Xiaomei Zhang1, Xingwu Ran2, Zhangrong Xu3, Zhifeng Cheng4, Feixia Shen5, Yanmei Yu6, Lin Gao7, Sanbo Chai1, Changjiang Wang8, Jianying Liu9, Jing Liu10, Zilin Sun11, Jiajun Zhao12, Linong Ji13. 1. Department of Endocrinology, Peking University International Hospital, Beijing 102206, China. 2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China. 3. Diabetes Center, Department of Endocrinology, The 306th Hospital of PLA, Beijing, China. 4. Department of Endocrinology, The Fourth Hospital of Harbin Medical University, Harbin 150006, China. 5. Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China. 6. Department of Endocrinology, Mudanjiang Diabetes Hospital, Mudanjiang 157011, China. 7. Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China. 8. Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, China. 9. Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China. 10. Department of Endocrinology and Metabolism, Gansu Provincial Hospital, Lanzhou 730000, China. 11. Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing 210008, China. 12. Department of Endocrinology, Shandong Provincial Hospital, Jinan 250021, China. 13. Department of Endocrinology, Peking University International Hospital, Beijing 102206, China; Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China. Electronic address: jiln@bjmu.edu.cn.
Abstract
AIMS: To determine the epidemiological characteristics of lower extremity arterial disease (LEAD) in high-risk patients and identify practical gaps in LEAD management. METHODS: This cross-sectional study consecutively enrolled 10681 patients with type 2 diabetes from 30 hospitals across China from June 2016 to January 2017. All patients were assessed for LEAD by the Ankle-Brachial Index in conjunction with lower limb ultrasonography according to local guidelines. RESULTS: The mean age of patients was 64.2 years, and the median duration of diabetes was 9.0 years. The overall prevalence of LEAD was 21.2%, with 10.6% of patients diagnosed with LEAD before enrollment and 11.8% newly diagnosed at the present visit. Patients with older age, hypertension and dyslipidemia as well as those who smoked were at higher risk of developing LEAD. Only 55.0%, 28.2%, and 42.5% of participating patients reached the guideline-recommended goals for glycemic, blood pressure, and lipid control, respectively. Anti-hypertensive agents, lipid lowering therapies, anti-platelet agents, and vasodilators were underused, especially in newly diagnosed LEAD patients (44.1%, 46.2%, 35.3%, and 31.7%, respectively). CONCLUSIONS: Despite the high prevalence of LEAD, it was still found to be underdiagnosed and undertreated in Chinese diabetes patients. More efforts should be directed at encouraging awareness of early LEAD and achieving guideline-recommended goals in type 2 diabetes patients.
AIMS: To determine the epidemiological characteristics of lower extremity arterial disease (LEAD) in high-risk patients and identify practical gaps in LEAD management. METHODS: This cross-sectional study consecutively enrolled 10681 patients with type 2 diabetes from 30 hospitals across China from June 2016 to January 2017. All patients were assessed for LEAD by the Ankle-Brachial Index in conjunction with lower limb ultrasonography according to local guidelines. RESULTS: The mean age of patients was 64.2 years, and the median duration of diabetes was 9.0 years. The overall prevalence of LEAD was 21.2%, with 10.6% of patients diagnosed with LEAD before enrollment and 11.8% newly diagnosed at the present visit. Patients with older age, hypertension and dyslipidemia as well as those who smoked were at higher risk of developing LEAD. Only 55.0%, 28.2%, and 42.5% of participating patients reached the guideline-recommended goals for glycemic, blood pressure, and lipid control, respectively. Anti-hypertensive agents, lipid lowering therapies, anti-platelet agents, and vasodilators were underused, especially in newly diagnosed LEAD patients (44.1%, 46.2%, 35.3%, and 31.7%, respectively). CONCLUSIONS: Despite the high prevalence of LEAD, it was still found to be underdiagnosed and undertreated in Chinese diabetespatients. More efforts should be directed at encouraging awareness of early LEAD and achieving guideline-recommended goals in type 2 diabetespatients.