scholarly journals Traditional and non-traditional risk factors for peripheral artery disease development/progression in patients with type 2 diabetes: the Rio de Janeiro type 2 diabetes cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Claudia R. L. Cardoso ◽  
Juliana V. Melo ◽  
Thainá R. M. Santos ◽  
Nathalie C. Leite ◽  
Gil F. Salles
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Peripheral Artery Disease ◽  
Microvascular Complications ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Prognostic Information ◽  
Traditional Risk Factors ◽  
Artery Disease

Abstract Background The prognostic importance of non-traditional risk factors for peripheral artery disease (PAD) development/progression is scarcely studied in diabetes. We investigated if carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) added prognostic information beyond traditional cardiovascular risk markers for PAD outcomes. Methods Ankle-brachial index (ABI) was measured at baseline and after a median of 91 months of follow-up in 681 individuals with type 2 diabetes. Multivariate Cox regressions examined the associations between the candidate variables and the outcome. PAD development/progression was defined by a reduction in ABI ≥ 0.15 (to a level < 0.9) or limb revascularization procedures, lower-extremity amputations or death due to PAD. The improvement in risk discrimination was assessed by increases in C-statistics of the models. Results Seventy-seven patients developed/progressed PAD: 50 reduced ABI to < 0.9, seven had lower-limb revascularizations, and 20 had amputations or death. Age, male sex, diabetes duration, presence of microvascular complications (peripheral neuropathy and diabetic kidney disease), baseline HbA1c, 24-h systolic BP (SBP) and mean cumulative office SBP and LDL-cholesterol were associated with PAD development/progression in several models. CIMT and cf-PWV were additionally associated with PAD outcomes, and their inclusion further improved risk discrimination (with C-statistic increases between 0.025 and 0.030). The inclusion of ambulatory 24-h SBP, instead of office SBP, also improved PAD risk discrimination. Conclusions Increased CIMT and aortic stiffness are associated with greater risks of developing/progressing PAD, beyond traditional risk factors, in type 2 diabetes.

Diabetic nephropathy and risk factors for peripheral artery disease in Chinese with type 2 diabetes mellitus

Metabolism ◽  
2009 ◽  
Vol 58 (4) ◽  
pp. 504-509 ◽  
Author(s):  
Ming-Chia Hsieh ◽  
Kai-Jen Tien ◽  
Daw-Shyong Perng ◽  
Jeng-Yueh Hsiao ◽  
Shun-Jen Chang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Clinical Manifestation of Peripheral Artery Disease in Type 2 Diabetes Melitus with Ankle Branchial Index Measurement

2019 ◽  
Vol 2 (3) ◽  
Author(s):  
Winny W Nasution ◽  
Henhen Heryaman ◽  
Januar W Martha ◽  
Apen A Ridwan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Clinical Manifestations ◽  
Research Subjects ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Quantitative Descriptive

Diabetes mellitus (DM) is a metabolic disease that has a high prevalence in Asia, including Indonesia. One of the complications of DM is Peripheral Artery Disease (PAP). Ankle Brachial Index (ABI) measurement is a simple and non-invasive methods that can be used for PAP evaluation. This study aims to provide an overview of the clinical manifestations of PAP and the value of ABI as early detection of PAP in patients with type-2 DM. This research uses quantitative descriptive design studies. The research variables used to assess PAP were ABI values, age, sex, duration of diabetes mellitus, hypertension, and clinical manifestations of PAP such as pain, intermittent claudication, muscle atrophy, skin discoloration, sweating, wound healing impairment, and gangrene. This study involved 92 research subjects. From the study we found out that the normal ABI value and the ABI value of the PAP category in patients with type 2 diabetes were 91.3% and 7.6%. The ABI value of the PAP category in DM patients is more commonly found in women (6.5%), adult patients (5.4%), duration of DM up to 2 years (5.4%), and with hypertension (5.4%) . Pain and numbness are the most common clinical manifestations of PAP in DM patients.     Keywords: diabetes mellitus, ankle brachial index, peripheral artery disease.

scholarly journals Ankle brachial index as a surrogate to vascular imaging in evaluation of peripheral artery disease in patients with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ejiofor Ugwu ◽  
Anthony Anyanwu ◽  
Michael Olamoyegun
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Invasive Procedure ◽  
Arterial Stenosis ◽  
Peripheral Artery ◽  
Good Reliability ◽  
Cardiovascular Morbidity And Mortality ◽  
Artery Disease

Abstract Background Peripheral artery disease (PAD) is common in persons with type 2 diabetes (T2DM) and contributes significantly to cardiovascular morbidity and mortality. Controversy exists regarding the utility of ankle brachial index (ABI) for clinical diagnosis of PAD in persons with diabetes. The aim of this study was to evaluate the reliability of ABI for diagnosis of PAD in patients with T2DM using duplex ultrasonography (DUS) as the gold standard. Results A total of 319 legs from 163 patients comprising of 156 subjects with intact legs and 7 patients who had undergone unilateral lower limb amputations were studied. The mean age of the participants was 56.1 ± 17.3 years. One hundred and ninety-five legs (61.1%) had sonographically confirmed PAD which was mild, moderate and severe in 40%, 41.5% and 18.5% respectively. The accuracy of ABI in detecting PAD was 76.7% for mild stenosis, 91.7% for moderate stenosis and 93.1% for severe stenosis. The sensitivity of ABI improved with increasing severity of arterial stenosis, reaching 100% in severe cases. ABI demonstrated good agreement with DUS [kappa = 0.65 (95% CI 0.49–0.88), P < 0.001]. Conclusion In comparison to DUS, the ABI demonstrated good reliability for diagnosis of PAD in high risk T2DM patients. The utility of this simple and non-invasive procedure should therefore be maximized in clinical practice.

