggering an inflammatory response and excessive release of free fatty acids and thrombosis. In the course of diabetes mellitus more than 10 years, age more than 60 years, the lower extremity atherosclerotic stenosis of diabetic patients often may appear, if again smoking, combined with hypertension, the age of its onset will be earlier; while non-diabetic lower extremity atherosclerotic stenosis often only after the age of 70 years. 2, clinical manifestations Diabetic patients often have combined neuropathy, and the appearance of neuropathy dulls the sensation of pain, and makes intermittent claudication more rare. Because pain is not obvious, such atherosclerosis may progress unnoticed for a long time, and when patients eventually develop symptoms, such as increased pain at night, or foot ulcers, it is usually an advanced manifestation of severe underlying arterial disease. The arteries of the lower extremities involved in diabetes are mainly the arteries below the knee joint. If you smoke and have hypertension in combination, the arteries above the knee joint will also be involved; the arterial lesions of the lower extremities in non-diabetic patients mainly involve the large arteries above the knee joint. 4, clinical routine examination The atherosclerosis of lower extremity arteries in diabetic patients is often combined with obvious calcification, so that even if the artery stenosis is very serious, the pulsation of dorsalis pedis artery and posterior tibial artery can often be detected, and the ankle brachial index (ABI) is often for 1 or 0, that is, false negative. Therefore, the lower extremity arterial lesions in diabetic patients are more likely to be missed by the examination of the dorsalis pedis and posterior tibial artery pulsations and the determination of ABI alone. In contrast, in non-diabetic patients with intermittent claudication, the dorsalis pedis artery and posterior tibial artery pulsations are often diminished, and ABI <0, 9. 5. Treatment For non-diabetic lower extremity atherosclerotic stenosis and occlusion very effective interventional treatment is balloon dilation and stent implantation; whereas in diabetic patients, because of their arterial endothelial dysfunction, 3-6 months after balloon dilation and stent implantation in stenosed and occluded arteries Because of the severe calcification, balloon dilation and conventional stent implantation are often not effective and often require plaque cutting or laser ablation devices, both of which are more expensive.