Determinants of Doppler confirmed lower limb atherosclerosis in asymptomatic type 2 diabetes: cross-sectional evidence from a tertiary centre in South India

Priyadharshini Krishnaswamy; Ashok M. L.; Chetana  Krishnegowda

doi:10.18203/2320-6012.ijrms20252790

Authors

Priyadharshini Krishnaswamy Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Ashok M. L. Department of General Medicine, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
Chetana Krishnegowda Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252790

Keywords:

Diabetic neuropathy, Diabetic retinopathy, Dyslipidaemias, HbA1C, Peripheral vascular diseases, Proteinuria, Coronary artery disease, Risk factors

Abstract

Background: Peripheral artery disease (PAD) in type 2 diabetes is frequently asymptomatic yet clinically significant, has multifactorial risk factors, the identification of which enable appropriate preventive strategies. Aims of study were-to identify clinical and biochemical determinants of Doppler‑confirmed lower‑limb atherosclerosis (PAD) in asymptomatic adults with type 2 diabetes and to establish the in- hospital prevalence of PAD in the study population. It was an observational cross‑sectional study conducted at a tertiary care centre in South India.

Methods: Adults ≥40 years with type 2 diabetes, asymptomatic for PAD were screened for PAD using colour duplex doppler, those with PAD were evaluated for demographic factors, diabetes duration, glycaemia (HbA1c), lipid profile, and diabetes complications [retinopathy, proteinuria/renal involvement, neuropathy, and coronary artery disease (CAD)]. Statistical analysis used was χ²/Fisher’s exact test for categorical variables and Welch’s t‑test for continuous variables. Analyses were performed in R, version 4.1.1

Results: Among 320 participants, PAD prevalence was 41.9% (n=134). PAD was associated with older age, longer diabetes duration, higher HbA1c, lower HDL and higher triglycerides, as well as retinopathy, proteinuria/renal involvement, neuropathy, and coronary artery disease (all p<0.001). Gender, LDL cholesterol and total cholesterol were not associated significantly with PAD (p>0.05).

Conclusions: Age, glycaemic burden, atherogenic dyslipidaemia, and microvascular/atherosclerotic comorbidities can help identify higher‑risk subgroups for targeted PAD screening in asymptomatic type 2 diabetes.

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