DOI: http://dx.doi.org/10.18203/2349-3933.ijam20221025

Prevalence of peripheral arterial disease in type 2 diabetes mellitus and it’s correlation with carotid intima-media thickness

Sandeep S. Palawat, Vishal K. Gupta, Ajesh Chandra Gupta, Richa Giri

Abstract


Background: Peripheral arterial disease (PAD) is one of the major macrovascular complications of diabetes mellitus (DM) which is largely neglected by clinicians. DM-associated atherosclerosis can lead to complications in all major of vascular beds, including the coronary arteries, carotid vessels, and lower extremity arteries. Aims and objective were to study the prevalence of PAD in patients with type 2 DM and to study the correlation with carotid artery intima-media thickness

Methods: Hospital based cross-sectional study was conducted among the 124 patients admitted with type 2 diabetes (age >25 year) from Dec 2019 to Oct 2021 in the various units of department of medicine or surgery, KPS institute, GSVM medical college Kanpur. Color doppler of limbs and carotid artery was done in study population.

Results: In our study based on doppler ultrasound, the prevalence of PAD was found in 31 patients (25%) out of 124 with men having a higher prevalence (24 out of 74; 77.4%), as compared to women (7 out of 50; 22.6%) (p=0.020). The mean Carotid IMT (mm) (Average) was 0.82±0.16 in all diabetics. Patients with PAD have more increase in CIMT (0.95±0.12) as compare to non-PAD (0.77±0.15) p<0.001.

Conclusions: By using doppler, we found evidence of PAD in 25% of type 2 diabetics (M>>F). Patients with PAD have more increase in CIMT as compare to non-PAD.

 


Keywords


PAD, Type 2 DM, Carotid intima media thickness

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References


International Diabetes Federation (IDF), Annual report 2020.

World Health Organization: Definition, diagnosis and classification of DM and its complications. Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva: World Health Organization. 1999. Available at: https://apps.who.int/iris/handle/10665/66040. Accessed on 3 January 20222.

Tehan PE, Bray A, Chuter VH. Non-invasive vascular assessment in the foot with diabetes: sensitivity and specificity of the ankle brachial index, toe brachial index and continuous wave Doppler for detecting peripheral arterial disease. J Diabetes Complications. 2016;30(1):155-60.

Hong B, Leonards CO, Endres M, Siegerink B, Liman TG. Ankle-brachial index and recurrent stroke risk: meta-analysis. Stroke. 2016;47(2):317-22.

Cang Y, Li J, Li YM. Relationship of a low ankle-brachial index with all-cause mortality and cardiovascular mortality in Chinese patients with metabolic syndrome after a 6-year follow-up: a Chinese prospective cohort study. Internal Med. 2012;51(20):2847-56.

Price JF, Lee AJ, Fowkes FG. Hyperinsulinaemia: a risk factor for peripheral arterial disease in the non-diabetic general population. J Cardiovasc Risk. 1996;3:501-5.

Sobngwi E, Mauvais-Jarvis F, Vexiau P, Mbanya JC, Gautier JF. Diabetes in Africans. Diabetes Metabol (Paris). 2001;27:628-34.

Rizzo M, Pernice V, Frasheri A, Berneis K. Atherogenic lipoprotein phenotype and LDL size and subclasses in patients with peripheral arterial disease. Atherosclerosis. 2008;197:237-41.

Marinelli MR, Beach KW, Glass MJ. Non-Invasive testing vs clinical evaluation of arterial disease, a prospective study. JAMA. 1997;241:2031-4.

Agrawal RP, Ranka M, Beniwal R. Prevalence of micro and macro vascular complications in type 2 diabetes and their risk factors. Int J Diabetes Dev Ctries. 2004;24:11-6.

Premalatha G, Shanthirani S, Deepa R. Prevalence and risk factors of peripheral vascular disease in a selected South Indian population: the Chennai Urban Population Study (CUPS). Diabetes Care. 2000;23(9):1295-300.

Karamanou M, Protogerou A, Tsoucalas G, Androutsos G, Poulakou-Rebelakou E. Milestones in the history of diabetes mellitus: the main contributors. World J Diabetes. 2016;7:1-7.

Madhu SV, Kant S. Preclinical evaluation of atherosclerosis. Int J Diabetes Dev Ctries. 2006;26:105-11

Mohan V, Ravikumar R, Shanthi Rani S, Deepa R. Epidemiology of Cardiovascular Disease in Type 2 Diabetes: The Indian Scenario. Diabetologia. 2000;43(4):494-9.

Walter DP, Gatting W, Mullee MA. The prevalence of diabetics and non-diabetic subjects in an English community. Diab Med. 1992;9:710-5.

Janka HU, Standl E, and Mehnert H. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors screening with Doppler. Diabetes Care. 1980;3:207-13.

Mostaza JM, González-Juanatey JR, Castillo J, Lahoz C, Fernández-Villaverde JM, Maestro-Saavedra FJ. Prevalence of carotid stenosis and silent myocardial ischemia in asymptomatic subjects with a low ankle-brachial index. J Vasc Surg. 2009;49(1):104-8.

Allan PL, Mowbray PI, Lee AJ, Fowkes FG. Relationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study. Stroke. 1997;28(2):348-53.

Brohall G, Odén A, Fagerberg B. Carotid artery intima-media thickness in patients with Type 2 diabetes mellitus and impaired glucose tolerance: a systematic review. Diabet Med. 2006;23(6):609-16.