Leg artery disease ups risk of death in diabetics

NEW YORK (Reuters Health) - Individuals with non-insulin dependent type 2 diabetes and reduced blood flow to the legs -- a condition known as peripheral artery disease or PAD -- are at increased risk for dying from a heart-related ailment, a study shows. Doctors can use a simple test called the ankle-brachial index (ABI) to detect PAD in diabetic patients.

The ABI is the ratio of the blood pressure in the ankle to the pressure in the arm. Any value below 1 is considered abnormal and values below 0.25 indicate severe blood flow problems.

Dr. Paul E. Norman and colleagues from the University of Western Australia, Fremantle, examined the natural history of PAD in nearly 1,300 type 2 diabetics. They defined PAD as an ABI of no more than 0.90 on two consecutive tests or any PAD-related lower-extremity amputation.

The prevalence of PAD at baseline was roughly 14 percent. Norman's team observed a strong independent association between both PAD and increasing age, systolic blood pressure, total serum cholesterol, and smoking.

They also observed an association between an abnormal baseline ABI (no more than 0.90) and a 67 percent increased risk of heart-related death.

"PAD is relatively common in diabetic patients, even when stringent criteria for the diagnosis ... are used," Norman and colleagues point out in a report in Diabetes Care this month. "This further supports the American Diabetes Association's recommendation for regular screening in the context of optimized vascular (circulatory) risk management."

SOURCE: Diabetes Care March 2006.