scholarly journals A study of prevalence of peripheral arterial disease in type 2 diabetes mellitus using ankle-brachial index and its correlation with coronary artery disease and its risk factors

Author(s):  
R. K. Sharma ◽  
Pashaura S. Sandhu ◽  
Ajay Chhabra ◽  
Jagbir Singh ◽  
Rajat Kharbanda

Background: Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM). There is significant difference in the reported prevalence of PAD and its associated risk factors between Indian and Western studies. The purpose of this study was to examine the PAD complicating T2DM, in particular the influence of PAD on the risk of CAD.Methods: Randomly selected 100 T2DM patients presented to Guru Nanak Dev hospital were included. In addition to a detailed history and physical examination, anthropometric parameters like body mass index was measured. CAD in patients was diagnosed by a history of angina, ECG changes, any past history of CAD or any treatment taken for CAD. Ankle brachial index (ABI) was measured. Data was collected systematically and analyzed according to the standard statistical methods.Results: The prevalence of PAD was 15%. CAD was present in 31%. PAD was found to be significantly correlated with age, duration of diabetes, smoking, systolic blood pressure, diastolic blood pressure, prevalence of BMI >25 kg/m2, HbA1c and serum HDL ≤40 mg%. Old age, high HbA1c level, and dyslipidaemia were found to be significant independent predictors of CAD.Conclusions: Using ABI authors found evidence of PAD in 15% patients of T2DM. The prevalence of CAD was higher in patients with PAD. So, there is definite and strong correlation between PAD and CAD. Thus, the early diagnosis of PAD should alert the clinician to a high probability of underlying CAD.

2021 ◽  
Vol 7 (2) ◽  
pp. 5
Author(s):  
Muhamad Taufik Ismail ◽  
Hariadi Hariawan ◽  
Firman Fauzan Arief Lutfie ◽  
Dhite Bayu Nugroho ◽  
Vina Yanti Susanti ◽  
...  

Aim: Diabetes mellitus increases the risk of peripheral artery disease (PAD) 2 times. PAD is diagnosed by ABI (Ankle Brachial Index). PAD increases mortality and morbidity of patient with Diabetes Mellitus (DM) Type 2. This study aims to determine the prevalence and risk factors of PAD in the population of type 2 diabetes mellitus (DM) in Yogyakarta, Indonesia.   Methods: This study was a community-based descriptive and analytic observational study that examines the prevalence and risk factors of PAD in type 2 diabetes mellitus. Diagnosis of PAD was detected by ABI examination using VaSera VS-1500N. All patients with type 2 diabetes mellitus in Yogyakarta who meet the inclusion criteria will be enrolled in this study. The research subjects were taken in multi-stage, cluster-random sampling in Yogyakarta. The patient will undergo an interview of demographic data which were assessed by one assessor.  Data from interviews and ABI examinations were analysed statistically.   Results: Two hundred and fifty-six (256) patients with type 2 DM consisted of 188 patients (73.4%) women and 68 patients (26.6%) men. Prevalence of PAD diagnosed by abnormal ABI was found in 41 (16%) of 256 patients. Subjects with age more than 67 years old was significantly associated with PAD occurrence (P=0,001) in type 2 DM population.   Conclusion: The prevalence of PAD was 16% of 256 type 2 DM patients. Age more than 67 years old was the strong risk factor of PAD in type 2 DM.   Key words: Ankle Brachial Index, Peripheral Arterial Disease, Diabetes mellitus, Prevalence, Risk Factor


2019 ◽  
Vol 6 (2) ◽  
pp. 100
Author(s):  
Em Yunir ◽  
Dekta Filantropi Esa ◽  
Adelia Nova Prahasary ◽  
Dicky Levenus Tahapary

Peripheral arterial disease (PAD) merupakan salah satu komplikasi makrovaskular diabetes melitus tipe 2 (DMT2) yang dikaitkan dengan peningkatan risiko mortalitas kardiovaskular. Pemeriksaan ankle-brachial index (ABI) merupakan salah satu pemeriksaan yang sederhana dan mudah dilakukan untuk menegakkan diagnosis PAD. Oleh karena itu, penulis ingin mengetahui tingkat mortalitas kardiovaskular pasien DMT2 dengan PAD. Dari hasil penelusuran literatur, didapatkan tujuh literatur. Studi Bundo dkk melaporkan hasil HR 2,45 (interval kepercayaan [IK] 95%: 0,84-7,17). Studi Mostaza dkk melaporkan hasil HR 1,64 (IK 95%: 0,64-4,49). Studi Aboyans dkk melaporkan hasil HR 2,21 (IK 95%: 1,16-4,22). Studi Mohammedi dkk melaporkan hasil HR 1,35 (IK 95%: 1,15-1,60). Studi Quiles dkk melaporkan hasil HR 6,61 (IK 95%: 2,47-17,72). Studi Mueller dkk melaporkan hasil  RR 3,53 (IK 95%: 1,80-6,91). Studi lanjutan Mueller dkk melaporkan hasil  RR 4,06 (IK 95%: 2,67-6,18). Dari hasil studi tersebut, dapat disimpulkan bahwa pasien DMT2 yang disertai dengan PAD akan meningkatkan mortalitas kardiovaskular, serta nilai ABI dapat digunakan sebagai instrumen stratifikasi independen mortalitas kardiovaskularKata Kunci:Ankle brachial index, diabetes melitus tipe 2, mortalitas kardiovaskular, penyakit arteri perifer Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes MellitusPeripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported  RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported  RR 4,06 ( 95% CI: 2.67 to 6.18).  In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality


