Prevalence of asymptomatic peripheral vascular disease in patients with type 2 diabetes by color Doppler study

Authors

  • Sanda Mallikarjuna Rao Assistant Professor, Department of General Medicine, Kamineni Academy of Medical Sciences and Research Centre, L.B. Nagar, Hyderabad, Telangana, India
  • Vemula Narendar Assistant Professor, Department of General Medicine, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20161454

Keywords:

Diabetes, Physical activity, Peripheral vascular disease

Abstract

Background:A diagnosis of peripheral vascular disease in patients with diabetes mandates a multifaceted treatment approach, involving aggressive risk factor modification, anti-platelet therapy and revascularization procedures. Objective of the study is to study the prevalence of asymptomatic Peripheral vascular disease in patients with type 2 diabetes mellitus by color Doppler study and to correlate it with risk factors and ischemic heart disease.

Methods: A total of 40 patients of type 2 diabetes mellitus patients attending outpatient department at Mamata General Hospital, Khammam during the period of August 2008 to August 2009 were selected randomly and a cross sectional analysis was done. The initial history was directed towards obtaining details regarding age/sex of the patient, symptoms/duration of type 2 diabetes, diet/treatment compliance, glycemic control based on HbA1c, presence of hypertension, habit of smoking, family history, symptoms suggestive of limb ischemia, past history of diabetic foot lesions, assessment of physical activity.

Results: The prevalence of asymptomatic peripheral vascular disease in type 2 diabetes mellitus was found to be 30%. Age more than 50 years, male sex, smoking, duration of type 2 diabetes mellitus more than 10 years, poor glycemic control (HbA1c > 8%), increased waist hip ratio, overweight and obesity (BMI > 25 kg/m2), increased waist circumference, increased serum cholesterol, increased serum LDL, increased serum Triglycerides, decreased serum HDL, hypertension, abnormal ECG, poor physical activity were found to be risk factors for peripheral vascular disease and they were statistically significant. But the factors like family history of diabetes, diet/treatment compliance were not found to be statistically significant.

Conclusions: Age more than 50 years, male sex, smoking, duration of type 2 diabetes mellitus more than 10 years, poor glycemic control (HbA1c > 8%), increased waist hip ratio, overweight and obesity (BMI > 25 kg/m2), increased waist circumference, increased serum cholesterol, increased serum LDL, increased serum Triglycerides, decreased serum HDL, hypertension, abnormal ECG, poor physical activity were found to be risk factors for peripheral vascular disease.

References

Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation. 1996;94:3026-49.

Dormandy JA, Rutherford RB. Management of peripheral arterial disease. TASC Working Group. J Vasc Surg. 2000;31:S1-296.

Pyorala K, Laakso M, Uusitupa M. Diabetes and atherosclerosis: an epidemiologic view. Diabetes Metab Rev. 1987;3:463-524.

Donahue RP, Orchard TJ. Diabetes mellitus and macrovascular complications. An epidemiological perspective. Diabetes Care. 1992;15:1141-55.

Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW. Peripheral vascular disease detection, awareness, and treatment in primary care. JAMA. 2001;286:1317-24.

Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral vascular disease in diabetic and non-diabetic patients: a comparison of severity and outcome. Diabetes Care. 2001;24:1433-7.

Criqui MH, Fronek A, Klauber MR, Connor EB, Gabriel S. The sensitivity, specificity and predictive value of traditional clinical evaluation of Peripheral vascular disease: results from non-invasive testing in a defined population. Circulation. 1985;71:516-22.

American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26:3333-41.

Mohler ER. Peripheral arterial disease: identification and implications. Arch Intern Med. 2003;163:2306-14.

Ness J, Aronow WS. Prevalence of co-existence of coronary artery disease, ischemic stroke and peripheral arterial disease in older persons mean age 80 years, in an academic hospital based geriatrics practice. J Am Geriatr Soc. 1999;47:1255-6.

Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis, epidemiology, pathophysiology and management. JAMA. 2002;287:2570-81.

Adler AI, Stevens RJ, Neil A, Stratton IM, Boulton AJ, Holman RR. Hyperglycemia and other potentially modifiable risk factors for peripheral vascular disease in type 2 diabetes. Diabetes Care 2002;25:894-9.

Beks PJ, Mackaay AJ, de Neeling JN, de Vries H, Bouter LM, Heine RJ. Peripheral arterial disease in relation to glycemic level in an elderly Caucasian population: the Hoorn study. Diabetologia. 1995;38:86-96.

Premalatha G, Shanthirani S, Deepa R, Markovitz J, Mohan V. Prevalence and risk factors of peripheral vascular disease in a selected South Indian population: the Chennai urban population study. Diabetes Care. 2000;23(9):1295-300.

Alcolado JC, Pacy PJ, Beevers M, Dodson PM. Risk factors for peripheral vascular disease in hypertensive subjects with type 2 diabetes mellitus. Diabet Med. 1992;9(10):904-7.

Al-Delaimy WK, Merchant AT, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men. Am J Med. 2004;116:236-40.

Katsilambros NL, Tsapogas PC, Arvanitis MP Tritos NA, Alexiou ZP, Rigas KL. Risk factors for lower extremity arterial disease in non-insulin dependent diabetic persons. Diabet Med. 1996;13(3):243-6.

Mohan V, Premlatha G, Sastry NG. Peripheral vascular disease in non-insulin dependent diabetes in south India. Diabetes Res Clin Pract. 1995;27(3):235-40.

Downloads

Published

2016-12-29

Issue

Section

Original Research Articles