scholarly journals High ankle brachial index predicts high risk of cardiovascular events amongst people with peripheral artery disease

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242228
Author(s):  
Jonathan Golledge ◽  
Joseph V. Moxon ◽  
Sophie Rowbotham ◽  
Jenna Pinchbeck ◽  
Frank Quigley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Artery Disease ◽  
Cardiovascular Events ◽  
Ankle Brachial Index ◽  
Cardiovascular Death ◽  
Peripheral Artery ◽  
Major Cardiovascular Events ◽  
Increased Risk ◽  
Traditional Risk Factors ◽  
Artery Disease

Ankle-brachial pressure index (ABPI) is commonly measured in people referred to vascular specialists. This study aimed to assess the association of high ABPI (≥ 1.4) with cardiovascular events in people with peripheral artery disease (PAD). 1533 participants with PAD diagnosed by a vascular specialist were prospectively recruited from four out-patient clinics in Australia. ABPI was measured at recruitment and the occurrence of myocardial infarction (MI), stroke or cardiovascular death (major cardiovascular events; MACE) and any amputation were recorded over a median (inter-quartile range) follow-up of 3.3 (1.0–7.1) years. The association of high, compared to normal, low (0.5–0.9) or very low (<0.5), ABPI with clinical events was estimated using Cox proportional hazard analyses, adjusting for traditional risk factors and reported as hazard ratio with 95% confidence intervals. 596 (38.9%), 676 (44.1%), 157 (10.2%) and 104 (6.8%) participants had normal, low, very low and high ABPI, respectively. Participants with high ABPI had increased risk of MACE, MI and death by comparison to those with either normal ABPI [1.69 (1.07, 2.65), 1.93 (1.07, 3.46) and 1.67 (1.09, 2.56)] or either low or very low ABPI [1.51 (1.02, 2.23), 1.92 (1.16, 3.19) and 1.47 (1.02, 2.14)] after adjusting for other risk factors. Findings were similar in a sensitivity analysis excluding people with ABPI only measured in one leg (n = 120). Participants with high ABPI also had an increased risk of MACE and MI compared to those with very low ABPI alone. High ABPI is a strong indicator of excess risk of cardiovascular events amongst people with PAD.

636-P: Effect of Obesity and Weight Variations on the Decline of Ankle-Brachial Index in Type 2 Diabetes Subjects without Peripheral Artery Disease

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 636-P
Author(s):  
YEOREE YANG ◽  
JAYOUNG LIM ◽  
EUN YOUNG LEE ◽  
KUN-HO YOON ◽  
BONG-YUN CHA ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Microvascular Complications, Peripheral Artery Disease and Mortality in Patients with Type 2 Diabetes Mellitus, in Two Counties of Southern Lithuania over 13 Years: Analysis Using a Cohort Database of the National Health Insurance

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1380
Author(s):  
Laima Piliponienė ◽  
Džilda Veličkienė ◽  
Rima Kregždytė
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Insurance ◽  
Peripheral Artery Disease ◽  
National Health Insurance ◽  
Microvascular Complications ◽  
Peripheral Artery ◽  
Artery Disease

Background and Objectives: People living with diabetes mellitus are at risk of developing many serious and life-threatening complications. The present study aimed to determine the occurrence of microvascular complications, peripheral artery disease, and mortality in patients with type 2 diabetes mellitus (T2DM), in 2 Lithuanian counties. Materials and Methods: The data on residents aged ≥ 18 years, who were diagnosed for the first time in 2004 with uncomplicated T2DM, were obtained from the National Health Insurance Fund database. The occurrence of T2DM microvascular complications, peripheral artery disease, and mortality during the period from 2004 to 2016 were assessed by gender and age groups (<65 and ≥65 years). Results: During the 13 years, 46.9% of the patients developed T2DM complications. More men than women developed at least 1 T2DM complication (50.8% vs. 44.8%, p = 0.035). The mean time for developing any T2DM complication was 9.2 years. The probability of occurrence of any complication was 0.07 in the second year and increased to 0.59 in the thirteenth year of living with diabetes. Within the 13 years, 38.2% of the patients died. More men (43.1%) than women (35.5%) died during the analysis period (p = 0.036). Mortality was higher among older patients (60.7%) than among younger patients (22.2%) (p < 0.001). Conclusions: The results of this study provide a comprehensive picture of microvascular complications, peripheral artery disease, and mortality among patients with T2DM of two Lithuanian counties. Information about the occurrence of T2DM complications and mortality will assist further studies in estimating the burden of T2DM and in performing economic evaluations of T2DM prevention and treatment in Lithuania.

2217-PUB: Type 2 Diabetes Is a Strong Predictor for LDL Cholesterol Target Achievement in Patients with Peripheral Artery Disease

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2217-PUB
Author(s):  
SIMON STERNBAUER ◽  
ALEXANDER VONBANK ◽  
CHRISTINE HEINZLE ◽  
DANIELA ZANOLIN-PURIN ◽  
JÖRN F. DOPHEIDE ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Artery Disease ◽  
Ldl Cholesterol ◽  
Strong Predictor ◽  
Peripheral Artery ◽  
Artery Disease
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