Jayasheel Eshcol1, Saravanan Jebarani2, Ranjit Mohan Anjana2, Viswanathan Mohan3, Rajendra Pradeepa2. 1. University of Iowa Hospitals and Clinics, Iowa City, IA, USA. 2. Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Education, Chennai, India. 3. Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Education, Chennai, India. Electronic address: http://www.drmohansdiabetes.com.
Abstract
OBJECTIVE: To assess the prevalence, incidence, etiology and factors related to progression of peripheral arterial disease [PAD] in Asian Indian type 2 diabetic patients. METHODS: Patients with type 2 diabetes (T2DM), with multiple Doppler studies done between 2001 and 2011 at a tertiary diabetes center in south India, were included. Baseline clinical and biochemical characteristics and ankle brachial index [ABI] measurements were abstracted from the electronic medical records. RESULTS: 2512 T2DM patients were followed for an average of 7years. 7.6% of the study population had PAD in 2001 [women, 11.8%; men, 5.1%] with an adjusted odds ratio (OR) of 3.09 [confidence interval (CI): 1.9-4.9] for women. Prevalent PAD was associated with increased mortality [hazards ratio (HR) 3.3, CI: 1.4-7.7]. 280 new patients of PAD were identified - crude incidence, 17/1000 patient years with higher rates in females [HR 1.94, CI: 1.4-2.7]. Age and duration of diabetes were the other predictors of incident PAD. Progression of PAD was seen in 16.5% of patients, with age (p=0.002) and HbA1c (p=0.022) being the predictors. CONCLUSIONS: Women had a higher prevalence of PAD. Older age, female gender and duration of diabetes were related to an increased incidence of PAD. An elevated HbA1c being associated with progression of PAD stresses the need for strict control of diabetes.
OBJECTIVE: To assess the prevalence, incidence, etiology and factors related to progression of peripheral arterial disease [PAD] in Asian Indian type 2 diabeticpatients. METHODS:Patients with type 2 diabetes (T2DM), with multiple Doppler studies done between 2001 and 2011 at a tertiary diabetes center in south India, were included. Baseline clinical and biochemical characteristics and ankle brachial index [ABI] measurements were abstracted from the electronic medical records. RESULTS: 2512 T2DM patients were followed for an average of 7years. 7.6% of the study population had PAD in 2001 [women, 11.8%; men, 5.1%] with an adjusted odds ratio (OR) of 3.09 [confidence interval (CI): 1.9-4.9] for women. Prevalent PAD was associated with increased mortality [hazards ratio (HR) 3.3, CI: 1.4-7.7]. 280 new patients of PAD were identified - crude incidence, 17/1000 patient years with higher rates in females [HR 1.94, CI: 1.4-2.7]. Age and duration of diabetes were the other predictors of incident PAD. Progression of PAD was seen in 16.5% of patients, with age (p=0.002) and HbA1c (p=0.022) being the predictors. CONCLUSIONS:Women had a higher prevalence of PAD. Older age, female gender and duration of diabetes were related to an increased incidence of PAD. An elevated HbA1c being associated with progression of PAD stresses the need for strict control of diabetes.
Authors: Claudia R L Cardoso; Juliana V Melo; Thainá R M Santos; Nathalie C Leite; Gil F Salles Journal: Cardiovasc Diabetol Date: 2021-02-27 Impact factor: 9.951