DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20185326

Assessment of peripheral arterial disease in diabetic adults with foot ulcers in an African population

Osita Ede, Ugochukwu N. Enweani, Iheuko S. Ogbonnaya, Kenechi A. Madu, Udo E. Anyaehie, Tochukwu Ikpegbu, Chinonso Basil-Nwachukwu

Abstract


Background: Peripheral arterial disease (PAD) is a recognized risk factor for diabetic foot ulceration. It was thought that PAD is not common in Sub-Saharan Africa. Studies show otherwise. It becomes necessary to assess the prevalence of PAD among diabetic adults with foot ulcers in Nigeria. The objective of the study was to assess the prevalence of PAD in diabetic subjects with foot ulcers in Nigeria.

Methods: Diagnosis of PAD was made with the ankle-brachial index (ABI). Edinburgh claudication questionnaire was administered to the patients. An ABI of <0.9 is diagnostic of PAD. Risk factors for PAD were assessed. A control group of non-diabetic adults was used.

Results: Sixty-seven per cent (67%) of the test group has PAD as compared to 18% of the control group. Smoking, duration of diabetes and systemic hypertension were strongly associated with PAD.

Conclusions: Diabetic adults with foot ulcers in Nigeria have a high prevalence of PAD.


Keywords


Diabetics, Foot ulcers, Peripheral arterial disease, Nigeria

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References


Dada AA, Awoyomi BO. Is the trend of amputation in Nigeria changing? A review of 51 consecutive cases seen at Federal Medical Center Ebute Meta, Lagos, Nigeria. Niger Med J. 2010;51(4):167-9.

Frederiks JP, Visagie S. The rehabilitation programme and functional outcomes of persons with lower limb amputations at a primary level rehabilitation centre. South African J Occup Ther. 2013;43(3):18–28.

Tesfaye S, Gill G. Chronic diabetic complications in Africa. Africa Health. 2011;33(4):37-8.

Mehta N, Ogendo S, Awori M. Prevalence, Progression and Associated Risk Factors of Asymptomatic Peripheral Arterial Disease. Annals of African Surgery. Available at: https://www.ajol. info/index.php/aas/article/view/164313. Accessed 12 June 2018.

Hennion DR, Siano KA. Diagnosis and treatment of peripheral arterial disease. Am Fam Physician. 2013;88(5):306–10.

Rabia K, Khoo EM. Is the Edinburgh Claudication Questionnaire a good screening tool for detection of peripheral arterial disease in diabetic patients? Asia Pac Fam Med. 2007;6(1):28-34.

Umuerri EM, Obasohan AO. Lower extremity peripheral artery disease: prevalence and risk factors among adult Nigerians with diabetes mellitus. West Afr J Med. 2013;32(3):200-5.

Ikem R, Ikem I, Adebayo O, Soyoye D. An assessment of peripheral vascular disease in patients with diabetic foot ulcer. The Foot. 2010;20(4):114–7.

Abbas ZG, Archibald LK. Foot complications in diabetic patients with symptomatic peripheral neuropathy Dar es Salaam, Tanzania. Diabetes Int. 2000;10:52-6.

Abbas ZG, Lutale JK, Morbach S, Archibald LK. Clinical outcome of diabetes patients hospitalized with foot ulcers. Diabetic Medicine.2002;19:575-79.

Clayton W, Elasy TA. A Review of the Pathophysiology, Classification, and Treatment of Foot Ulcers in Diabetic Patients. Clin Diabetes. 2009;27(2):52–8.

Boulton AJM, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive Foot Examination and Risk Assessment. Diabetes Care. 2008;31(8):1679–85.

Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in diabetic and nondiabetic patients. Diabetes Care. 2001;24:1433-7.

Syvänen K, Aarnio P, Jaatinen P, Korhonen P. Effects of age, sex and smoking on ankle-brachial index in a Finnish population at risk for cardiovascular disease. Int J Angiol. 2007;16(4):128–30.

Kumar A, Mash B, Rupesinghe G. Peripheral arterial disease - high prevalence in rural black South Africans. S Afr Med J. 2007;97(4):285–8.

Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, et al. Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects. J Am Coll Cardiol. 2013;61(16):1736–43.

Hooi JD, Kester AD, Stoffers HE, Overdijk MM, van Ree JW, Knottnerus JA. Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: a longitudinal study. Am J Epidemiol. 2001;153(7):666–72.