Decreased oxygenation of leg muscles due to peripheral vascular disease and the pain of diabetic neuropathy can also be mistaken for cramps.

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Most talked about is the risk of cardiovascular disease, which includes an increased risk of heart attack, stroke and peripheral vascular disease, as well as kidney disease and diabetic eye disease.

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With windchills approaching the single digits and below zero, it is possible to develop frostnip with progression to frostbite in exposed areas in as little as 20-30 minutes, especially in those patients with peripheral vascular disease, a history of smoking or diabetes.

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"If people come in and say my chest hurts, that gets attention, but if they say my leg hurts when I walk a couple of blocks, most doctors don't think that is a big deal, " says William Hiatt, professor of cardiovascular research at the University of Colorado School of Medicine and chairman of the American Heart Association's Peripheral Vascular Disease Council.

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