scholarly journals PERIPHERAL ARTERIAL DISEASE

2012 ◽  
Vol 19 (04) ◽  
pp. 501-507
Author(s):  
ATIF SITWAT HAYAT ◽  
MOHAMMAD ADNAN BAWANY ◽  
GHULAM HUSSAIN BALOCH ◽  
NAILA Shaikh
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Foot Ulcers ◽  
Non Invasive ◽  
Type 2 Diabetics ◽  
Arterial Pulses ◽  
Peripheral Arterial

Background: The increase in prevalence of type 2 diabetes and its complications is alarming. The incidence of diabetic footulcers due to peripheral arterial disease, which leads to foot amputations far too often, is unacceptably high especially in developing countries.This study has been conducted to find out frequency and degree of peripheral arterial disease in type 2 diabetics having foot ulcers at tertiarycare settings in Abbottabad. Methods: This was a prospective descriptive study-being conducted at Northern Institue of Medical Sciences(NIMS) and Ayub teaching hospital Abbottabad from August 2009 to June 2010. Type 2 diabetics with non-healing foot ulcers lasting longer thanten days, were selected for this study by non-probability purposive sampling method. All study subjects have undergone for palpation ofperipheral arterial pulses in the lower limbs. Ankle-brachial index (ABI) is the ratio of the systolic blood pressure at the ankle to that in the arm.Peripheral arterial disease (PAD) was considered to be present if ABI was less than 0.90. It was further graded as mild, moderate and severeaccording to ABI values between 0.70-0.90, 0.50-0.69 and less than 0.49 respectively, as per recommendations of American DiabetesAssociation. Results: A total of 83 type 2 diabetics with foot ulcers were enrolled during eleven months period of this study. The mean age ofstudy subjects was 53.68±9.51 years. There were 33 (39.75%) males and 50 (60.24%) females with M to F ratio of 1:1.51. Mean duration ofdiabetes was 13.67±5.80 years (ranging from 9-23 years). Majority 57 (68.67%) of our patients were obese having poor glycemic control.Peripheral arterial disease has been found in 35(42.16%) patients, out of them 18(51.42%) had mild PAD as their ABI values remained between0.70-0.90, 15(42.85%) had moderate PAD due to their ABI values between 0.50-0.69 and 2 (5.71%) had severe PAD as their ABI values liebelow 0.49. Conclusions: Ankle-brachial index is a non-invasive, inexpensive and office-based diagnostic tool for peripheral arterial diseasein type 2 diabetics having foot ulcers, Healthcare professionals must be trained about early referral and regular feet care of these patients.

scholarly journals Prevalence and predictors of peripheral arterial disease determined by ankle brachial index in diabetes population treated within primary care services in a non-urban area of lower northern Thailand

2020 ◽  
Vol 17 (6) ◽  
pp. 147916412096699
Author(s):  
Preaw Suwannasrisuk ◽  
Sarinya Sattanon ◽  
Watcharaporn Taburee ◽  
Pantitra Singkheaw ◽  
Non Sowanna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
University Hospital ◽  
Peripheral Arterial ◽  
Diabetes Patients

In diabetes patients, urban lifestyle has been concerned as one of the risk factors for peripheral arterial disease (PAD). The aims of this study were to find out the prevalence and associated risk factors of PAD in type 2 diabetes patients who live in a non-urban community area. A total of 885 participants with type 2 diabetes mellitus were enrolled from six primary care units in the health network centered at Naresuan University Hospital, Phitsanulok, between May and June 2018. Ankle-brachial index (ABI) was performed in all subjects using a vascular screening device. PAD was defined by an ABI value of 0.9 or lesser at least on one leg. The predictors of PAD were analyzed using multiple logistic regression. The prevalence of PAD was 7.2% among 884 evaluable patients. Diabetic neuropathy and a history of macrovascular complications were significant predictors of PAD.

scholarly journals Assessment of peripheral arterial disease in diabetic adults with foot ulcers in an African population

