Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study.

Rudolf Kirchmair,Davis Kibirige,Raymond Mbayo Mwebaze

doi:10.1371/journal.pone.0105211

Rudolf Kirchmair, Davis Kibirige + Show 1 more

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https://doi.org/10.1371/journal.pone.0105211

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Abstract

BackgroundPeripheral arterial disease (PAD) is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda.MethodsIn this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c) levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI) to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5–10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without.ResultsThe mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%). PAD was prevalent in 57 (39%) study participants. Of these, 34 (59.6%) had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria.ConclusionsThis study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.

Highlights

Cardiovascular diseases (CVD) are a major cause of morbidity and mortality in adult patients with diabetes mellitus (DM)
We report a prevalence of Peripheral arterial disease (PAD) of 39% in this study population with preponderance in male patients (57.8%)
The presence of symptoms of intermittent claudication and microalbuminuria were significantly associated with PAD

Summary

Introduction

Cardiovascular diseases (CVD) are a major cause of morbidity and mortality in adult patients with diabetes mellitus (DM). PAD is a manifestation of widespread systemic atherosclerosis characterized by atherosclerotic occlusive disease of the lower extremities and is one of the macro vascular complications highly prevalent in adult diabetic patients. The majority of diabetic patients with PAD have concomitant coronary artery disease [2,3] and a significant burden of morbidity and mortality in these patients is intimately associated with myocardial infarction, ischemic stroke or sudden cardiovascular death [4]. Peripheral arterial disease (PAD) is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, significant morbidity and mortality. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda

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