INTRODUCTION

Diabetic peripheral neuropathy and PVD both contribute to the development of a diabetic foot. The risk of amputation increases in the presence of PVD. The modifiable risk factors associated with development of PVD in diabetes are found to be advancing age, uncontrolled hyperglycemia, hypertension, dyslipidemia and smoking. Effective implementation of preventive measures in the targeted highrisk group will pave the way for limb protection.

AIM OF STUDY

The main objectives of the study are as follows

1.        To estimate the proportion of PVD among type 2 diabetes mellitus patients.

2.        To determine the risk factors associated with the development of PVD.

3.        To determine the role of ABPI in predicting PVD.

MATERIALS AND METHODS

After obtaining informed written consent, 75 randomly chosen established cases of type 2 diabetic mellitus attending Tirunelveli Medical College between September 2014 and September 2015 have formed the study sample and followed up every 3 months for subsequent 1 year. Lipid profile, h/o smoking and h/o hypertension were recorded.  During each follow up the glycemic control of the patient, Hypertension control were analyzed. A comprehensive physical examination was done with focus to the peripheral nerve and vascular examination. ABPI was recorded during the start of the study, during each follow up and at the end of 1 year.

RESULTS AND OBSERVATION

The incidence of PVD is 9.33%. Incidence of PVD was maximum in the geriatric age group with a mean age of 63.57 years Incidence of PVD was 10% among the Males and 7% among the Females. The mean duration of diabetes for the PVD in the sub group is 13.57 years. 33.33%of HT with DM had PVD compared with 3.33% of Normotensives with Diabetes. The incidence of PVD in smoker male was 25% when compared with that of non–smokers (0%). Those with elevated lipid profile had an increased incidence of PVD (20%) when compared with that of the normal lipid profile patients (2.22%).  In this study, among 8 patients with ABPI of <0.9, 7 patients had the duplex evidence of PVD.

CONCLUSION

Incidence of PVD is about 10% in the present study. This has to be viewed seriously considering the huge diabetic population and due importance to be given for screening and prevention of PVD.Almost all of the PVD patients are totally asymptomatic and hence the need for active screening with estimation of ABPI is to be done annually for all diabetes patients. Modifiable risk factors to be controlled to prevent the development of PVD.