Population Of Diabetic Patients Research Articles

Daytime variation does not impact outcome of cardiac surgery: Results from a diverse, multi-institutional cardiac surgery network

ObjectiveRecent single-center and experimental data suggested greater adverse cardiac events for patients undergoing aortic valve replacement (AVR) in the morning (AM) versus the afternoon (PM). However, previous studies in patients undergoing coronary artery bypass grafting (CABG) have found no similar time-related difference. We examined the impact of AM versus PM operative time on surgical outcomes of CABG and AVR in a diverse, multi-institutional cardiac surgery network between January 2008 and September 2018. MethodsThe AM group included patients whose surgery start time was between 6:30 and 9 AM, whereas noon to 2:30 PM was considered PM (8901 AM/1962 PM) for CABG and (2598 AM/617 PM) for AVR. Because of imbalances in sample size, risk factors, and Society of Thoracic Surgeons predicted risk between groups, propensity score matching using all baseline characteristics was used to create 2 well-matched patient groups whose outcomes were compared. ResultsAfter propensity score matching, there was no difference in mortality, stroke, prolonged ventilation, renal failure, deep sternal wound infection, reoperation, myocardial injury, atrial fibrillation, or readmission between AM and PM groups for both isolated CABG and AVR. However, there were mixed differences noted in intensive care unit length of stay, postoperative length of stay, blood product use, and crossclamp time. Findings were stable when accounting for site and physician effects, whereas subgroup analyses showed similar findings in the elective, diabetic, Hispanic, and off-pump patient populations. ConclusionsThere were no differences in operative mortality nor in major morbidity between well-matched AM and PM patients undergoing either CABG or AVR.

Contact dermatitis caused by glucose sensors in diabetic children.

Allergic contact dermatitis caused by glucose sensors has been recently described in diabetics, mostly in adult patients. Isobornyl acrylate and N-N dimethylacrylamide are the potent causative agents. To describe a child population with contact dermatitis caused by glucose sensors, determine the causative allergen, and assess the prevalence of isobornyl acrylate (IBOA) sensitization. Overall, 12 children with a reaction to medical devices, either glucose sensors or insulin sets, were patch tested with the European baseline series, glues and rubber, (meth) acrylates series, and with piece of the adhesive part of the glucose sensor FreeStyle Libre. Isobornyl acrylate 0.1% pet. was patch tested in 11 patients, and N-N dimethylacrylamide in two. Some patients were tested with adhesive parts of the infusion set. Overall, 10 children reacted to the adhesive part of the sensor FreeStyle Libre, and 10 children were sensitized to IBOA. One patient turned out to be negative in all patch tests. Allergic contact dermatitis caused by glucose sensors is common in the pediatric diabetic patient population. Like in the adult patient population, IBOA was the culprit allergen, with 83.3% sensitization prevalence in children exhibiting adverse cutaneous reactions caused by FreeStyle Libre.

Incretin-based therapy and risk of cholangiocarcinoma: a nested case-control study in a population of subjects with type 2 diabetes.

One cohort and several basic science studies have raised suspicion about an association between incretin therapies and cholangiocarcinoma. Our aim was to verify the occurrence of CC in relation to incretin-based medication use versus any antidiabetic treatment in an unselected population of diabetic patients. A population-based matched case-control study was conducted using administrative data from the Region of Piedmont (4,400,000 inhabitants), Italy. From a database of 312,323 patients treated with antidiabetic drugs, we identified 744 cases hospitalized for cholangiocarcinoma from 2010 to 2016 and 2976 controls matched for gender, age and initiation of antidiabetic therapy; cases and controls were compared for exposure to incretin-based medications. All analyses were adjusted for risk factors for CC, as ascertained by hospital discharge records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by fitting a conditional logistic model. The mean age of the sampled population (cases and controls, 75years) was very high, with no gender prevalence. Five per cent was treated with incretin-based medications. After adjusting for possible confounders, we found no increased risk of cholangiocarcinoma associated with the use of either DPP4i (OR 0.98, 95% CI 0.75-1.29: p = 0.89) or GLP-1-RA (OR 1.09, 95% CI 0.63-1.89; p = 0.76) in the 24months before hospital admission. Neither the duration of the therapy nor the dose modified the risk of cholangiocarcinoma. Our findings suggest that, in an unselected population, the use of both classes of incretin-based medications is not associated with an increased risk of cholangiocarcinoma.

