Abstract

Diabetes mellitus (DM) is characterized by chronic hyperglycemia and a disorder of carbohydrate, lipid, and protein metabolism caused by a complete or partial insufficiency of insulin secretion and/or insulin action. Diabetes has moved into the top 10 causes of death after a significant increase of 70% since 2000. Peripheral arterial disease in Diabetes mellitus has been constantly found to increase with the age of the patient, duration of the diabetes mellitus and with presence of other complications like diabetic neuropathy. It adds to the list of conventional risk factors for peripheral arterial disease such as physical inactivity, hypertension, smoking, deranged lipid profile. Peripheral arterial disease also leads to a significant morbidity and mortality in the diabetic population due to the development of Diabetic Foot Syndrome. Evaluation of the peripheral vascular disease in male and female patients of type 2 diabetes mellitus of more than 5 years using the ankle brachial index. Materials and Methods: 160 patients of Type 2 diabetes mellitus of more than 5 years duration were studied cross sectionally for peripheral vascular disease using ABI as a tool. The data was collected from department of medicine, Gajra Raja Medical College and JA group of hospital Gwalior. A comparison between male and female patients was done using unpaired t test. Result: In total of 160 patients, 104 were males (65%) and 56 were female (35%). The median age was (49.74±8.47) years (interquartile range (IQR) = 30 - 60 yrs.). According to ABI measurements of the lower limb (LL), a total of 65 patients (40%) had an association with PVD (p<0.01) in which 26 (46%) females had ABI (< 0.9) and males 39 (37%) had ABI (<0.9). Conclusion: We found Prevalence of the asymptomatic peripheral vascular disease (ABI≤0.9) 40% in our study. This has to be viewed seriously considering the huge burden of type 2 diabetic population. Females appears to be more prone to develop PVD. The exact mechanism by which females suffer to PVD more is still unknown. There are some potential explanation like role of estrogen in developing PVD. In Diabetic females PVD peak after menopause (age > 50 years). These results suggest that estrogen protects and delays the development of vascular disease. Further studies are required to study the underlying mechanism by which estrogen influences PVD and other vascular complications in DM.

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