AIM: The aim of this study was to determine the prevalence and risk factors for peripheral occlusive vascular disease (POVD) in subjects with diabetes mellitus (DM) in Brazil. METHODS: We evaluated 236 diabetic individuals, in spontaneous demand, representing 471 legs. POVD was assessed by the ankle brachial index (ABI). RESULTS: The mean age was 62.1 years (range 22-89 years), 52% were male, 93.2% type II DM and the mean time to diagnosis was 7.9 years (range 0-37 years). Sixty percent were hypertensives. In 61% at least one pulse was diminished or absent. The prevalence of ischemia was 18% (ABI<0.9) while 22% had an ABI compatible with high grade arterial calcification (ABI>1.3). Overall less than 1/3 of the cases had the vascular exam that could be considered normal. The ABI was lower in subjects with pulse deficit (p<0.001), and a normal pulse had a negative predictive value for ischemia of more than 90%. Subjects with normal pulses were younger and had a decreased diabetes duration (p<0.001 and p<0.05, respectively). An increase in the duration of the diabetes was associated with a progressive decrease in the ABI (p<0.01). Female gender and hypertension were associated with a reduced ABI (p<0.01 and p<0.05, respectively). CONCLUSION: There is a high prevalence of POVD in diabetic individuals. The disease is associated with hypertension and female gender and gets worse with increasing duration of the diabetes.
AIM: The aim of this study was to determine the prevalence and risk factors for peripheral occlusive vascular disease (POVD) in subjects with diabetes mellitus (DM) in Brazil. METHODS: We evaluated 236 diabetic individuals, in spontaneous demand, representing 471 legs. POVD was assessed by the ankle brachial index (ABI). RESULTS: The mean age was 62.1 years (range 22-89 years), 52% were male, 93.2% type II DM and the mean time to diagnosis was 7.9 years (range 0-37 years). Sixty percent were hypertensives. In 61% at least one pulse was diminished or absent. The prevalence of ischemia was 18% (ABI<0.9) while 22% had an ABI compatible with high grade arterial calcification (ABI>1.3). Overall less than 1/3 of the cases had the vascular exam that could be considered normal. The ABI was lower in subjects with pulse deficit (p<0.001), and a normal pulse had a negative predictive value for ischemia of more than 90%. Subjects with normal pulses were younger and had a decreased diabetes duration (p<0.001 and p<0.05, respectively). An increase in the duration of the diabetes was associated with a progressive decrease in the ABI (p<0.01). Female gender and hypertension were associated with a reduced ABI (p<0.01 and p<0.05, respectively). CONCLUSION: There is a high prevalence of POVD in diabetic individuals. The disease is associated with hypertension and female gender and gets worse with increasing duration of the diabetes.
Authors: Thilak P Weerarathna; Meththananda Herath; Gayani Liyanage; Miyuru K Weerarathna; Vidarsha Senadheera Journal: Int J Prev Med Date: 2019-06-07