Diabetes Mellitus and Peripheral Vascular Disease

Chronic complications or the long-term side effects ofdiabetes mellitus includes microvascular complications whichaffects smaller blood vessels such as retinopathy, nephropathy,neuropathy and macrovascular complications which affectslarger blood vessels supplying the heart, brain, and extremities.Prevalence of Peripheral Vascular Disease (PVD) in diabetesranges between 20% and 30%. Endothelial cell dysfunction,vascular smooth muscle cell dysfunction, inflammation,impaired platelet function and abnormal coagulation are theother key factors in progression of PVD in diabetes. AnkleBrachial Index can be used as a screening tool at regularintervals. Apart from the intensified multifactorial treatmentof all modifiable risk factors, intensive therapy targetedat glycemic control and other modifiable cardiovascularrisk factor is needed to prevent micro and macro vascularcomplications of diabetes, especially PVD.

​Screening for Peripheral Vascular Disease among Type 2 Diabetes Patients of Lower Socio Economic Status using Ankle Brachial Index - A Descriptive Cross Sectional Study

Introduction: Diabetes mellitus is one of the key importantnon-communicable diseases of this century in terms ofmortality and prevalence. Peripheral Vascular Disease (PVD)is one of the most common macrovascular complications ofType II DM. PVD in risky cases exhibits as claudication organgrene, but in maximum cases, manifests hidden symptoms.Early detection of vascular changes helps in effective handlingof Diabetes and its complications. Study objectives were toassess Ankle Brachial Index in all asymptomatic vasculopathyin type2 diabetic patients of low socio-economic status usinga hand-held doppler and to correlate the findings of AnkleBrachial Index with PVD.Material and methods: A descriptive cross sectional studydone among the patients with asymptomatic vasculopathyin Type 2 diabetes mellitus patients coming to outpatientdepartment as well as admitted as inpatients in Shri SathyaSai Medical College and Research Centre, Ammapettai,Tamilnadu, India. The study duration was 18 months. Samplesize was calculated to be 130.Results: In the study population of 130, using the anklebrachial index, 110 (84.6%) were normal (1 and above). 11(8.5%) and 9 (6.9%) were having asymptomatic claudication(0.9-0.99) and claudication (<0.9) respectively. The prevalenceof PVD is 15.4% in the study population.Conclusion: Ankle Brachial Index is a simple, easy toperform, rapid, reliable and accurate test which can beperformed especially among the high risk groups.