Abstract
BackgroundPeripheral arterial disease (PAD) is rarely sought for and generally under-diagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test.ObjectivesTo determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD.MethodA cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI) was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease.ResultsThe overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05), sex (p < 0.05), and marital status (p < 0.05). The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses.ConclusionThe prevalence of PAD is relatively high in diabetic subjects in the south-western region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.
Highlights
Key focusPeripheral Arterial Disease (PAD) is an important cause of ischemic limb, delayed wound healing and lower extremity amputation in diabetic patients
The prevalence of Peripheral arterial disease (PAD) assessed through the use of ankle-brachial index (ABI) was 52.5% (115 subjects), whilst when the assessment was done with the use of a history of intermittent claudication, the prevalence was 24.7% (54 subjects)
The use of the ankle-brachial index in the assessment of peripheral arterial disease in this study clearly demonstrated the higher prevalence of asymptomatic PAD
Summary
Peripheral Arterial Disease (PAD) is an important cause of ischemic limb, delayed wound healing and lower extremity amputation in diabetic patients. The prevalence of PAD worldwide has been estimated at between 4.5% and 29%.1. The prevalence of PAD in diabetics in sub-Saharan Africa varies from 1.7% to 28%.2. In our Nigerian environment there is a paucity of studies to assess its prevalence especially in diabetics. Agaba[3] at the Jos University Teaching Hospital found that the prevalence of PAD in type 2 diabetics type 2 with end stage renal failure was 51.7%. Peripheral arterial disease (PAD) is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is detected and diagnosed by the ankle-brachial index, a simple and reliable test
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