Συχνότητα της περιφερικής αγγειοπάθειας σε ασθενείς με σακχαρώδη διαβήτη τύπου 2
Καραμήτσος, Δημήτριος - Σπυρίδων - Έριχ
Aim:To determine the prevalence of Peripheral Arterial Disease (PAD) in Greek patients with Diabetes Mellitus type 2 (DM), who followed up in Diabetes Center of 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital. Patients- Methods: We studied 402 consecutive patients with DM, 259 women, with mean age 60.3 years (range 35-75 years), who followed up in Diabetes Center in a four month period. The median known duration of DM was 10.86 years (range 1-41 years). Patients divided in two groups according to duration of DM: Group A (n=193) with duration >10 years and Group B (n= 209) with duration <10 years. Results: Gangrene was present in 4 patients (1%) and amputation in 8 patients (2%) (4 at the finger level of the lower extremities and 4 below knee). Intermittent claudication was present in 25 patients (6.2%) and rest pain 2 patients (0.5%). Pulse absence in one femoral artery was observed in 5 patients (1.3%), absence of popliteal pulses in 11 patients (2.8%), absence of dorsalis pedis pulse in 48 legs – 32 patients (8%) and absence of posterior tibial pulse in 44 legs – 28 patients (7%). Absence of one or more peripheral arterial pulses were observed in 36 patients (12%). The Ankle-Brachial arterial Index (ABI) was assessed in all patients with a Doppler device. The index was <0.9 in 51 legs (6.3%) and <0.7 in 5 patients (1.3%) and 9 legs (1.13%). Sixteen patients from group A (8.3%) presented intermittent claudication versus 9 patients from group B (4.34%), p=0.05. One hundred sixty nine patients with DM (42%) were smokers. Dorsalis pedis pulses were absent in 17.6% and posterior tibial pulses were absent in 14.7% of them, versus 7.87% (p=0.012) and 6.66% (p<0.032) in non-smokers patients, respectively. Conclusions: Long duration of Diabetes Mellitus type 2 and cigarette smoking are significant risk factors for development of peripheral artery disease. Patients with these factors must be evaluated by Ankle-Brachial arterial Index.
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