Key result
Asymptomatic PAD affects ~15% of T2D patients and is linked to reduced eGFR.
Why the study?
PAD is an important marker of CV risk and is markedly increased in T2DM, making early diagnosis and treatment critically important to reduce CV events.
Cross-Sectional (n=2,423)
No
Asymptomatic peripheral artery disease is highly prevalent (15.3%) among Sri Lankan patients with type 2 diabetes and is significantly associated with reduced eGFR and higher blood pressure.
May support considering asymptomatic PAD screening in type 2 diabetes; cross-sectional association with reduced eGFR leaves open causal validation.
Background: Peripheral arterial disease (PAD) is an important marker of cardiovascular (CV) risk and the risk of PAD is markedly increased in patients with type 2 diabetes mellitus (T2DM). Consequently, early diagnosis and treatment of PAD in patients with T2DM are critically important to reduce the risk of CV events. The aim of this study was to determine the prevalence of asymptomatic PAD in patients with T2DM and to investigate the demographic and clinical associations of PAD among them. Methods: This cross-sectional study included 2423 diabetic patients >20 years old, who were regularly followed up at the regional diabetes clinic, Galle, Sri Lanka. Data were obtained using structured questionnaires for information on demographic characteristics and risk factors. Assessment of ankle-brachial pressure index (ABPI) was performed in all. PAD was diagnosed when ABPI was < 0.9 on either leg. Results: The overall prevalence of PAD was 15.3% with no significant age or gender difference. Patients with PAD had significantly higher systolic blood pressure (SBP) (127 vs 125 mmHg, P = 0.002) and diastolic blood pressure (DPB) (80 vs 78 mmHg, P = <0.001) and significantly lower estimated glomerular filtration rate (eGFR) (80 vs 84 ml/min, P = 0.007) than those without PAD. No significant relationships were found between the duration of diabetes mellitus, hypertension, dyslipidemia, and PAD. Conclusions: Prevalence of PAD was relatively high in the diabetic population of this study when compared with findings from other countries. There is a significant association of subclinical PAD with reduced eGFR among patients with T2DM.
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Herath et al. (2019) conducted a cross-sectional in Type 2 diabetes mellitus without clinical macrovascular disease (n=2,423). Peripheral arterial disease (PAD) vs. No PAD was evaluated on Prevalence of asymptomatic PAD (ABPI < 0.9). The prevalence of asymptomatic peripheral arterial disease among patients with type 2 diabetes was 15.3%, and PAD was significantly associated with reduced eGFR (80 vs 84 ml/min, P=0.007).
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