A study of the prevalence and risk factors associated with peripheral vascular disease in type 2 diabetes mellitus patients in Government Dharmapuri Medical College Hospital, Dharmapuri
Journal Title: International Archives of Integrated Medicine - Year 2017, Vol 4, Issue 9
Abstract
Introduction: Peripheral vascular disease (PVD) is one of the significant Macro vascular complications of type 2 diabetes mellitus. Peripheral vascular disease assumes importance, for prevention of morbidity and mortality related to diabetic foot. PVD is the single most important factor which raises the incidence of leg amputation risk in type 2 DM patients. While peripheral neuropathy alone leads to, trophic ulcer which has a chronic indolent course provided super added infection is prevented and controlled, the presence of PVD leads to the ischemic foot which leads to rapid spread of infection. The aim of the study: To investigate the prevalence of PVD among type 2 diabetes patients, to assess the risk factors associated with the development of pvd.to correlate the prevalence of cardiovascular risk factors and vascular complications of type 2 diabetes patients. Materials and Methods: Cross sectional observational analytical study was conducted. Patients were interviewed with a special note on elicitation of history regarding symptoms of PVD, in the form of intermittent claudication, Ischemic rest pain, history of foot ulcers in the past and present. Smoking was recorded in pack-years of cigarettes smoked. Duration of diabetes since diagnosis was recorded and they were grouped accordingly. The anthropometric measurements were recorded and the body-mass index was calculated. Waist-hip ratio was also recorded. The blood pressure was recorded in both the upper limbs and both the lower legs using the standard B.P cuff. An comprehensive physical examination was done and findings recorded. Special importance was given to foot examination. Peripheral neuropathy assessment was done using Simmel-Weiss monofilament testing and timed vibration sense perception recordings. Symptoms of peripheral neuropathy were also noted. Results: The duration of diabetes ranged from newly detected to 28 years, with a mean duration of 8.2 years + 6.24 S.D. For patients affected with PVD, the duration of diabetes was found to be longer than others. The mean FPG for the PVD sub group is 173.6mg % + 34.9 SD, while for the other subjects the mean FPG is 151.8 mg % + 36.3 SD and the difference was statistically significant. (P = 0.006). Among the hypertensive diabetic subjects (n=57), 26.3% had peripheral vascular disease and the prevalence of PVD among normotensive diabetes subjects (n = 55) was 9.1% (P = 0.0329). Smokers among Hypertensive Diabetic males had 58.3% prevalence of PVD (ABI < 1) compared to 14.3% among non – smoking Hypertensive Diabetic males. Difference in the lipid parameters above was all statistically significant. This shows that individuals with a triad of increased LDL – cholesterol, lower HDL – cholesterol (Higher LDL / HDL ratio) and increased triglycerides were more at higher risk for peripheral vascular disease. Conclusion: As the duration of diabetes increased, the risk of PVD increased. There was relatively poor glycemic control in the PVD sub-set. Hypertension, when associated with Type2 Diabetes raised the risk of PVD nearly threefold. The duration of Hypertension also significantly correlated with the risk of PVD.
Authors and Affiliations
M. Arivumani
Keywords
Related Articles
- EP ID EP409864
- DOI -
- Views 92
- Downloads 0
Study of anthropometric parameters in children (18-25 years) of diabetic parents in medical students, Agra
Introduction: Diabetes mellitus is a leading public health care problem in developing and developed world, with increasing incidence and long term complications. It is the most common endocrine disorder in the world toda...
Study of incidence and risk factors of urinary tract infection in catheterized patients admitted at tertiary care hospital, Nizamabad, Telangana State, India
Background: Catheter-associated urinary tract infections (CAUTIs) are the most common hospital acquired infections and a leading cause of morbidity and mortality in hospitalized patients with various life threatening com...
Correlative study between modified mallampati score with Cormack Lehane and POGO scoring
Background: Assessing the difficulty level of the airway for intubation is extremely important in anaesthetic practice to avoid delays in intubation and resulting adverse consequences. Multiple grading systems are used b...
A study of clinical manifestations of right ventricular myocardial infarction
Introduction: Myocardial Infarction is the term used when the myocardium is necrosed due to ischemia. It may be trans mural or subendocardial. Inferior wall infarction has got some special features like the association w...
A comparative study of 0.75% ropivacaine and 0.5% bupivacaine for epidural anesthesia in patients undergoing lower abdominal and lower extremity surgeries
Background: Regional anaesthesia has come to occupy an important part in clinical anaesthesiology today. As with other fields, regional anaesthesia too has undergone major developments both in techniques and drug availab...