TITLE:
Screening of Peripheral Artery Disease by Systematic Measurement of Ankle-Brachial Index among Diabetic Patients in Dakar
AUTHORS:
Abdoulaye Leye, Nafy Ndiaye, Ngone Diaba Diack, Michel Assane Ndour, Ameth Dieng, Daouda Thioub, Awa Fall, Samira Elfajri, Yakham Mohamed Leye
KEYWORDS:
Diabetes, Ankle-Brachial Index, Peripheral Artery Disease, Screening, Dakar
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.7 No.4,
November
16,
2017
ABSTRACT: Introduction: The peripheral artery disease (PAD) is one of the chronic and frightening
vascular complications of the diabetes whose tracking can be done by the
Ankle-Brachial Index (ABI) measurement. We conducted in this context a study
which consisted in measuring the ABI among hospitalized diabetic patients at
Teaching Hospital of Pikine in Dakar, over 18 months’ duration. The aim was to
determine the prevalence and evaluate factors correlated to the presence of the
PAD. Patients and Method: This cross-sectional descriptive study
interested the whole of diabetic patients hospitalized in Internal Medicine/Endocrinology
Department, from January 2013 to June 2014. We carried out a complete clinical
examination associated with ABI measurement by a Doppler probe for each
included patient after having collected the clinical and paraclinical data. Results: Our population of study comprised 209 diabetic patients with a
female predominance (126, 60.3%).
The sex-ratio man/woman was 0.6. The median age of the population of study was
54 ± 2 years. In our series, 157 (75.1%) patients
discovered their diabetes with the waning of an affection while the 52 (24.9%) other patients
discovered their diabetes at the time of a systematic assessment. The PAD
appeared by an intermittent claudication among 38 patients (18.2%). The ABI was
normal for 126 patients (60.3%).
The ABI was low for 51 patients (24.4%), unilateral in 3.8% of cases and
bilateral in 20.6% of cases. The ABI was high among 32 patients (15.3%),
unilateral in 7.2% of cases and bilateral in 8.1% of cases. The ABI extremes
values were 0.11 and 2. In the population of study, 46 patients (22%) had a
well-compensated PAD. The PAD was low compensated for 3 patients (1.4%) and
severe for 2 patients (1%). The ABI was more frequent and significantly among
women than men, with 32 cases (25.4%) against 19 (22.9%) cases (p = 0.021). The proportion of low ABI was more important
among patients whose diabetes had evolved for more than 5 years (42.3% of
cases) with a peak of frequency in the duration of 6 - 10
years (47.7% of cases). Conclusion: The PAD global prevalence among
hospitalized diabetic patients appeared high with 24.4% patients presenting low
ABI. Its early diagnosis among subjects at risk as for our study population
allowed identifying asymptomatic subjects having another cardiovascular damage.
Thus, the screening of obstructive arteriopathy of lower limb PAD by the
measurement of ABI should be applied to all diabetic patients for a better
assessment of atherosclerotic complication.