Detection of Lower Extremity Occlusive Peripheral Artery Disease (LEOPAD) by Measuring Systolic Pressure Index in Type 2 Diabetic Patients

Abstract

Objective: The aims of our study are to identify the prevalence of LEOPAD in type 2 diabetes, to study the predictive factors of LEOPAD and to demonstrate the importance of establishing a specialized screening consultation in diabetic patients with LEOPAD and with high cardiovascular risk. Research design and methods: We carried out a prospective and descriptive study. The study involved 150 patients with type 2 diabetes who were followed on a regular basis. The different epidemiological, clinical and biological data were collected patient’s medical file. Each patient was investigated for cardiovascular risk factors. A thorough physical examination was performed in addition to biological assessment (fasting plasma glucose, HbA1c, lipid profile). After consent had been obtained, all patients underwent the ankle-brachial systolic pressure index (ABI) test. Results: The mean age of our patients was 57.46 ± 8.04 of the 150 patients, 24.7% had abnormal ABI suggestive of lower limb ischemia. Among them, 8.7% had an ABI of 1, 3, a presumed marker of vascular stiffness. The mean age of the LEOPAD population was 58 years. LEOPAD was predominantly asymptomatic in our population (88.1%). Only 5 patients (11.9%) had intermittent claudication. The comparative study of patients with LEOPAD showed a statistically conversely significant correlation between LEOPAD and lower levels of HDL. However, there is no statistically significant correlation with the following factors: smoking, sex, hypertension, dyslipidemia, obesity or overweight android pattern, the presence of microalbuminuria, renal failure and sedentary lifestyle. In terms of glycemic control, it did not show a statistically significant difference between the two groups. Moreover, it was noted that the patients with LEOPAD had had more micro vascular complications compared to patients without LEOPAD. Conclusion: Lower extremity occlusive peripheral artery disease occurred more commonly than it was expected in the diabetic population, associated with a high cardiovascular comorbidity. The sensitivity, specificity and simplicity of the ABI measurement promote its routine use and integration into the clinical approach of high-risk LEOPAD patients, especially the diabetics.