Peripheral Arterial Disease and Its Associated Factors among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia

Abstract

Background. Peripheral arterial disease (PAD), one of the major macrovascular complications of diabetes, is associated with cardiovascular mortality and a high rate of disability following the amputation of an extremity in diabetes patients. However, there is no data on the prevalence of PAD among type 2 diabetes patients in Ethiopia. Therefore, the current study is aimed at determining the prevalence and associated factors of PAD among type 2 diabetes patients at Debre Tabor General Hospital, Debre Tabor, Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among type 2 diabetes mellitus patients from February 1 to August 30, 2019. A pretested interviewer-administered questionnaire was used to collect the data. The presence of stenosis and its grading were determined by color Doppler ultrasonography. Data were entered using EpiData-V.4.6 and analyzed by STATA-14. Bivariable and multivariable logistic regression was performed to identify associated factors of peripheral arterial disease. Adjusted odds ratio (AOR) and its confidence interval were estimated for potential predictors included in the final model. P≤0.05 was used to declare statistical significance. Results. The mean age of the study participants was 61.2±7.3 years. One hundred seventy-two (61.4%) patients were males. The prevalence of PAD in this study was 30.7% (95% CI (25.3-36.2%)). Of these, 37 (43%) were symptomatic. Age (AOR=1.09, 95% CI (1.03-1.16)), higher HbA1c (AOR=1.97, 95% CI (1.03-3.40)), being an ex-smoker (AOR=4.68, 95% CI (1.93-11.30)), and current cigarette smoking (AOR=5.84, 95% CI (1.79-19.04)) were significantly associated with PAD. Conclusion. The prevalence of peripheral arterial disease among type 2 diabetes patients was high. Increasing age, high HbA1c, and being cigarette smokers increase the likelihood of developing peripheral arterial disease. Clinicians should prevent PAD; screen T2DM patients who are aged, with high HbA1c, and cigarette smokers; and treat them timely.

Risk factors for peripheral arterial disease in elderly patients with Type-2 diabetes mellitus: A clinical study

“…In the current study, the prevalence of PAD was 31.5%. Compared with previously published studies 1 , 6 , the rate of PAD is higher. In this study, only elderly patients were included, with age increasing the level of atherosclerosis increased significantly.…”

“…In addition, a blood sample specimen from antecubital vein was obtained in each participant after 10-12 hour overnight fasting for the analysis of hemoglobin A1c (HbA1c), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), hs-CRP and uric acid, which were measured using an automatic analyzer. 1 In addition, the information including living habits such as smoking history and alcohol use as well as complications of T2DM were also recorded.…”

“…Type-2 Diabetes Mellitus (T2DM), a complex chronic metabolic disorder, is steadily increasing in the world, especially in elderly population. 1 Through time, T2DM may lead to many complications. Peripheral arterial disease (PAD), defined as lower extremity arterial atherosclerosis precipitated by the obstruction of a peripheral arterial vessel, 2 is a primary cause of morbidity and mortality in elderly population, 3 also one of the important complications of T2DM.…”

“… 6 In another study of 280 patients with T2DM, Akalu found increasing age, high HbA1c, and being cigarette smokers increase the likelihood of developing PAD. 1 However, the results of these studies are inconsistent, no definite conclusions are available. In addition, these studies recruited patients with different ages instead of elderly patients.…”

Impact of Gender Differences and Glycated Haemoglobin on Atherosclerosis Risk in Type 2 Diabetic Patients from North Western Algeria

“…Likewise, higher levels of the mediators of inflammation, such as C-reactive protein (CRP), interleukin-6 (IL-6), plasminogen activator inhibitor 1 (PAI-1), are observed in diabetic patients suggesting a positive correlation between diabetes and atherosclerosis [3]. Type 2 diabetes is, however, more associated to cardiovascular co-morbidities and mortality comparing to the other types of diabetes mellitus [4,5]. As of 2016, the American Diabetes Association "ADA" has focused specifically in its treatment guidelines in type 2 diabetic disease on "atherosclerotic cardiovascular disease" and suspected peripheral arterial disease of atherosclerotic origin [6].…”