Evaluating glycemic control and its correlation with peripheral artery disease in ambulatory type 2 diabetic patients of an urban area of Gujarat, India

Abstract

Background and Aim: Persistant hyperglycemia and insulin resistance in type 2 diabetes mellitus (T2DM) increases the risk for peripheral artery diseases (PAD), which can be measured by ankle brachial pressure index (ABPI), a simple yet validated tool. In the present study, we attempted to correlate the glycemic control with PAD and to find its significance, if any. Methods: We recruited 147 ambulatory T2DM patients under treatment with minimum 1 year of disease duration representing the various socioeconomic strata. Fasting blood sugar (FBS), postprandial blood sugar (PP2BS) and glycosylated hemoglobin (HbA1c) were measured at an accredited laboratory, and the glycemic control was defined as per American Diabetes Association 2012 criteria. PAD was tested by ABPI, using vascular doppler following standard protocol, defined as ABPI ≤ 0.9 and compared within them in groups based on glycemic control. Results: We found glycemic control in just one‑third of the subjects who correlated negatively with ABPI values for all three parameters (OR: HbA1c ‑ 3.00, FBS ‑ 2.88, PP2BS ‑ 2.13). Odds risk for PAD in poorly controlled glycemics proved to be the highest for HbA1c and statistically significant for FBS (P value 0.016). Conclusion: Poor glycemic control and under‑use of ABPI assessment for PAD need to be rectified. All means of glycemic control were correlated with PAD, of which FBS is a better predictor than HbA1c.