Prevalence of peripheral arterial disease and its association with claudication in individuals with type 2 Diabetes Mellitus: a prospective cross-sectional study in Brazil

TL;DR

This study finds that 14.6% of type 2 diabetes patients in Brazil have peripheral arterial disease, with most showing no symptoms.

Contribution

The study provides new prevalence data for peripheral arterial disease in Brazil's type 2 diabetes population.

Findings

14.6% of participants had peripheral arterial disease based on ankle-brachial index measurements.

Most individuals with peripheral arterial disease were asymptomatic, with only 15% experiencing typical claudication.

Those with peripheral arterial disease were significantly older and had higher BMI and longer diabetes duration.

Abstract

Few studies have described the prevalence of peripheral arterial disease (PAD) in the diabetic population of Brazil.

To evaluate the prevalence of PAD and its association with the presence of claudication and to compare risk factors for atherosclerosis between subjects with and without PAD.

An analytical, observational, prospective, cross-sectional study was conducted with 150 volunteers with type 2 Diabetes Mellitus (T2DM) treated at a university endocrinology outpatient clinic (Federal University of Paraná, Curitiba, Brazil) and assessed using the ankle-brachial index (ABI) and the Edinburgh Claudication Questionnaire.

ABI was evaluated in 143 volunteers (7 did not meet the inclusion criteria). Six individuals had an ABI > 1.4. Excluding these cases and adopting an ABI ≤ 0.9 to identify PAD, the prevalence of PAD was 14.6% (20 of 137), 15.8% in men (6 of 38), and 14.1% in women (14 of 99). We identified twenty-five participants with borderline ABI (18.2%). Claudication was present in 25% of subjects with PAD; however, only 15% had typical claudication. A significant association with the presence of typical claudication was observed only when ABI values were stratified above or below 1.0 (p = 0.04, Fisher’s exact test). Participants with PAD were older (median difference: 5.5 years, 95% CI 3.0 to 9.0, p < 0.001) and tended to have a longer duration of DM and higher BMI.

The prevalence of PAD in T2DM volunteers with no prior screening was 14.6% and 75% were asymptomatic.

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