2018 ◽  
Vol 5 (1) ◽  
pp. 8
Author(s):  
Osita Ede ◽  
Ugochukwu N. Enweani ◽  
Iheuko S. Ogbonnaya ◽  
Kenechi A. Madu ◽  
Udo E. Anyaehie ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Test Group ◽  
Arterial Disease ◽  
Sub Saharan Africa ◽  
Systemic Hypertension ◽  
Foot Ulcers ◽  
Control Group ◽  
Sub Saharan ◽  
Peripheral Arterial

<p class="abstract"><strong>Background:</strong> Peripheral arterial disease (PAD) is a recognized risk factor for diabetic foot ulceration. It was thought that PAD is not common in Sub-Saharan Africa. Studies show otherwise. It becomes necessary to assess the prevalence of PAD among diabetic adults with foot ulcers in Nigeria. The objective of the study was to assess the prevalence of PAD in diabetic subjects with foot ulcers in Nigeria.</p><p class="abstract"><strong>Methods:</strong> Diagnosis of PAD was made with the ankle-brachial index (ABI). Edinburgh claudication questionnaire was administered to the patients. An ABI of &lt;0.9 is diagnostic of PAD. Risk factors for PAD were assessed. A control group of non-diabetic adults was used.<strong></strong></p><p class="abstract"><strong>Results:</strong> Sixty-seven per cent (67%) of the test group has PAD as compared to 18% of the control group. Smoking, duration of diabetes and systemic hypertension were strongly associated with PAD.</p><p class="abstract"><strong>Conclusions:</strong> Diabetic adults with foot ulcers in Nigeria have a high prevalence of PAD.</p>

Abstract 3078: The Poor Prognosis of Diabetic Patients with High Ankle-Brachial Index Depends on the Presence of Masked Peripheral Arterial Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Victor Aboyans ◽  
Minh Hoang Tran ◽  
Claire Salamagne ◽  
Francoise Archambeaud ◽  
Michael H Criqui ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Primary Endpoint ◽  
Poor Prognosis ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Diabetic Patients ◽  
Cvd Risk ◽  
The Poor ◽  
Peripheral Arterial

Background: A high ankle-brachial index (ABI >1.40) is associated with poor prognosis. An underlying peripheral arterial disease (PAD) is frequent in diabetic patients with high ABI, although it cannot be adequately diagnosed by the ankle pressure measurement, due to stiff arteries. We hypothesized that in diabetic patients, the poor cardiovascular disease (CVD) prognosis associated with high ABI would depend on the coexistence of masked PAD. Methods: We reviewed the data of 403 consecutive diabetic patients who had a Doppler assessment of their lower limbs between 1999 and 2000. They were classified as “normal” when Doppler waveform patterns (DWP) were normal and ABI within the 0.91–1.39 range, “PAD only” in case of ABI ≤0.90, “stiff only” if ABI ≥1.40 with normal DWP, and “mixed disease” when ABI ≥1.40 with abnormal DWP. Patients were followed until 04/2008. The primary endpoint was the occurrence of any of the following events: death, stroke or myocardial infarction. Results: The patients (age: 65.6 ± 13.2 yrs, 54.6% females; 90.2% type-2 diabetes) were classified as “normal” (14.4%), “PAD only” (48.4%), “stiff only” (16.4%) and “mixed disease” (20.8%). During a mean follow-up of 6.5 years, the event-free survival curves of “PAD only” and “mixed disease” groups showed poorer prognosis than the “stiff only” and “normal” groups (figure ). In a model adjusted for age, sex, diabetes type and duration, traditional CVD risk factors, renal failure and CVD history, only the presence of PAD was significantly associated with the primary endpoint (OR: 3.36 (1.25 – 4.44), p=0.008). Conclusions: In diabetic patients with high ABI (>1.40), only those with an associated PAD have a poorer prognosis.

