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[Peripheral arteriopathy in type 2 diabetes mellitus]
Objectives:
To find the prevalence of peripheral arteriopathy (PA) in type 2 diabetics registered at a Health Centre, to detect their main risk factors and examine the usefulness of the portable Doppler in Primary Care consultations.
Design:
A crossover descriptive study.
Setting:
Urban Health Centre.
Patients:
All the type 2 diabetics registered.
Measurements And Results:
Anamnesis, physical examination, analysis and base ECG were performed. A portable Doppler determined systolic blood pressure in the lower extremities (foot and posterior tibial arteries) and brachial arteries in order to calculate the ankle/arm index (AAI). PA well recorded in the clinical history and AAI < or = 0.90 were considered criteria of PA. Diabetics with AAI > or = 1.25 were analysed separately. 289 patients with an average age of 65.3 (+/- 10.8 SD) were studied. 45.7% were men and 67% had Diabetes Mellitus for less than 10 years. 37.4% followed a dietary treatment and 21.1% were treated with insulin. Multivariate analysis showed that risk factors were: tobacco dependency, age, Hypertension and the type of treatment for the DM.
Conclusions:
The prevalence of PA found (21.4%) was very much higher than what had been previously diagnosed (6.9%). Identified risk factors were tobacco dependency, age, Hypertension and the type of DM treatment. A portable Doppler is easy to handle and allows peripheral arteriopathy to be diagnosed at an early stage.