2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Derison Marsinova Bakara ◽  
Kurniyati Kurniyati

Introduction: Peripheral arterial disease often occurs in patients with type 2 diabetes mellitus. Peripheral arterial disease in patients with type 2 diabetes mellitus occurs due to decreased blood circulation in the lower extremities. Looking at the value of the ankle-brachial index is one of the actions that can be taken to detect peripheral arterial disease. Objective: The purpose of this study was to determine the effect of a foot exercise intervention on the ankle-brachial index value of type 2 diabetes mellitus patients. Methods: This research was a quantitative research with a pre-experimental design, with one pre-test and post-test design. The research was carried out at Rejang Lebong Hospital from August to November 2020. The number of samples used in this study were 35 patients experiencing type 2 diabetes mellitus for more than five years. The analysis used in this study was the Wilcoxon test. Results: The results showed a difference in the mean of the ankle-brachial index before (1.02) and after (1.12) the intervention. Thus, there was an increase of 0.10 in the average value of the ankle-brachial index. The analysis result of this study showed the value of p = 0.001 (p<0.05). Conclusion: Foot exercise can be used as an alternative intervention to increase the value of the ankle-brachial index in patients with type 2 diabetes mellitus.


2013 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
H Howlader ◽  
S Ahmed ◽  
N Sultana ◽  
Z Hasan ◽  
U Sadia ◽  
...  

Peripheral arterial disease is a macrovascular complication of type 2 diabetes mellitus. Hyper-homocysteinemia is found to be associated with peripheral arterial disease. Homocysteine induced endothelial-cell injury is mediated by hydrogen peroxide. Hydrogen peroxide exposes the underlying matrix and smooth muscle cells of the arteries which, in turn, proliferate and promote the activation of platelets and leukocytes. The present study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011 to observe the association of hyperhomocysteinemia with peripheral arterial disease in type 2 diabetes mellitus. A total of 100 subjects (50 cases and 50 controls) were selected by purposive sampling from Bangladesh Institute of Health sciences (BIHS) and BIRDEM Hospital, Dhaka. Subjects having ankle brachial index <0.9 were considered as cases and those having ankle brachial index 0.9 were considered as controls. Subjects with absent peripheral pulses or nonrecordable ankle brachial index were considered as ankle brachial index <0.9. All study subjects were normotensive, normolipidemic and non- smoker. The study showed a higher level of homocysteine (?mol/L) in cases when compared with that of controls (15.95±1.80 vs. 9.31±2.11; p<0.001). In cases, males had higher proportion of arterial disease (56%) than females. Other variables (age and body mass index) showed no significant difference between two groups. DOI: http://dx.doi.org/10.3329/bjmb.v6i1.13282 Bangladesh J Med Biochem 2013; 6(1): 14-18


2019 ◽  
Vol 16 (4) ◽  
pp. 344-350 ◽  
Author(s):  
João Soares Felício ◽  
Camila Cavalcante Koury ◽  
Nathalie Abdallah Zahalan ◽  
Fabrício de Souza Resende ◽  
Manuela Nascimento de Lemos ◽  
...  

Background: Peripheral arterial disease in patients with type 2 diabetes mellitus is an important risk factor for vascular events. Recommendations about whether ankle-brachial index should be performed differ depending on the source; therefore, it is necessary to re-evaluate the most important risk factors associated with peripheral arterial disease and whether it is useful to perform ankle-brachial index in newly diagnosed and drug-naïve patients with diabetes, independent of age or peripheral arterial disease symptoms. Methods: A total of 711 subjects were divided into groups: group 1, 600 type 2 diabetes mellitus patients, symptomatic or not for peripheral arterial disease; group 2, 61 type 2 diabetes mellitus patients newly diagnosed and drug naïve; and group 3, 50 subjects without diabetes. Ankle-brachial index, medical records and physical examination were performed in all patients, accessing cardiovascular risk factors. Results: Analysing group 1 asymptomatic patient to peripheral arterial disease, we found abnormal ankle-brachial index in 49% (77/156) ⩾50 years and 42% (16/38) <50 years ( p = not significant). Considering drug-naïve patients, a peripheral arterial disease prevalence of 39% (24/61) was found; among these, 48% (13/27) were <50 years and 32% (11/34) were ⩾50 years ( p = not significant). A forward stepwise regression model was developed, with type 2 diabetes mellitus duration ( r2 = 0.12) and sedentary lifestyle ( r2 = 0.14) found as independent variable predictors of severity of peripheral arterial disease, related to ankle-brachial index. Conclusion: We suggest that, in type 2 diabetes mellitus, ankle-brachial index should be measured at diagnosis. In addition, sedentary lifestyle was strongly associated with presence and severity of peripheral arterial disease.


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