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Peripheral artery disease, diabetes, and reduced lower extremity functioning.

Nancy C Dolan1, Kiang Liu, Michael H Criqui

  • 1Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA. ndo428@northwestern.edu

Diabetes Care
|January 5, 2002
PubMed
Summary

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Peripheral artery disease (PAD) patients with diabetes exhibit poorer lower extremity function compared to those without diabetes. This decline is linked to neuropathy, leg pain, and cardiovascular issues.

Area of Science:

  • Vascular Medicine
  • Diabetology
  • Orthopedics

Background:

  • Peripheral artery disease (PAD) significantly impacts lower extremity function.
  • Diabetes mellitus is a common comorbidity in PAD patients, potentially exacerbating functional limitations.

Purpose of the Study:

  • To compare lower extremity function and dysfunction in patients with PAD, stratified by the presence or absence of diabetes.
  • To identify factors contributing to functional differences between these groups.

Main Methods:

  • Cross-sectional study of 460 PAD patients (147 with diabetes) from academic medical centers.
  • Assessments included ankle-brachial index (ABI), neuropathy score, 6-minute walk distance, 4-meter walk velocity, Walking Impairment Questionnaire, and Summary Performance Score (SPS).

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Main Results:

  • PAD patients with diabetes had worse neuropathy scores and more cardiovascular comorbidities.
  • Individuals with diabetes demonstrated significantly shorter walk distances, slower walking velocities, and lower SPS, even after adjusting for age.
  • Differences were largely explained by neuropathy, leg pain characteristics, and cardiovascular comorbidities.

Conclusions:

  • Peripheral artery disease patients with diabetes exhibit poorer lower extremity function compared to those with PAD alone.
  • Diabetes-associated neuropathy, distinct exertional leg symptoms, and increased cardiovascular disease burden contribute significantly to this functional deficit.