Relation of Increased Hemoglobin A1c Levels to Severity of Peripheral Arterial Disease in Patients With Diabetes Mellitus

The association between hemoglobin A1c levels and the severity of peripheral arterial disease (PAD) was investigated in 224 patients with diabetes mellitus and PAD. The mean hemoglobin A1c levels were 9.1 ± 2.1% in patients with diabetes with ankle-brachial indexes (ABIs) <0.60 and 7.1 ± 0.9% in those with ABIs of 0.60 to 0.89 (p <0.0001). Hemoglobin A1c levels <6.5% were present in 2 of 89 patients with diabetes (2%) with ABIs <0.60 and in 24 of 135 (18%) with ABIs of 0.60 to 0.89 (p = 0.0004). Hemoglobin A1c levels <7.0% were present in 24 of 89 patients with diabetes (27%) with ABIs <0.60 and in 63 of 135 (47%) with ABIs of 0.60 to 0.89 (p = 0.003). Hemoglobin A1c levels <7.5% were present in 30 of 89 patients with diabetes (34%) with ABIs <0.60 and in 92 of 135 (68%) with ABIs of 0.60 to 0.89 (p <0.0001). In conclusion, the higher the hemoglobin A1c levels in patients with diabetes with PAD, the higher the prevalence of severe PAD.