The Value of Automated Diabetic Retinopathy Screening with the EyeArt System: A Study of More Than 100,000 Consecutive Encounters from People with Diabetes.

Background: Current manual diabetic retinopathy (DR) screening using eye care experts cannot scale to screen the growing population of diabetes patients who are at risk for vision loss. EyeArt system is an automated, cloud-based artificial intelligence (AI) eye screening technology designed to easily detect referral-warranted DR immediately through automated analysis of patient's retinal images.Methods: This retrospective study assessed the diagnostic efficacy of the EyeArt system v2.0 analyzing 850,908 fundus images from 101,710 consecutive patient visits, collected from 404 primary care clinics. Presence or absence of referral-warranted DR (more than mild nonproliferative DR [NPDR]) was automatically detected by the EyeArt system for each patient encounter, and its performance was compared against a clinical reference standard of quality-assured grading by rigorously trained certified ophthalmologists and optometrists.Results: Of the 101,710 visits, 75.7% were nonreferable, 19.3% were referable to an eye care specialist, and in 5.0%, the DR level was unknown as per the clinical reference standard. EyeArt screening had 91.3% (95% confidence interval [CI]: 90.9–91.7) sensitivity and 91.1% (95% CI: 90.9–91.3) specificity. For 5446 encounters with potentially treatable DR (more than moderate NPDR and/or diabetic macular edema), the system provided a positive “refer” output to 5363 encounters achieving sensitivity of 98.5%.Conclusions: This study captures variations in real-world clinical practice and shows that an AI DR screening system can be safe and effective in the real world. This study demonstrates the value of this easy-to-use, automated tool for endocrinologists, diabetologists, and general practitioners to address the growing need for DR screening and monitoring.

Postoperative Oral Antibiotics in Outpatient Foot and Ankle Surgery: Are We Affecting Postoperative Infections or Wound Healing Complications?

Category:InfectionIntroduction/Purpose:Postoperative infections after foot and ankle surgery can cause devastating outcomes for patients. Studies of postoperative infection rates in outpatient foot and ankle surgery range from 0.5-6.5%, with increasing numbers found in diabetic patient populations. The use of perioperative antibiotics in the prevention of postoperative infection in outpatient surgery is a topic that has often been discussed yet there remains considerable controversy. The authors hypothesize that there is no difference in postoperative infection rate or wound healing complications in patients who received postoperative oral antibiotics versus those that did not. Additionally, the authors sought to identify patient characteristics associated with postoperative infections or wound complications.Methods:Retrospective chart review of 649 elective outpatient foot and/or ankle surgery cases over a 2-year period performed by two fellowship trained foot and ankle surgeons at an academic medical center ambulatory surgical unit. All cases were included with at least one follow-up visit and no evidence of chronic wounds or infection. Those cases that did not have adequate follow up or if postoperative antibiotic treatment could not be determined were subsequently excluded. Analysis evaluated patients that received postoperative oral antibiotics (PAB) and those that did not receive postoperative oral antibiotics (NAB) to identify whether a difference in infection rate or wound healing complication were present. Patient demographics, medical comorbidities, BMI, smoking status, and tourniquet time were analyzed to identify contributing factors or comorbidities that may be more prevalent in those that developed postoperative infections in the PAB and NAB groups.Results:633 operative cases were included in the study. The average age of patients in the PAB group and NAB group was equal (age 45 ± 17). The number of infections in PAB was 6, while the number of infections in NAB was 10 (3% vs. 2%, p = 0.60). The number of deep versus superficial infections and wound complications between the two groups was not statistically significant. Patients that developed infections versus those that did not were older (average age 55 vs. 45, p = 0.02), demonstrated a higher prevalence of hypertension (44% vs. 17%, p = 0.01), and a history of neoplasm (19% vs. 2%, p < 0.01). No significant difference was found between groups based on BMI, diabetes, tourniquet time, or smoking status.Conclusion:There are limited studies published on the efficacy of routine postoperative antibiotics in outpatient foot and ankle surgery, despite a majority of surgeons (75%) reporting using postoperative antibiotics.2 The present study suggests there is no benefit to prescribing postoperative oral antibiotics in an outpatient surgery setting. Additionally, older patients, patients with hypertension, and patients with a history of neoplasm made up a larger percentage of patients in the postoperative infection group. BMI, diabetes, tourniquet time and smoking status did not have a significant difference in postoperative infections between the PAB group and NAB group.

