ABSTRACT
The prevalence of prediabetes in the world continues to increase. These patients have elevated the risk of atherosclerosis. The current study was designed to assess the prevalence of peripheral arterial disease [PAD] and its related risk factors in prediabetes patients. This was the case-control study in which 135 adults in three groups: Diabetes, prediabetes, and normal were studied. We evaluated the prevalence of PAD through the measurement of ankle-brachial index [ABI]. All the patients were interviewed about demographic and medical data, including age, sex, disease duration, body mass index, hypertension [HTN], fasting blood glucose, hemoglobin A1C [HbA1C], lipid profile, and medication use. The prevalence of PAD in diabetes patients was higher than the normal group [8.5%vs. 0.0%] [P < 0.05], but the differences between prediabetes compared with diabetes and normal group were not significant. The mean level of ABI in normal, prediabetes, and diabetes group was [1.11 +/- 0.11], [1.09 +/- 0.12], and [1.05 +/- 0.03] respectively [P < 0.1]. There were marginally significant differences of ABI observed between the normal group and the diabetes group. The observed differences between groups in the ABI were significant after adjusting the effects of age and sex [P < 0.05]. There was an association observed between ABI and HbAlC in diabetes patients [r= 0.249, P < 0.01] and a significant association seen between PAD and HTN in the prediabetes group [P < 0.01]. Peripheral arterial disease is common in asymptomatic diabetes and prediabetes patients. Management of hypertensive prediabetes patients and early detection of PAD in this group as well as in asymptomatic patients is important
ABSTRACT
There are some evidences that control the blood sugar decreasing the risk of diabetes complications, and even fatal. There are so many studies, but they are mostly cross-sectional and ignore the trend and hence it is necessary to implement a longitudinal study. The aim of this prospective study is to find the trend of glycosylated hemoglobin [HbA1c] over time and the associative factors on it. Participants of this longitudinal study were 3440 eligible diabetes patients referred to Isfahan Endocrine and Metabolism Research Center during 2000-2012 who are measured 2-40 times. A linear mixed model was applied to determine the association between HbA1c and variables, including lipids, systolic, diastolic blood pressure and complications such as nephropathy, and retinopathy. Furthermore, the effect of mentioned variables on trend of HbA1c was determined. The fitted model showed total cholesterol, retinopathy, and the method of therapy including oral antidiabetic drugs [OADs] plus insulin and insulin therapy decreased the trend of HbA1c and high-density lipoprotein, weight, hyperlipidemia and the method of therapy including diet, and OADs increased the trend of HbA1c. The present study shows that regular visits of diabetic patients as well as controlling blood pressure, lipid profile, and weight loss can improve the trend of HbA1c levels during the time