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Vasculopathy in the diabetic foot.

P Richards-George1

  • 1Nuttal Medical Centre, Kingston, Jamaica.

The West Indian Medical Journal
|June 25, 2005
PubMed
Summary

Diabetic patients often have asymptomatic peripheral occlusive arterial disease (POAD), impacting blood flow and increasing mortality risk. Regular ankle-brachial pressure index (A/BI) testing is crucial for early detection and management of POAD in diabetics.

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Area of Science:

  • Vascular Medicine
  • Diabetology
  • Public Health

Background:

  • Diabetic vasculopathy, specifically peripheral occlusive arterial disease (POAD), is a significant complication.
  • POAD in diabetic patients can be asymptomatic, leading to delayed diagnosis and treatment.
  • Existing research indicates a variable prevalence of POAD among diabetic populations.

Purpose of the Study:

  • To analyze vasculopathy findings in Jamaican diabetic clinic attendees.
  • To determine the prevalence of peripheral occlusive arterial disease (POAD) using Doppler ankle-brachial pressure index (A/BI) testing.
  • To highlight the implications of POAD on cardiovascular health and mortality in diabetic individuals.

Main Methods:

  • Doppler measurements of ankle-brachial pressure index (A/BI) were conducted on Jamaican diabetic clinic attendees.
  • Plethysmographic blood flow studies assessed vasodilatory response to increased flow demand.
  • Literature review of POAD prevalence from other studies was incorporated for comparison.

Main Results:

  • 23% of diabetic attendees exhibited peripheral occlusive arterial disease (POAD), predominantly asymptomatic.
  • A profound reduction in vasodilatory response was observed in plethysmographic studies.
  • Cited studies reported POAD prevalence ranging from 13% to 47% in diabetic cohorts.

Conclusions:

  • Peripheral occlusive arterial disease (POAD) is prevalent and often asymptomatic in Jamaican diabetics.
  • POAD is associated with increased all-cause and coronary heart disease mortality.
  • Regular Doppler A/BI testing is recommended for improved POAD recognition, treatment, and prevention of cardiovascular events.

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