Abstract

Introduction: Peripheral arterial disease (PAD) is a common vascular disorder in Saudi Arabia where diabetes mellitus, hypertension and smoking are common risks. As this disease carries significant morbidity and mortality. Objective: This study aimed to screen for PAD in the community among diabetics, determining its prevalence, severity and associated risk factors. Patients and Methods: This study was done at 3 primary health care centers (PHCCs) at Domat Aljandal and two centers at Quraiat, Aljouf region. The included patients were 149, all were diabetic, 114 males and 35 females. The sociodemographic data, special habits, symptoms of peripheral ischemia and biochemical profiles [including blood lipids and fasting sugar] were extracted from the medical files and asked during interview. After clinical assessment, the ankle brachial index (ABI) was bilaterally determined on supine position using 8 MHz vascular Doppler. PAD was diagnosed if an ABI was <0.9. Results: The means of age, duration of diabetes and body mass index were 59.2, 9.13 years and 30.07 kg/m2 respectively. Of all, 47% were smokers and 56.7% had hypertension. Out of the 149 studied patients, 21 (14.1%) were previously diagnosed to have PAD and had undergone angioplasty. Symptoms of PAD were found only in 10 of these 21 and none of the remaining 128. By the ABI measurement, PAD was diagnosed in 48 patients (32.2%), being unilateral in 27 and bilateral in 21 patients. Most of PADs (79.2%) were mild to moderate severity while it was severe 20.8%. The frequency of PAD was non-significantly more among females, patients with co-morbid hypertension, patients on oral hypoglycemic drugs and smokers (P>0.05 for each). The frequency of low ABI was significantly more frequent among patients with history of vascular surgery (P=0.001). Patients with PAD had significantly higher mean ages (P=0.048) and non- significantly higher mean of duration of DM. If patients known to have PAD are excluded, new diagnosis of PAD was made in 30 of 128 naïve patients (23.4%). Conclusion: The prevalence of PAD in diabetic individuals in the community is high, probably due to the high frequency of other risks such as smoking and hypertension. These finding warrants activation of the nationwide screening program for prevention of cardiovascular diseases to decrease the morbidity and mortality of this diabetic complication.

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