Author/Authors :
Bassyouni, Atef Cairo University - Department of Internal Medicine, Egypt , El Ebrashy, Ibrahim Cairo University - National Institute of Diabetes and Endocrinology - Department of Internal Medicine, Egypt , Salem, Gamal Cairo University - Department of Internal Medicine, Egypt , Amam, Sayed Cairo University - Department of Internal Medicine, Egypt , Abdella, Aly Cairo University - Department of Internal Medicine, Egypt , Mahfouz, Amr Cairo University - Department of Internal Medicine, Egypt , Ramadan, Heba Cairo University - Department of Internal Medicine, Egypt , Hussein, Ghada Cairo University - Clinical Pathology, Egypt , Omar, Ghada A. Cairo University - Clinical Pathology, Egypt , Ghanem, Ayat I. Cairo University - Clinical Pathology, Egypt
Abstract :
Among different population of patients, pulse palpation was not a sensitive tool for the detection of PAD. However, the specificity of an absent pulse for the diagnosis of PAD was excellent. The objective of this study first was to determine the frequency of absent pedal pulsations and intermittent claudication among type 2 diabetic patients attending the medical clinics of National Institute of Diabetes and Endocrinology (NIDE) and to assess them as markers of PAD among these patients. And secondly was to determine the frequency of PAD and its relationship with various risk factors among these patients. Subjects and methods: This study was carried out at the outpatient medical clinics of NIDE. A total of 1,012 diabetic subjects were recruited. All the diabetic patients underwent a clinical evaluation but only a randomly selected 100 of these patients were underwent biochemical investigation (that included lipid profile, fasting plasma glucose (FPG), Glycated hemoglobin (Hb Ale) , serum creatinine C reactive protein (CRP) and ankle brachial index (ABI). Results: While 15.1% of whole study patients were suffering of intermittent claudication, only 6.1% had absent pedal pulsation. On other hand, in randomly selected subgroup of these type2 diabetic patients (69 patients), 23.5% of these patients was suffering of intermittent claudication but only 7.2 % had absent pedal pulses. However, on using ABI estimation, 46.4% of patients of this subgroup was diagnosed to have PAD. Within this subgroup ofpatients, patients with and without PAD were comparable as regards all clinical and biochemical criteria except ABI of pedal pulsations which was significantly higher among these patients without than those patients with PAD. Furthermore, there was no significant association between presence of PAD and the known risk factors of PAD. Conclusion: Among type2 diabetic patients attending medical clinics of National Institute of Diabetes and Endocrinology both history of intermittent claudication and absent pedal pulses are not sensitive markers for the detection of PAD compared to ABI Although the majority of our patients were asymptomatic, a relatively high frequency of PAD (46.4%) was detected among them. Screening for PAD by ABI is recommended in for type2 diabetic patients
