The PAD screening debate heats up at ADA 2026. Experts clashed over whether all adults with diabetes should be screened for peripheral artery disease (PAD). One side says the evidence doesn't support routine screening of asymptomatic patients; the other argues that too many people are losing limbs because PAD goes undetected and untreated.
The PAD screening debate heats up at ADA 2026
At the American Diabetes Association's 2026 Scientific Sessions, two experts went head-to-head on a pressing question: should all adults with diabetes be routinely screened for peripheral artery disease (PAD)? The answer, it turns out, depends heavily on how you weigh the evidence — and the human cost of inaction.
On the "no" side, University of Michigan's Dr. Shihchen Kuo argued that no randomized trial has proven ABI screening improves limb or cardiovascular outcomes in asymptomatic patients, that ABI results can be misleading in people with diabetes due to arterial calcification, and that most CVD-prevention therapies already apply to all diabetic patients regardless of PAD status. Boston University's Dr. Naomi Hamburg pushed back, pointing out that many patients are misclassified as "asymptomatic" when their leg symptoms are dismissed as neuropathy, and that newer treatments — including semaglutide (STRIDE trial) and rivaroxaban + aspirin (COMPASS trial) — can meaningfully change outcomes once PAD is identified.
By the Numbers
Why it matters: With amputation rates rising and powerful new therapies available, the stakes of missing a PAD diagnosis in a diabetic patient have never been higher. Clinicians may need to lower their threshold for PAD testing — especially when patients report any leg symptoms.
