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BACKGROUND: Peripheral arterial disease (PAD) is an important marker of cardiovascular (CV) risk and the risk of PAD is markedly increased in patients with type 2 diabetes mellitus (T2DM). Consequently, early diagnosis and treatment of PAD in patients with T2DM are critically important to reduce the risk of CV events. The aim of this study was to determine the prevalence of asymptomatic PAD in patients with T2DM and to investigate the demographic and clinical associations of PAD among them. METHODS: This cross-sectional study included 2423 diabetic patients >20 years old, who were regularly followed up at the regional diabetes clinic, Galle, Sri Lanka. Data were obtained using structured questionnaires for information on demographic characteristics and risk factors. Assessment of ankle-brachial pressure index (ABPI) was performed in all. PAD was diagnosed when ABPI was < 0.9 on either leg. RESULTS: The overall prevalence of PAD was 15.3% with no significant age or gender difference. Patients with PAD had significantly higher systolic blood pressure (SBP) (127 vs 125 mmHg, P = 0.002) and diastolic blood pressure (DPB) (80 vs 78 mmHg, P = <0.001) and significantly lower estimated glomerular filtration rate (eGFR) (80 vs 84 ml/min, P = 0.007) than those without PAD. No significant relationships were found between the duration of diabetes mellitus, hypertension, dyslipidemia, and PAD. CONCLUSIONS: Prevalence of PAD was relatively high in the diabetic population of this study when compared with findings from other countries. There is a significant association of subclinical PAD with reduced eGFR among patients with T2DM.
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INTRODUCTION: Implementation of effective measures to control rising burden of cardiovascular diseases among patients with type 2 diabetes mellitus (T2DM) requires information on the adequacy of control and identification of specific groups with suboptimal control of blood glucose, lipids and blood pressure. METHODS: A cross-sectional study of patients with T2DM referred from primary care to a diabetes center was carried out to estimate the proportion of patients achieving the recommended therapeutic targets of four major modifiable cardiovascular risk factors: glycosylated hemoglobin (HbA1c <7%), low-density lipoprotein cholesterol <100 mg/dL, systolic blood pressure (SBP) <130 mmHg and diastolic blood pressure (DBP) <80 mmHg and their associations with age, gender, duration of diabetes and body mass index were studied. RESULTS: Mean (SD) age and the duration of the sample of 2422 (65% males) were 52 (11) and 9 (3), respectively. Percentages with optimal HbA1c, low-density lipoprotein cholesterol, SBP and DBP were 25.2%, 24.3%, 32% and 56.7%, respectively. Only 2% had achieved optimal control of all four risk factors. Significantly higher percentages of males were having optimal HbA1C, SBP and DBP, and regression analysis revealed that male gender was significantly associated with optimal control of SBP. CONCLUSION: Control of cardiovascular risk diseases factors among patients with T2DM managed in the primary care settings needs further improvements in target achievement in all four modifiable risk factors.
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INTRODUCTION: Influence of dietary and drug compliance of patients with diabetes on attainment of optimal metabolic (glucose and lipid) control remains underexplored in developing countries. MATERIALS AND METHODS: Self-reported dietary and drug compliance score of 0-10, glycosylated hemoglobin (HbA1c), and low-density lipoprotein (LDL) levels were obtained from patients with diabetes. HbA1c <7% and LDL <100 mg/dL were used to define optimal glucose and lipid control, respectively. Proportions achieving each and both optimal parameters were estimated. Regression analysis was used to study the association of age, gender, age of onset and the duration of diabetes, self-reported dietary, and drug compliance scores with achievement of both parameters. RESULTS: Mean (SD) age and duration of diabetes of 207 patients were 55 (10) and 10 (03) years. Optimal glucose and LDL control were achieved by 30% and 62%, and 23% had achieved both. Regression analysis revealed significant association of self-reported high dietary compliance with achievement of both targets. CONCLUSIONS: Findings highlight the suboptimal glucose and lipid control among patients with diabetes. Significant association of better dietary compliance with control of both parameters emphasizes the value of proper dietary adherence in achieving the optimal metabolic control among patients with diabetes.
