Prevalence of lower limb occlusive vascular disease in outclinic diabetic patients

The aim of this study was to determine the prevalence and risk factors for peripheral occlusive vascular disease (POVD) in subjects with diabetes mellitus (DM) in Brazil.

We evaluated 236 diabetic individuals, in spontaneous demand, representing 471 legs. POVD was assessed by the ankle brachial index (ABI).

The mean age was 62.1 years (range 22-89 years), 52% were male, 93.2% type II DM and the mean time to diagnosis was 7.9 years (range 0-37 years). Sixty percent were hypertensives. In 61% at least one pulse was diminished or absent. The prevalence of ischemia was 18% (ABI<0.9) while 22% had an ABI compatible with high grade arterial calcification (ABI>1.3). Overall less than 1/3 of the cases had the vascular exam that could be considered normal. The ABI was lower in subjects with pulse deficit (p<0.001), and a normal pulse had a negative predictive value for ischemia of more than 90%. Subjects with normal pulses were younger and had a decreased diabetes duration (p<0.001 and p<0.05, respectively). An increase in the duration of the diabetes was associated with a progressive decrease in the ABI (p<0.01). Female gender and hypertension were associated with a reduced ABI (p<0.01 and p<0.05, respectively).

There is a high prevalence of POVD in diabetic individuals. The disease is associated with hypertension and female gender and gets worse with increasing duration of the diabetes.