A Study of Peripheral Arterial Disease in Type 2 Diabetes Mellitus Using the Ankle-Brachial Pressure Index and Its Correlation With Glycaemic Control and Duration of Diabetes in a Tertiary Care Teaching Hospital.

INTRODUCTION

Peripheral arterial disease (PAD) is a macrovascular complication of diabetes mellitus. PAD is linked strongly with cardiovascular morbidity and mortality.

OBJECTIVES

To detect the burden of PAD in type 2 diabetes patients using the ankle-brachial pressure index (ABI) and to find its correlation with glycaemic control as well as duration of diabetes mellitus.

METHODOLOGY: This study was conducted on 300 type 2 diabetes mellitus patients aged 30-70 years, with diabetes for a minimum period of five years. All patients were screened for PAD by a vascular Doppler instrument using the ABI. Patients with ABI < 0.9 are subjected to colour Doppler to confirm the presence of PAD. Blood investigations, like fasting and postprandial blood glucose and glycated haemoglobin (HbA1C), were also done. Data were analysed by SPSS version 20 (IBM Corp., Armonk, NY) using appropriate tests.

RESULTS

A total of 68 (22.7%) patients out of 300, who had diabetes mellitus for more than five years, had PAD. Prevalence increases with age and duration of diabetes. There was no difference between males and females. The possibility of PAD increases with raised body mass index (BMI). A total of 38 (55.9%) out of 68 patients with PAD were asymptomatic. Claudication was the most common symptom of PAD, found in 30 (44.1%) patients. Increased systolic pressure was found to be associated with PAD. The sensitivity and specificity of ABI in diagnosing PAD were found to be 89% and 94%, respectively. Chronic hyperglycaemia (high HbA1C) was found to be associated with a higher prevalence of PAD. ABI correlated significantly with the duration of diabetes, systolic hypertension, age, BMI, postprandial blood sugar level, and HbA1C.

CONCLUSION

Prevalence of PAD in diabetes mellitus is positively associated with duration of diabetes, age, BMI, systolic hypertension, and chronic hyperglycaemia (high HbA1C). It can be easily and reliably diagnosed using the ABI (less than 0.9), which will help in early detection and management.