Introduction Diabetes is considered worldwide as a major health issue, with devastating consequences on morbidity, mortality, and quality of life.1 Diabetes is responsible for vascular damage and atherosclerosis, with progressive and systemic complications.2 Peripheral artery disease (PAD) is a macrovascular complication of diabetes related to an increase of the risk of cardiovascular events.3 Moreover, PAD represents a main determinant of the onset and the prognosis of diabetic foot ulcer, as well as a main cause of lower-extremity amputation in people with diabetes.4,5 In 2010, PAD prevalence involved more than 200 million people globally, of whom 20% were affected by diabetes.6 The occurrence of PAD in individuals with diabetes shows peculiar features; particularly, it appears earlier, with diffuse and distal location of the atherosclerotic lesions. Clinical manifestations of PAD in individuals with diabetes may be extremely different because of the concomitant presence of diabetic neuropathy, which may determine the lack of symptoms or atypical presentation.7 Therefore, diagnosis and follow-up may be challenging.