ASSESSMENT OF PLANTAR FASCIITIS AMONG ADULTS HAVING HIGHER BODY MASS INDEX AND GLUCOSE INTOLERANCE IN A MEDICAL INSTITUTE OF RAIPUR.

Introduction: Plantar fasciitis (PF) is a degenerative syndrome of the plantar fascia resulting from repeated trauma at its origin on the calcaneus. PF is reported to be the most common cause of inferior heel pain in diabetic and non diabetic patient population. Calcaneal spurs (CS) have commonly been implicated as a risk factor for PF. To this purpose we have evaluated the frequency of Calcaneal spur (CS) in obese patients with Type-2 diabetes. Method: Study was designed as a cross sectional Analytical study . Male and female study subjects who were Obese (BMI ≥30 kg/m2), Having Diagnosed type 2 diabetes &amp; above the age of 18 years, with a history of plantar heel tenderness and/or pain were included in the study Information was analysed by using the Microsoft Excel and SPSS . Chi square test was used for analysis. Results:Atotal of 65 obese diabetic patients were included into the study. The mean age of the patients was 54±5.8 years. There were 25 males and 40 females. The median duration of diabetes was 4.2 years (1-10 years). The mean HbA1c was 8.4±0.9. 78% were having plantar fasciitis. Conclusion: Poor diabetes control Peripheral Neuropathy seems to be the main reasons Existence seems to be in a relationship with diabetic complications; therefore, obese diabetic patients may be more prone to these complications. Therefore, weight reduction should be encouraged in these patients.

ASSESSMENT OF PLANTAR FASCIITIS AMONG ADULTS HAVING HIGHER BODY MASS INDEX AND GLUCOSE INTOLERANCE IN A MEDICAL INSTITUTE OF RAIPUR

Introduction: Plantar fasciitis (PF) is a degenerative syndrome of the plantar fascia resulting from repeated trauma at its origin on the calcaneus. PF is reported to be the most common cause of inferior heel pain in diabetic and non diabetic patient population. Calcaneal spurs (CS) have commonly been implicated as a risk factor for PF. To this purpose we have evaluated the frequency of Calcaneal spur (CS) in obese patients with Type-2 diabetes. Method: Study was designed as a cross sectional Analytical study . Male and female study subjects who were Obese (BMI ≥30 kg/m2), Having Diagnosed type 2 diabetes &amp; above the age of 18 years, with a history of plantar heel tenderness and/or pain were included in the study Information was analysed by using the Microsoft Excel and SPSS . Chi square test was used for analysis. Results:Atotal of 65 obese diabetic patients were included into the study. The mean age of the patients was 54±5.8 years. There were 25 males and 40 females. The median duration of diabetes was 4.2 years (1-10 years). The mean HbA1c was 8.4±0.9. 78% were having plantar fasciitis. Conclusion: Poor diabetes control Peripheral Neuropathy seems to be the main reasons Existence seems to be in a relationship with diabetic complications; therefore, obese diabetic patients may be more prone to these complications. Therefore, weight reduction should be encouraged in these patients.

Metformin increases cancer specific survival in colorectal cancer patients—National cohort study

