Screening for peripheral arterial disease by means of the ankle-brachial index in newly diagnosed Type 2 diabetic patients.
OBJECTIVE
To evaluate the prevalence of peripheral arterial disease (PAD) with the ankle-brachial index (ABI) in newly diagnosed Type 2 diabetic subjects.


METHODS
Between autumn 2002 and spring 2003, 2559 newly diagnosed Type 2 diabetic subjects (about 15% of the cases/year in Italy) were enrolled in 265 diabetology centres. Family history of diabetes, smoking, height, weight, waistline, fasting glycaemia, glycosylated haemoglobin, total and HDL-cholesterol and triglyceride values were collected. Claudication, cyanosis, cold foot, foot hair anomalies, skin thinning and femoral, popliteal, posterior tibial and dorsalis pedis pulses were assessed. The ABI was measured with a portable Doppler continuous-wave instrument.


RESULTS
An ABI < 0.9 was found in 539 (21.1%) patients. Claudication was present in 187 (7.3%). Femoral pulse was absent in 218 (8.5%), popliteal in 316 (12.3%), tibial in 563 (22.0%) and dorsalis pedis in 578 (22.6%). Foot cyanosis was observed in 88 (3.4%), cold foot in 359 (13.9%), skin thinning in 468 (18.3%) and hair anomalies in 857 (33.5%). Multivariate analysis of the variables associated with ABI < 0.9 in the univariate analysis confirmed the independent role of age [relative risk (RR) 1.02, P < 0.001, confidence interval (CI) 1.01, 1.04], claudication (RR 4.53, P < 0.001, CI 2.97, 6.93), absence of tibial pulse (RR 3.45, P < or = 0.001. CI 2.54, 4.68) and pedis pulse (RR 1.96, P < or = 0.001, CI 1.4, 2.68).


CONCLUSIONS
PAD, as represented by ABI < 0.9, is common in newly diagnosed Type 2 diabetic patients.
Faglia
E
E
Internal Medicine Unit, Diabetology Centre. Policlinico Multimedica, Sesto S. Giovanni, Milano, Italy. ezio.faglia@multimedica.it
Caravaggi
C
C
Marchetti
R
R
Mingardi
R
R
Morabito
A
A
Piaggesi
A
A
Uccioli
L
L
Ceriello
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000842:Ankle; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity