Prevalence of peripheral arterial disease in diabetics attending the national center for diabetes and hypertension of the Yaoundé central hospital

CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL100

Peripheral arterial disease(PAD) is one of the macro-vascular complications of diabetes. This diabetic complication is usually diagnosed late when patients present with symptoms in an advanced stage of the disease. Its presence complicates the management of diabetic foot ulcers and also increases the risk of diabetic foot amputations significantly. It has also received a significantly high unawareness amongst many physicians and is rarely diagnosed especially in a resource poor setting like ours.This study was aimed at determining the prevalence, associated risk factors and symptomatic patients of PAD in diabetics.

This was a hospital based cross sectional study in diabetic patients 20 years and above carried out at the National Centre for Diabetes and Hypertension of the Yaoundé Centre hospital. Participants were administered a pretested questionnaire containing socio-demographic, clinical and Para-clinical characteristics. Ankle Brachial Pressure Index (ABPI) measurements were done for all patients and ABPI ≤0.9 considered as having PAD. Lastly, the Edinburg’s Claudication Questionnaire (ECQ) was administered to those with ABPI≤0.9 to determine those with symptoms of claudication.

We enrolled a total of 478 diabetic patients. Mean age of participants was 59.4±10.6 years and majority were of the female gender (65.5%). 99% of participants had type 2 diabetes and the mean duration of diabetes was 7.7±6.7 years. 86 participants (18%) had PAD; amongst which, 72 (83.7%) had mild PAD and 14 (16.3%) had moderate PAD. Amongst the 86 participants with PAD, 23.3% reported claudication with a positive ECQ most of whom had claudication below the knee (61.9%). Correlates of PAD included; age (p=0.03), duration of diabetes (p=0.006), past history of hypertension (p=0.009), past diagnosis of myocardial infarction(p=0.02),high systolic blood pressure(p=0.01) and presence of foot ulcers(p=0.04). In multivariate analysis; age(p=0.004, OR=0.45), presence of foot ulcers(p=0.008,OR=0.08) and high systolic B.P(p=0.02, OR=0.51) were independently associated with PAD.

The prevalence of PAD in diabetics is high with aging, high systolic and presence of foot ulcers identified as independent significant risk factors for the development of PAD. We therefore recommend regular screening for PAD in diabetics with ABPI especially in patients with the above significant risk factors.

Peripheral arterial disease, Diabetes, Risk factors, Claudication