PurposeWe aimed to assess oncological outcomes in colorectal cancer patients with type 2 diabetes mellitus (T2DM) using metformin. MethodsPatients with colorectal cancer and T2DM during 2000–2012 period were identified form Lithuanian Cancer Registry and the National Health Insurance Fund database. Colorectal cancer-specific survival (CS) was the primary outcome. It was measured from date of colorectal cancer diagnosis to date of death due to colorectal cancer, or last known date alive. Results15,052 people who met eligibility criteria for this analysis, including 1094 (7.27%) with pre-existing type 2 diabetes (271 metformin never users and 823 metformin users) and 13 958 people without diabetes assessed. During follow-up (mean follow-up time was 4.4 years, with range from 1 day to 17 years) there were 10,927 deaths including 8559 from colorectal cancer. Significantly lower risk in CS between diabetic and non-diabetic people with lower risk of cancer-specific mortality (HR 0.87, 95% CI 0.80–0.94) in diabetic patient population was seen. After adjustment for age, stage at diagnosis and metformin usage, significant difference in colorectal CS between metformin users in diabetic patient population compared to non-diabetics and metformin non-users in diabetic patient population was found (0.80 (0.72–0.89) vs 1.00 and vs 1.05 (0.91–1.23)). Overall survival (OS) was better for diabetic patients with significant difference in diabetic metformin users (HR 0.91, 95% CI 0.79–0.94). ConclusionsColorectal cancer patients with T2DM treated with metformin as part of their diabetic therapy appear to have a superior OS and CS. However, prospective controlled studies are still needed to evaluate the efficacy of metformin as an anti-tumor agent.

Review on the Vibration Perception Threshold to Early Detect Diabetes Mellitus

The total population of diabetic patients increases from 4.7 % to 8.5 % in the adult population worldwide in only three decades. In Malaysia, more than 3 million of total population have been inflicted with diabetes. Vibration Perception Threshold is a non-invasive technique that can measure loss of sensation due to diabetic peripheral neuropathy. The threshold mainly depends on the frequency of vibration, the area of contact, the applied force, and the location of measurement. This paper will review on the factors influencing the vibration perception threshold and recent studies on the use of VPT to detect diabetes.

Otological and Visual Implications of Diabetes Mellitus in North Indian Population.

The worldwide population of diabetic patients is increasing alarmingly with India claiming number one position. It causes irreversible damage to cochlear hair cells, vestibular apparatus, visual pathway, nephrons, nerves, if not checked in time. A total of 188 patients of diabetes mellitus were included in this prospective study. The patients underwent routine anamnesis, hearing handicap inventory and dizziness handicap inventory assessment along with clinical examination for audiological, vestibular, neurological and ophthalmological (fundoscopy) status. In our study a sensorineural hearing loss, retinopathy, neuropathy, vestibulopathy was seen in diabetic patients.

Nano crystalline silver: a breakthrough in treating diabetic foot ulcers

India harbours world’s largest population of diabetic patients thus earning an infamous designation of ‘diabetic capital of the world’. Apart from various metabolic aberrations that are bound to happen in a patient with uncontrolled hyperglycemia, foot ulcers are one of the serious complications that may become limb and life threatening, if not addressed properly. Surgical debridement along with appropriate antibiotics, remain as the mainstay of management of such wounds. Conventional dressing methods involving povidone-iodine and other antiseptic agents have offered limited scope of effective wound healing owing to their inherent toxicity towards fibroblasts. In the present scenario where a large chunk of population crosses over to the list of newly diagnosed diabetics every year, nano crystalline silver has come as a breakthrough in effective management and early healing of diabetic foot ulcers through its effective antimicrobial action and limited toxicity for the host tissue.

Burnout Syndrome, Mental Splitting and Depression in Female Health Care Professionals.

BackgroundThe early days of a given experience are associated with typically what might be characterized as an idealized enthusiasm. Conversely burnout syndrome experienced later in the given experience is associated with disillusionment, disappointment, and symptoms which resemble a depression. This very common propensity is a parallel to the concept of “splitting” described by Kernberg with a pronounced “black and white” perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, depression, and Kernberg’s concept of splitting.Material/MethodsIn this present study, we assessed 132 female health care professionals working with a population of diabetic patients utilizing Burnout Measure (BM) Splitting Index (SI), Beck Depression Inventory II (BDI-II), and additional psychometric instruments, the Toronto Alexithymia Scale and the Trauma Symptoms Checklist.ResultsThe study results indicated significant Spearman correlations between burnout syndrome as measured by BM and depression (BDI-II) (R=0.62, P<0.01), and burnout syndrome as measured by BM and splitting (SI) (R=0.45, P<0.01). These findings may have implications for prevention and treatment of burnout syndrome.ConclusionsThe current study findings provide implications that the defensive mechanism of splitting may allow for the prediction of burnout symptoms which in turn may allow for the prediction of burnout syndrome. This dynamics may potentially be of use in both the potential detection and prevention of burnout syndrome.

