Prevalence of peripheral artery disease in diabetic patients of a tertiary care hospital

Sangeetha Meena, Manikandan R. C.


Background: Peripheral Arterial disease (PAD) is a major microvascular complication of diabetic mellitus. Patients with diabetes have an increased prevalence of PAD. The Ankle branchial Index (ABI) is an easy, noninvasive and often underutilized tool for diagnosis of PAD. The aim of this study is to detect the prevalence of PAD in diabetic patients using Ankle Brachial Index (ABI). Since most of the patients with PAD are asymptomatic, routine screening for the same is necessary to avoid lower limb ulcerations and amputation.

Methods: In this cross-sectional study, 200 diabetic patients attending a tertiary care hospital in the Kancheepuram district of Tamilnadu were screened for the prevalence of PAD using ABI and to find out risk factors associated with it.

Results: Among the 200 diabetic patients who underwent ABI measurements using handheld Doppler, 19.5% were found to be having PAD. Most of them were symptomatic. Age more than 50 years and female gender were considered as statistically significant (P<0.05) determinants of PAD.

Conclusions: PAD is relatively common in elderly diabetics. ABI measurement is a valid tool in early detection of PAD and therefore regular follow up will decrease disabilities in the diabetic population.


Ankle brachial index, Claudication symptom, Peripheral arterial disease, Peripheral Arterial disease patient

Full Text:



Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke. Circulation. 2007;115:478-534.

Agnelli G, Cimminiello C, Meneghetti G, Urbinati S. Polyvascular Atherothrombosis Observational Survey (PATHOS) Investigators. Low ankle-brachial index predicts an adverse 1-year outcome after acute coronary and cerebrovascular events. J Thromb Haemost. 2006;4:2599-606.

Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295:180-9.

Catalano M. Epidemiology of critical limb ischemia. Eur J Med. 1993;2:11-4.

Criqui MH, Denenberg JO, Langer RD, Fronek A. The epidemiology of peripheral arterial disease: the importance of identifying the population at risk. Vasc Med. 1997;2:221-6.

European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for the management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis. 2008;25:457-507.

Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. Edinburgh Artery Study: prevalence of the asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1991;20:384-92.

Fowkes FG, Housley E, Riemersma RA, Macintyre CC, Cawood EH, Prescott RJ, et al. Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol. 1992;135:331-40.

Hooi JD, Stoffers HE, Kester AD, Rinkens PE, Kaiser V, van Ree JW, et al. Risk factors and cardiovascular diseases associated with the asymptomatic peripheral arterial occlusive disease. The Limburg PAOD Study. Peripheral Arterial Occlusive Disease. Scand J Prim Health Care. 1998;16:177-82.

Kennedy M, Solomon C, Manolio TA, Criqui MH, Newman AB, Polak JF, et al. Risk factors for declining ankle-brachial index in men and women 65 years or older: The Cardiovascular Health Study. Arch Intern Med. 2005;165:1896-902.

Khawaja FJ, Kullo IJ. Novel markers of peripheral arterial disease. Vasc Med. 2009;14:381-92.

Leng GC, Lee AJ, Fowkes FG, Lowe GD, Housley E. The relationship between cigarette smoking and cardiovascular risk factors in peripheral arterial disease compared with ischaemic heart disease. Eur Heart J. 1995;16:1542-8.

Leng GC, Lee AJ, Fowkes FG, Whiteman M, Dunbar J, Housley E et al. Incidence, natural history and cardiovascular events in symptomatic and asymptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1996;25:1172-81.

Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997;349:1269-76.

Price JF, Stewart MC, Douglas AF, Murray GD, Fowkes GF. Frequency of a low ankle-brachial index in the general population by age, sex, and deprivation: a cross-sectional survey of 28 980 men and women. Eur J Cardiovasc Prev Rehabil. 2008;15:370-5.