Key result
In newly diagnosed, drug-naïve patients with type 2 diabetes, the prevalence of peripheral arterial disease was 39%, with sedentary lifestyle strongly associated with disease severity.
Why the study?
Recommendations on ankle-brachial index testing differ, prompting re-evaluation of peripheral arterial disease risk factors and the utility of ankle-brachial index measurement in newly diagnosed, drug-naïve type 2 diabetes mellitus patients.
Does ankle-brachial index measurement identify peripheral arterial disease in newly diagnosed and drug-naïve patients with type 2 diabetes mellitus?
Cross-Sectional (n=711)
Does ankle-brachial index measurement identify peripheral arterial disease in newly diagnosed and drug-naïve patients with type 2 diabetes mellitus?
Ankle-brachial index measurement reveals a high prevalence of peripheral arterial disease even in newly diagnosed, drug-naïve type 2 diabetes patients, suggesting it should be measured at diagnosis regardless of age.
High early PAD prevalence in drug-naïve T2D supports considering ABI at diagnosis; leaves open prospective validation and outcome impact.
Background: Peripheral arterial disease in patients with type 2 diabetes mellitus is an important risk factor for vascular events. Recommendations about whether ankle-brachial index should be performed differ depending on the source; therefore, it is necessary to re-evaluate the most important risk factors associated with peripheral arterial disease and whether it is useful to perform ankle-brachial index in newly diagnosed and drug-naïve patients with diabetes, independent of age or peripheral arterial disease symptoms. Methods: A total of 711 subjects were divided into groups: group 1, 600 type 2 diabetes mellitus patients, symptomatic or not for peripheral arterial disease; group 2, 61 type 2 diabetes mellitus patients newly diagnosed and drug naïve; and group 3, 50 subjects without diabetes. Ankle-brachial index, medical records and physical examination were performed in all patients, accessing cardiovascular risk factors. Results: Analysing group 1 asymptomatic patient to peripheral arterial disease, we found abnormal ankle-brachial index in 49% (77/156) ⩾50 years and 42% (16/38) <50 years ( p = not significant). Considering drug-naïve patients, a peripheral arterial disease prevalence of 39% (24/61) was found; among these, 48% (13/27) were <50 years and 32% (11/34) were ⩾50 years ( p = not significant). A forward stepwise regression model was developed, with type 2 diabetes mellitus duration ( r 2 = 0.12) and sedentary lifestyle ( r 2 = 0.14) found as independent variable predictors of severity of peripheral arterial disease, related to ankle-brachial index. Conclusion: We suggest that, in type 2 diabetes mellitus, ankle-brachial index should be measured at diagnosis. In addition, sedentary lifestyle was strongly associated with presence and severity of peripheral arterial disease.
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Felício et al. (2019) conducted a cross-sectional in Type 2 diabetes mellitus and peripheral arterial disease (n=711). Type 2 diabetes mellitus vs. Subjects without diabetes was evaluated on Prevalence of peripheral arterial disease (abnormal ankle-brachial index) in newly diagnosed drug-naïve T2DM patients. In newly diagnosed, drug-naïve patients with type 2 diabetes, the prevalence of peripheral arterial disease was 39%, with sedentary lifestyle strongly associated with disease severity.
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