A study of the fractional‐order mathematical model of diabetes and its resulting complications

Diabetes is a worldwide problem that affects one of every 11 persons nowadays. The IDF Diabetes Atlas (Eighth edition, 2017) states that approximately 415 million people in the world are living with the disease and that this number will rise to 629 million by the year 2045. It is a very serious problem of the world. A major part of the world population is affected by this disease and its resulting complications. In this paper, we propose to investigate a fractional‐order model of diabetes and its resulting complications. The mathematical model's parameters define the population of diabetic patients and those who are diabetic with complications at a given time t. We have also discussed the existence, uniqueness, and stability of the fractional‐order model, which we consider here. We make use of the homotopy decomposition method (HDM) in order to solve the problem.

97-LB: Point-of-Care HbA1c Testing in Redesign of Diabetes Management Program Lowered Costs and Improved Outcomes

Introduction: Empowering a low-income population of diabetic patients with onsite HbA1c testing results, coaching, and culturally appropriate diabetes self-management education materials improve outcomes and lower costs in a public health setting. Objectives: This study examines the positive outcomes of a redesign in the Diabetes Education and Care Management (DECM) program at Denton County Public Health, (DCPH) a participant in Delivery System Reform Incentive Payment (DSRIP) plan. Methods: Funding for ongoing management of diabetic patients across the U.S.A. remains an ongoing challenge. The DECM program elected to participate in the DSRIP program to secure funding to reach more diabetic patients with the goal of reducing their HbA1c and improve quality of life. Diabetic patients with an HbA1c of more than 9% met the DSRIP criteria for eligibility to DSRIP. Participants in the education program who followed the quarterly HbA1c appointment schedule were provided with diabetic medications and testing supplies to monitor glucose at no cost. Glycemic control was monitored by onsite testing of HbA1c during a quarterly visit at DCPH with the objective to lower the patients baseline HbA1c by 2.5%. Results presented reflect patient outcomes from Oct 2014 to Sept 2017. Results: Approximately 251 of the 400 patients met the DSRIP criteria of HbA1c over 9% during the selected dates. The average baseline HbA1c was 10.7% in year 3, which was lowered to 8.2% by year end. Health economic models have shown that, for a population of 500 patients, the improvement of 1.0% in the HbA1c results can lead to multiple complications episodes avoidance (e.g.,: amputation, cataract extraction, etc.) which would result in over U$ 500,000.00 in savings for the healthcare system. Conclusions: Our study suggests that empowering diabetic patients with education, state of art diabetes management, and onsite testing can lower overall HbA1c results leading to the reduction of complications and heath care costs. Disclosure J.P. Gallo: None. M. Richardson: None.

Ramadan fasting effects on the clinical and metabolic parameters of a previously educated population of diabetic, hypertensive and dyslipidemic patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Weight change of a population of diabetic patients previously educated and having fasted the month of Ramadan

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Clinical and metabolic characteristics of a population of diabetic patients previously educated having fasted all month of Ramadan

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

MicroRNA expression profiles in a human induced pluripotent stem cell‐derived model of diabetic cardiomyopathy

