An older adult with Type 2 diabetes reports leg pain when walking that is relieved by rest. Which behavior indicates understanding of treatment to promote more effective arterial circulation?

• A. Completely stops cigarette/cigar smoking
• B. Walks more slowly around the home
• C. Sits with legs dependent to relieve pain
• D. Uses leg elevation at night

Answer: (A)

The key idea is that improving arterial circulation in peripheral artery disease hinges on removing factors that narrow or block vessels. Quitting smoking is the most impactful step, because nicotine causes acute vasoconstriction and smoking accelerates atherosclerosis, reduces oxygen delivery (carbon monoxide binds to hemoglobin), and increases platelet aggregation. When a person with diabetes stops smoking, arterial blood flow tends to improve over time, claudication symptoms often lessen, and the risk of progression decreases. This behavior directly targets the cause of reduced arterial circulation and shows understanding of how to promote better blood flow to the legs.

Walking more slowly around the home doesn’t address the underlying arterial block; while gradual activity can help with conditioning, it doesn’t modify the vascular disease as effectively as stopping smoking. Sitting with legs dependent and leg elevation at night are not beneficial for arterial circulation because elevation can reduce arterial pressure at the feet and worsen ischemia, and keeping legs dependent won’t improve arterial blood flow.