Prevalence and Associated Factors to Peripheral Arterial Disease in Patients with Diabetes Type 2

Type 2 diabetes mellitus (T2DM) is the principal risk factor for developing Peripheral Arterial Disease (PAD), which is the most frequent non cardiac arteriopaty according to the American Heart Association (AHA). The Ankle-Brachial Index (ABI) is the main diagnostic test for PAD with a 90%-95% sensibility and 96%-100% specificity.

Objective: Establish the prevalence and associated factors for PAD in patients with T2DM according to their ABI, in primary care.

Material and Methods: Descriptive and cross-sectional study, in “Sur Valdivia” medical center between August 2015-March 2016, with T2DM patients older than 50 years to whom the ABI test was performed according to the AHA guidelines. A multiple logistic regression analysis was made between independent variables and the presence of an ABI≤0,90.

Results: ABI test was performed on 196 people, 14 were excluded because they weren’t evaluable for having an ABI> 1.40. The final sample was conformed of 182 patients, with an average age of 64.1 years old, consisting of 95 (52.20%) women and 87 (47.8%) men; from which 27 (14.84%) obtained an ABI≤0.90. The multivariate analysis showed a significant relationship with age ≥70 years (p = 0.0001, OR 1.14), having more than 10 years with T2DM (p = 0.036, OR 2.91), and the presence of intermittent claudication (p = 0.025; OR 2.67). An unilateral negative correlation was determined between age and ABI results (r_s = -0.279, p = 0.001); In addition, an adjusted model of binary regression was performed in those with less than 10 years with T2DM and intermittent claudication, showing a statistically significant relationship with the presence of an ABI ≤0.90 (p = 0.01, OR 11.46).

Conclusions: The prevalence of an ABI ≤0.90 was higher than the world prevalence. The ABI test should be a common practice in primary care, especially on patients with several years with diabetes, advanced age and/or intermittent claudication.