Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Golledge, Jonathan, Quigley, Frank, Velu, Ramesh, Walker, Phillip J. and Moxon, Joseph V. (2014) Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study. Cardiovascular Diabetology, 13 147: 1-9. doi:10.1186/s12933-014-0147-2


Author Golledge, Jonathan
Quigley, Frank
Velu, Ramesh
Walker, Phillip J.
Moxon, Joseph V.
Title Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study
Journal name Cardiovascular Diabetology   Check publisher's open access policy
ISSN 1475-2840
Publication date 2014-11-01
Year available 2014
Sub-type Article (original research)
DOI 10.1186/s12933-014-0147-2
Open Access Status DOI
Volume 13
Issue 147
Start page 1
End page 9
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2015
Language eng
Formatted abstract
Background

Pre-diabetes and untreated diabetes are common in patients with peripheral artery disease however their impact on outcome has not been evaluated. We examined the association of impaired fasting glucose, diabetes and their treatment with the presentation, mortality and requirement for intervention in peripheral artery disease patients.

Methods

We prospectively recruited 1637 patients with peripheral artery disease, measured fasting glucose, recorded medications for diabetes and categorised them by diabetes status. Patients were followed for a median of 1.7 years.

Results

At entry 22.7% patients were receiving treatment for type 2 diabetes by oral hypoglycaemics alone (18.1%) or insulin (4.6%). 9.2% patients had non-medicated diabetes. 28.1% of patients had impaired fasting glucose (5.6-6.9 mM). Patients with non-medicated diabetes had increased mortality and requirement for peripheral artery intervention (hazards ratio 1.62 and 1.31 respectively). Patients with diabetes prescribed insulin had increased mortality (hazard ratio 1.97). Patients with impaired fasting glucose or diabetes prescribed oral hypoglycaemics only had similar outcomes to patients with no diabetes.

Conclusions

Non-medicated diabetes is common in peripheral artery disease patients and associated with poor outcomes. Impaired fasting glucose is also common but does not increase intermediate term complications. Peripheral artery disease patients with diabetes requiring insulin are at high risk of intermediate term mortality.
Keyword Peripheral artery disease
Diabetes
Mortality
Surgery
Patient management
Vascular disease
Metabolic syndrome
Metformin
Mellitus
Insulin
Events
Diagnosis
Survival
Tolerance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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