Peripheral arterial disease of the lower limbs in African diabetic patients: Ultrasonography and determining factors

Introduction: Diabetic peripheral arterial disease(PAD) of the lower limbs is underdiagnosed. Methodology: This was a prospective study conducted over a six-month period from November 2012 to April 2013. A total of 308 diabetic patients were included from three diabetes centers in Abidjan (Ivory Coast). Aim: To screen for PAD of the lower limbs in a diabetic population and to identify the determining factors. Results: Among the 308patients, the ankle-brachial index (ABI) was. <. 0.9 in 68 (22.07%) patients considered to have PAD; the ABI was. >. 1.3 in 56 (18.2%) patients who had suspected mediacalcosis. The average age of the PAD patients was 60.2years. Female gender predominated (55.9%). The mean duration of diabetes was 9.6years: 97.1% type2 diabetes. The other cardiovascular risk factors in this population were hypertension (58.8%) and dyslipidemia (40.9%). Smoking was present in 29.4% of patients and obesity in 23.9%. PAD of the lower limbs was mild in 46patients (67.6%), moderate in 16 (23.5%) and severe in 6 (8.8%). Duplex Doppler commonly showed lesions of the tibial arteries. Determining factors of diabetic PAD of the lower limbs were hypertension (58.8% vs 36.6%; OR. =. 2.46; 95% CI: 1.13-5.36; P=. 0.034) and dyslipidemia (40.9% vs 8.3%; OR. =. 7.6; 95% CI: 2.31-25.08; P=. 0.0009). For mediacalcosis, male gender (71.5% vs 39.7; OR. =. 0.26 95% CI/0.10-0.64. P=. 0.004) was the only factor identified. Conclusion: Hypertension and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our African population.