The Correlation between Symptoms and Non-Invasive Test Results in Patients Referred for Peripheral Arterial Disease Testing

1996 ◽  
Vol 1 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Michael H Criqui ◽  
Julie O Denenberg ◽  
Cameron E Bird ◽  
Arnost Fronek ◽  
Melville R Klauber ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Residual Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Leg Pain ◽  
Non Invasive ◽  
Invasive Test ◽  
Peripheral Arterial ◽  
Pain At Rest ◽  
Specific Symptoms

The WHO/Rose questionnaire has served as the epidemiologic and clinical standard in the assessment of leg pain in patients with peripheral arterial disease (PAD) for over three decades. However, the structure of this questionnaire does not allow assessment of leg-specific (i.e. right versus left) symptoms. We studied 508 patients aged 39–95 years (mean 68 years), initially referred for PAD non-invasive testing. A revised questionnaire, the San Diego Claudication Questionnaire, was administered which allowed determination of leg-specific symptoms and evaluated thigh and buttock as well as calf pain. Leg-specific symptoms were categorized into no pain, pain at rest, non-calf claudication, non-Rose calf claudication, and Rose claudication. At the same visit, the ankle brachial index, the toe brachial index, and peak posterior tibial flow velocity were measured by Doppler ultrasound and five categories of non-invasive results by type and severity of PAD were defined. Legs with previous intervention (Rx), surgery or angioplasty, were evaluated separately. Claudication was reported in 42% of no Rx legs and 50% of Rx legs; 40% of claudication was atypical (not Rose); 64% of no Rx and 81% of Rx legs had PAD by non-invasive testing, and 27% of affected legs had severe PAD. The correlation between the severity of symptoms and the severity of ipsilateral PAD in no Rx legs was r=−0.40, p< 0.001. In Rx legs, this correlation was somewhat less ( r=0.27, p< 0.001) due to more symptomatology at lesser degrees of PAD, suggesting reporting bias and/or more residual disease than evident from non-invasive testing. To our knowledge, these results provide the first comparison between a standardized assessment of leg pain and the severity of ipsilateral PAD by non-invasive testing.

scholarly journals Physiotherapeutic intervention in peripheral arterial disease by functional hyperemia in diabetic patients

2015 ◽  
Vol 28 (4) ◽  
pp. 731-740
Author(s):  
Cristiane Wichnieski ◽  
Flávia Natacha Salvatori Kirchhof ◽  
Pedro Cezar Beraldo ◽  
Luiz Bertassoni Neto ◽  
Christian Campos Jara
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Walking Distance ◽  
Diabetic Patients ◽  
Functional Hyperemia ◽  
Peripheral Vascular ◽  
Vascular Disorders ◽  
Peripheral Arterial

Abstract Introduction : Diabetes Mellitus (DM) is conceptualized as a public health problem with varying degrees of morbidity. The physical and functional alternatives for the treatment of circulatory complications of diabetes, such as intermittent claudication, are poorly explored. This indicates the need to search for ancillary techniques that can be used in the physical therapy treatment of diabetic patients. Objective : To investigate the effects of functional hyperemia on peripheral arterial disease in patients with diabetes. Materials and methods: This study was conducted with a group of five volunteers from the Diabetics Association of Parana (Associação Paranaense do Diabético , APAD ), who suffered from peripheral vascular disorders in the lower limbs. All subjects attended 10 sessions (twice weekly). Functional hyperemia was induced by programmed exercise therapy that consisted of walking on a treadmill. Results : There was a significant increase in mean activity time (F9,36 = 13.710; p < 0.001 ), mean walking distance (F9,36 = 27.689 ; p < 001), and mean speed (F9,36 = 15.638 ; p < .001). No statistically significant differences in the ankle-brachial index were noted. Conclusion : There was a significant increase in walking distance, time, and speed for diabetic subjects. Our findings indicate the importance of physical therapists in the supervised treatment of peripheral vascular disorders in diabetic patients.

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