UNDIAGNOSED PERIPHERAL ARTERIAL DISEASE PREVALENCE AMONG PATIENTS OF DIABETES MELLITUS

Introduction: Peripheral Artery Disease (PAD) affects 12 million people in the US. 11.7% in Pakistan. Diabetes (DM) has a significant correlation with PAD. Patients with PAD and DM have a greater risk of amputation than just PAD.

Aim: Our study aimed to measure the prevalence of PAD among diabetics, and to explore quality of management by determining the frequency of ankle-brachial index (ABI) measurement among them. Moreover, it aimed to educate people about PAD and its risk factors.

Place and Duration: In the Medicine Unit II of Services Hospital, Lahore for one-year duration from March 2018 to March 2019.

Methods and materials: A cross-sectional study involving 161 diabetic patients. They were interviewed using a questionnaire about demographics, past medical history and ordinary history. The second part concerned the physical examination of the lower limbs and ABI measurements; values below 0.9 or higher than 1.3 were considered incorrect.

Results: Of the 161 diabetic patients included in the study, 104 (64.6%) were middle-aged 55.3 ± 11.472 and 59.39 ± 12.974 male. 55.9% were hypertensive and 75.8% hypercholesterolemic. 18 (11.2%) smokers were 14 (77.8%) men. 64 (39.8%) cases performed regular exercises, 38 (59.4%) were women. ITB <0.9 was detected in 32 (19.9%). While 24 of them (75%) are middle-aged women 59, 66 are men. Among people with low ITB 7 (23.3%) had symptoms. The most common symptom was numbness and tingling. In addition, 31 (96.9%) patients with PAD had an additional diagnosis other than diabetes. 24 of them (77.4%) are women, and hypercholesterolemia was the most common comorbid disease. Three (9.4%) PAD patients smoked.

Conclusion: In Pakistan, one fifth of DM patients had PAD; the majority is asymptomatic and was females. Large percent of the subjects were not checked by ABI, or the patient was not well informed about PAD, which urge all physicians to consider a periodic check-up for PAD using ABI. Majority of subjects had multiple co morbidities.

Keywords: peripheral artery disease; Diabetes; atherosclerosis; Ankle arm indicator; superiority