title: Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study.
abstract: BACKGROUND
  Pre-diabetes and untreated diabetes are common in patients with peripheral artery disease however their impact on outcome has not been evaluated. We examined the association of impaired fasting glucose, diabetes and their treatment with the presentation, mortality and requirement for intervention in peripheral artery disease patients.
  
  
  METHODS
  We prospectively recruited 1637 patients with peripheral artery disease, measured fasting glucose, recorded medications for diabetes and categorised them by diabetes status. Patients were followed for a median of 1.7 years.
  
  
  RESULTS
  At entry 22.7% patients were receiving treatment for type 2 diabetes by oral hypoglycaemics alone (18.1%) or insulin (4.6%). 9.2% patients had non-medicated diabetes. 28.1% of patients had impaired fasting glucose (5.6-6.9 mM). Patients with non-medicated diabetes had increased mortality and requirement for peripheral artery intervention (hazards ratio 1.62 and 1.31 respectively). Patients with diabetes prescribed insulin had increased mortality (hazard ratio 1.97). Patients with impaired fasting glucose or diabetes prescribed oral hypoglycaemics only had similar outcomes to patients with no diabetes.
  
  
  CONCLUSIONS
  Non-medicated diabetes is common in peripheral artery disease patients and associated with poor outcomes. Impaired fasting glucose is also common but does not increase intermediate term complications. Peripheral artery disease patients with diabetes requiring insulin are at high risk of intermediate term mortality.
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Australia, 4811. jonathan.golledge@jcu.edu.au.|Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia. jonathan.golledge@jcu.edu.au.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
authors.affiliation: Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia. fqu05412@bigpond.net.au.
authors.forename: Frank
authors.initials: F
authors.lastname: Quigley
authors.affiliation: Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia. ramesh.velu@health.qld.gov.au.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Velu
authors.affiliation: Discipline of Surgery and Centre for Clinical Research, University of Queensland School of Medicine, Brisbane, Australia. p.walker@uq.edu.au.|Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Australia. p.walker@uq.edu.au.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Walker
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Australia, 4811. joseph.moxon@jcu.edu.au.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Moxon
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000502:physiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D005215:Fasting; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000401:mortality; D011236:Prediabetic State / Q000188:drug therapy; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents