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Title: Predictors of decrease in ankle-brachial index among patients with diabetes mellitus
Authors: Hoe, J.
Koh, W.-P. 
Jin, A.
Sum, C.-F.
Lim, S.-C.
Tavintharan, S.
Keywords: Ankle-brachial index
Peripheral artery disease
Issue Date: Sep-2012
Citation: Hoe, J., Koh, W.-P., Jin, A., Sum, C.-F., Lim, S.-C., Tavintharan, S. (2012-09). Predictors of decrease in ankle-brachial index among patients with diabetes mellitus. Diabetic Medicine 29 (9) : e304-e307. ScholarBank@NUS Repository.
Abstract: Aim Screening for peripheral arterial disease, a complication among patients with diabetes, is performed by periodic assessment of ankle-brachial index. We aimed to study the degree of ankle-brachial index change over time and factors associated with significant change. Method We assessed difference between two ankle-brachial index measurements over time in a consecutive series of 82 patients with Type2 diabetes. All patients had ankle-brachial index >0.9 but ≤1.3 for the first measurement, and significant ankle-brachial index decrease was defined as a decrease of >0.1 in the follow-up measurement compared with the baseline. Results The mean follow-up duration was 27.6 (median 30.0) months. Significant ankle-brachial index decrease was seen in 20.7% of patients, including 5% with follow-up ankle-brachial index of ≤0.9, consistent with the diagnosis of peripheral arterial disease. After adjusting for age and gender, higher baseline HbA1c and serum creatinine levels, increase in follow-up serum LDL cholesterol levels compared with baseline and history of retinopathy were predictors of significant ankle-brachial index decrease. Conclusions Our study suggests that, within twoyears, one in five patients with diabetes and a normal ankle-brachial index may have significant progression of peripheral arterial disease. Annual ankle-brachial index assessment and better control of hyperlipidaemia may thus be required for at-risk patients with poor glycaemic control, renal impairment and retinopathy. © 2012 Diabetes UK.
Source Title: Diabetic Medicine
ISSN: 07423071
DOI: 10.1111/j.1464-5491.2012.03705.x
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