The present report is an analysis of the course of peripheral vascular disease (PVD) in 619 patients with non-insulin-dependent diabetes (NIDDM) recruited within 1 yr of diagnosis and followed quarterly for up to 14 yr (X = 10.5 yr). At 13 yr duration, the actuarially determined cumulative risks for intermittent claudication (IC), nonpalpable dorsalis pedis pulse (NPUL), and arterial calcification (CALC) were, respectively, 37.9%, 34.5%, and 60.9% for men and 24.3%, 37.6%, and 32.2% for women. Major amputations (AMP) occurred in only 1.3% of the patients, equivalent to approximately one case per 1000 patients per year. The corresponding incidences of IC, NPUL, and CALC were, respectively, 29, 27, and 47 per 1000 men and 19, 27, and 25 per 1000 women per year. CALC and NPUL were strongly related to mortality. Baseline risk factors with probability levels that suggest a relationship to PVD were, in women, age versus CALC (P < 0.01), age versus NPUL (P < 0.05), weight versus NPUL (P < 0.05), systolic BP versus CALC (P < 0.01), summed glucose tolerance test versus CALC (P < 0.01), and triglyceride level versus CALC (P < 0.05). In men, the only significant risk factors were diminished vibration perception, which was related to NPUL (P < 0.05), and the serum triglyceride level, which was related to IC (P < 0.05). In patients who are carefully followed prospectively, IC is far more common, but AMP is far less common than has been generally appreciated. Further studies are needed to clarify the roles of the diverse risk factors that are possibly related.
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May 01 1985
The Course of Peripheral Vascular Disease in Non-insulin-dependent Diabetes
Kenneth Kreines, M.D.;
Kenneth Kreines, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Eugene Johnson, Ph.D.;
Eugene Johnson, Ph.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Margaret Albrink, M.D.;
Margaret Albrink, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Genell L Knatterud, M.D.;
Genell L Knatterud, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Marvin E Levin, M.D.;
Marvin E Levin, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Alexander Lewitan, M.D.;
Alexander Lewitan, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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William Newberry, M.D.;
William Newberry, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Frederick A Rose, M.D.
Frederick A Rose, M.D.
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Cincinnati College of Medicine, Biometry Division, School of Public Health, University of Minnesota.
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Address reprint requests to Kenneth Kreines, M.D., Bethesda Oak Professional Center, 629 Oak Street, Cincinnati, Ohio 45206.
Citation
Kenneth Kreines, Eugene Johnson, Margaret Albrink, Genell L Knatterud, Marvin E Levin, Alexander Lewitan, William Newberry, Frederick A Rose; The Course of Peripheral Vascular Disease in Non-insulin-dependent Diabetes. Diabetes Care 1 May 1985; 8 (3): 235–243. https://doi.org/10.2337/diacare.8.3.235
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