Plasma concentrations of lipoproteins and risk of lower-limb peripheral artery disease in people with type 2 diabetes: the SURDIAGENE study

Background: The prevalence of diabetes mellitus and its associated complications such as peripheral artery disease is increasing worldwide. We aimed to explore the distinct impact of type 1 diabetes mellitus and type 2 diabetes mellitus on treatment and on short- and long-term outcome in patients with peripheral artery disease. Methods: Retrospective analysis of anonymized data of hospitalized patients covered by a large German health insurance. Assessment of patient’s characteristics (comorbidities, complications, etc.) and outcome using multivariable Cox regression and Kaplan–Meier curves. Results: Among 41,702 patients with peripheral artery disease, 339 (0.8%) had type 1 diabetes mellitus and 13,151 (31.5%) had type 2 diabetes mellitus. Patients with diabetes mellitus had more comorbidities and complications than patients without diabetes mellitus ( p < 0.001). Type 1 diabetes mellitus patients exhibited the highest risk for limb amputation at 4-year follow-up (44.6% vs 35.1%, p < 0.001), while type 2 diabetes mellitus patients had higher mortality than type 1 diabetes mellitus (43.6% vs 31.0%, p < 0.001). Conclusion: Although the fraction of type 1 diabetes mellitus among patients with peripheral artery disease and diabetes mellitus is low, it represents a subset of patients being at particular high risk for limb amputation. Research focused on elaborating the determinants of limb amputation and mortality in peripheral artery disease patients with diabetes mellitus is warranted to improve the poor prognosis of these patients.

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Abstract: P375 CLINICAL SIGNIFICANCE OF BRANCHIAL-ANKLE PULSE WAVE VELOCITY AS A MARKER OF PERIPHERAL ARTERY DISEASE IN PATIENTS WITH TYPE 2 DIABETES

Atherosclerosis Supplements ◽

10.1016/s1567-5688(09)70670-1 ◽

2009 ◽

Vol 10 (2) ◽

pp. e685

Author(s):

M Iiyama ◽

Y Go ◽

H Kitaoka

Keyword(s):

Type 2 Diabetes ◽

Pulse Wave Velocity ◽

Clinical Significance ◽

Wave Velocity ◽

Peripheral Artery Disease ◽

Pulse Wave ◽

Peripheral Artery ◽

Artery Disease

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Influence of Changes in Sedentary Time on Outcomes of Supervised Exercise Therapy in Individuals with Comorbid Peripheral Artery Disease and Type 2 Diabetes

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.03.040 ◽

2020 ◽

Vol 68 ◽

pp. 369-383 ◽

Cited By ~ 1

Author(s):

Mary O. Whipple ◽

Erica N. Schorr ◽

Kristine M.C. Talley ◽

Julian Wolfson ◽

Ruth Lindquist ◽

...

Keyword(s):

Type 2 Diabetes ◽

Peripheral Artery Disease ◽

Exercise Therapy ◽

Sedentary Time ◽

Peripheral Artery ◽

Supervised Exercise ◽

Artery Disease

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Single And Combined Effects Of Peripheral Artery Disease And Of Type 2 Diabetes Mellitus On The Risk Of Cardiovascular Events In Women

Atherosclerosis ◽

10.1016/j.atherosclerosis.2019.06.512 ◽

2019 ◽

Vol 287 ◽

pp. e169

Author(s):

C.H. Saely ◽

M. Schindewolf ◽

A. Vonbank ◽

C. Heinzle ◽

D. Purin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Peripheral Artery Disease ◽

Cardiovascular Events ◽

Combined Effects ◽

Peripheral Artery ◽

Artery Disease

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Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes

Journal of Clinical Medicine ◽

10.3390/jcm9092809 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2809

Author(s):

Nidhi Jain ◽

Manyoo A. Agarwal ◽

Diana Jalal ◽

Ayotunde O. Dokun

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Peripheral Artery Disease ◽

Limb Amputation ◽

Peripheral Artery ◽

Type 2 Dm ◽

Artery Disease ◽

Type 1 Dm

Background: Limited data exist comparing how type 1 diabetes mellitus (DM) and type 2 DM may have differential effects on peripheral artery disease (PAD) severity. We aimed to study the association of type of DM with the procedure utilized in hospitalizations with a diagnosis of PAD. Methods: We used the national inpatient sample databases from 2003 to 2014 to identify hospitalizations with a diagnosis of PAD and type 1 or type 2 DM. Logistic regression was utilized to evaluate the association between type of DM and procedure utilized (amputation-overall, major, endovascular revascularization, surgical revascularization). Results: We identified 14,012,860 hospitalizations with PAD diagnosis and DM, 5.6% (n = 784,720) had type 1 DM. The patients with type 1 DM were more likely to present with chronic limb-threatening ischemia (CLTI) (45.2% vs. 32.0%), ulcer (25.9% vs. 17.7%), or complicated ulcer (16.6% vs. 10.5%) (all p < 0.001) when compared to those with type 2 DM. Type 1 DM was independently and significantly associated with more amputation procedures (adjusted odds ratio = 1.12, 95% confidence interval [CI] I 1.08 to 1.16, p < 0.001). Overall, in-hospital mortality did not differ between the individuals with type 1 and type 2 DM. The overall mean (95% CI) length of stay (in days) was 6.6 (6.5 to 6.6) and was significantly higher for type 1 DM (7.8 [7.7 to 8.0]) when compared to those with type 2 DM (6.5 [6.4 to 6.6]). Conclusion: We observed that individuals with PAD and type 1 DM were more likely to present with CLTI and ulcer and undergo amputation when compared to those with PAD and type 2 diabetes. Further studies are needed to better understand the underlying mechanisms behind these findings and to identify novel interventions to reduce the risk of amputation in patients with type 1 DM.

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