Underrecognition and Undertreatment for Peripheral
Arterial Disease in Diabetic Patients in Thailand
Supapong Arworn MD*, Natapong Kosachunhanun MD*, Kiran Sony MD**, Nimit Inpankaew MD***,
Piyamitr Sritara MD****, Arintaya Phrommintikul MD* ,Chonlisa Chariyalertsak BSc, MPHM *****,
Antika Wongthanee MSc* , Ampica Mangklabruks MD*, Kittipan Rerkasem MD, PhD*
Affiliation :
* NCD Center, Faculty of Medicine-RIHES, Chiang Mai University, Thailand
** Department of Internal Medicine, Chiangrai Prachanukroh Hospital, Thailand
*** Department of Internal Medicine, Lamphun Hospital, Thailand
**** Department of Internal Medicine, Ramathibodi Hospital , Thailand
***** Chiang Mai Provincial Public Health Office, Chiang Mai, Thailand
Objective : Although several guidelines emphasized the importance of atherosclerotic risk factor management in peripheral
arterial disease (PAD) in diabetic patients to reduce the cardiovascular mortality, authors do not know to what extent phy-
sicians follow these guidelines.
Material and Method: Between May 2014 and August 2014, consecutive eligible outpatients, aged ≥45 years with established
DM, were invited to be involved in this study. History, physical exam and laboratory test were reviewed. Ankle brachial index
≤0.9 was considered PAD. Then patients were evaluated the percentage of risk factor control according to American Heart
Association (AHA) criteria. The good control was defined that patients have adequate risk factor control between 3-5 factors.
Results : 2,247 diabetic patients were recruited for the study. 286 patients out of 2,247 were diagnosed PAD (12.7%). 236
PAD patients (82.5%) did not have any symptom of intermittent claudication, rest pain, gangrene or ulcer. According to AHA
criteria, the percentage of adequate control in low density lipoprotein, HbA1C and systolic blood pressure in PAD patients
was 18.9, 30.1 and 33.2% respectively. 49.8% in PAD patients had met our good risk factor control criteria.
Conclusion : Most PAD in diabetic patients was asymptomatic. The atherosclerotic risk factor control was poor in this group.
Keywords : peripheral arterial disease, diabetes, risk factor, ankle brachial index
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