Diabetic cardiomyopathy (DCM) is a common and important health concern in the rapidly growing population of diabetic patients. At present, no specific drug treatment exists to prevent diabetes‐induced cardiac dysfunction, a complex multifactorial condition that is distinguished by a unique set of metabolic, structural, and molecular changes within the DCM. The advances in disease modeling using human induced pluripotent stem cells (iPSCs) have opened novel paths to study human physiology and disease at the cellular level. Here, we characterized an in vitro cell based model for DCM developed by exposing human induced pluripotent stem cell‐derived cardiomyocytes (iPSC‐CMs) to a diabetic‐like environment (10 mM glucose, 10 nM human‐endothelin‐1, and 1 mM cortisol). The treated cells exhibited metabolic shift (demonstrated by reduced glucose oxidation and increased fatty acid oxidation) and hypertrophy (demonstrated by hypertrophic morphology and increased expression of hypertrophic markers such as BNP, ANP, ACTA1 and MYH7. MicroRNAs (miRNAs) are key factors in controlling complex regulatory networks in cellular functions and disease processes. We performed a small RNA deep sequencing analysis to identify miRNAs associated with this in vitro DCM model. We identified 57 differentially regulated (p&lt;0.05) miRNAs (26 up‐ and 31 down‐regulated) in diabetic CMs compared with control iPSC‐CMs (10 mM mannitol). The differential expression of several miRNAs was verified by real‐time PCR. These findings suggest miRNAs might be involved in this model of DCM. Further investigation will be required to examine functional roles for these miRNAs and identify the mechanisms by which these miRNAs might contribute to the development of DCM.Support or Funding InformationSupported by NIH Grant P01GM066730.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Predictors of lower extremity amputation in patients with diabetic foot ulcer

Background: Diabetic foot lesions are responsible for more hospitalisations than any other complication of diabetes and diabetes is a predominant aetiology for non-traumatic lower extremity amputations. Authors, therefore, examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients. The objective of the study was to describe independent predictors for lower extremity amputation in patients with a diabetic foot ulcer and to validate the predictive value of PEDIS (IWGDF) classification system for a diabetic foot ulcer.Methods: A retrospective study of 197 patients presenting with diabetic foot ulcer presenting to a tertiary care hospital in Mysuru, India. The recorded parameters were age, sex, various risk factors, laboratory parameters, the presence of DM-related complications and ulcer characteristics as determined by PEDIS system. The main outcomes recorded were healed ulcer and amputation.Results: Authors have found that factors strongly associated with risk of amputation are (in order of strength): PVD, past amputation, nephropathy, past ulcer, ulcer duration, TLC, Hb and sr. creatinine. Authors also validated the PEDIS scoring system as an effective classification system with prognostic value. The PEDIS score of &gt;7 is a highly significant predictor of adverse outcome (amputation) of diabetic foot ulcer.Conclusions: Several risk factors for lower extremity amputation in a patient with diabetic foot ulcer were identified. An integrated risk-assessment model including the above significant risk factors and PEDIS system can be developed that is both clinically accurate as well as quick to assess for predicting the adverse outcome in a patient of diabetic foot ulcer and providing an opportunity to save the limb.

Peripheral arterial disease of the lower limbs in asymptomatic diabetic patients: Prevalence and determining factors

Peripheral arterial disease (PAD) of the lower limbs is an important predictor of cardiovascular disease; however it's still underdiagnosed over asymptomatic diabetic patients, free of cardiovascular disease. Determining the prevalence and risk factors for PAD in an asymptomatic population of diabetic patients at low or intermediate risk factors of cardiovascular disease, with a free history of cardiovascular disease. This was a prospective study conducted over 14 months period from November 2017 to January 2018. A total of 309 diabetic patients were included from two diabetes centers. PAD was defined as an ankle-brachial index (ABI) less than 0,9. Among the 309 patients, the ankle-brachial index (ABI) was < 0.9 in 98 (31,71%) patients considered to have PAD. The ABI was > 1.3 in 36 (11,35%) patients who had suspected mediacalcosis. The average age of the PAD population was 56.2 years. Female gender predominated (57%). The mean duration of diabetes was 11 yeras: 80% type II Diabetes. PAD of the lower limbs was mild in 26 patients (26,53%) moderate in 49 (50%) and severe in 23 (23,46%). Duplex Doppler commonly showed lesions of the femoral and tibial arteries. Factors associated with PAD were advanced age ( P < 0.0001), age of diabetes > 6 years ( P < 0.0001), uncontrolled diabetes as assessed by HbA1c levels > 7% ( P < 0), 0001) and elevated fasting glucose levels ( P = 0.039), Hypertension ( P < 0.0001) and dyslipidemia ( P < 0.0001). For mediacalcosis, male gender was the only factor identified. Primary prevention outpatient screening of asymptomatic diabetic patients with lower or intermediate cardiovascular risk can identify numerous patients with PAD. Advanced age, a mean duration of diabetes over 6years, uncontrolled diabetes, hypertension, and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our population.