Peripheral arterial disease in diabetic patients selected from a primary care setting: Implications for nursing practice
Authors: Khattab, A.D., Ali, I.S. and Rawlings, B.
Journal: Journal of Vascular Nursing
Volume: 23
Issue: 4
Pages: 139-148
ISSN: 1062-0303
DOI: 10.1016/j.jvn.2005.09.005
Abstract:Although the care of patients with diabetes is increasingly provided in primary care, there is relatively little information on the prevalence and long-term progression of asymptomatic peripheral arterial disease (PAD) in diabetic populations selected from primary care settings. The aims of this study were to investigate prevalence and progression of PAD in 146 diabetic patients, and to compare mortality with 113 nondiabetic controls over a 7-year period. The prevalence of PAD in individual pedal arteries varied between 28.6% in the right posterior tibial artery to 48.8% in the left peroneal artery. During the 7-year period, 34.25% of the diabetic subjects died, and 17.5% moved to other locations. Of the remaining 70 patients, 35 (50%) showed no change in ankle-brachial index and 35 (50%) did show change. Comparison of risk factors between those who did and did not show evidence of progression revealed (1) a strong, significant, independent association between hyperglycemia (measured by plasma HbA1c) and progression of PAD among the diabetic population; and (2) a strong association between progression of the disease and family history of diabetes and ischemic vascular disease. There was a high death rate (34.25%) among the diabetic group, which was greater than for the age- and sex-matched nondiabetic controls (13.2%) drawn from the same practice. This high mortality was significantly related (P < .001) to the presence of PAD identified during first-year assessment. Once PAD develops in association with diabetes the long-term prognosis is poor and carries a high mortality rate mainly because of cardiovascular and cerebrovascular diseases. Both progression and mortality were significantly related to poor diabetic control. The role of the primary care nurse in assessing such patients by using Doppler-assisted measurements is one that should be expanded with the massive increase in the number of diabetic patients in the coming years. Copyright © 2005 by the Society for Vascular Nursing, Inc.
Source: Scopus
Peripheral arterial disease in diabetic patients selected from a primary care setting: Implications for nursing practice.
Authors: Khattab, A.D., Ali, I.S. and Rawlings, B.
Journal: J Vasc Nurs
Volume: 23
Issue: 4
Pages: 139-148
ISSN: 1062-0303
DOI: 10.1016/j.jvn.2005.09.005
Abstract:Although the care of patients with diabetes is increasingly provided in primary care, there is relatively little information on the prevalence and long-term progression of asymptomatic peripheral arterial disease (PAD) in diabetic populations selected from primary care settings. The aims of this study were to investigate prevalence and progression of PAD in 146 diabetic patients, and to compare mortality with 113 nondiabetic controls over a 7-year period. The prevalence of PAD in individual pedal arteries varied between 28.6% in the right posterior tibial artery to 48.8% in the left peroneal artery. During the 7-year period, 34.25% of the diabetic subjects died, and 17.5% moved to other locations. Of the remaining 70 patients, 35 (50%) showed no change in ankle-brachial index and 35 (50%) did show change. Comparison of risk factors between those who did and did not show evidence of progression revealed (1) a strong, significant, independent association between hyperglycemia (measured by plasma HbA1c) and progression of PAD among the diabetic population; and (2) a strong association between progression of the disease and family history of diabetes and ischemic vascular disease. There was a high death rate (34.25%) among the diabetic group, which was greater than for the age- and sex-matched nondiabetic controls (13.2%) drawn from the same practice. This high mortality was significantly related (P < .001) to the presence of PAD identified during first-year assessment. Once PAD develops in association with diabetes the long-term prognosis is poor and carries a high mortality rate mainly because of cardiovascular and cerebrovascular diseases. Both progression and mortality were significantly related to poor diabetic control. The role of the primary care nurse in assessing such patients by using Doppler-assisted measurements is one that should be expanded with the massive increase in the number of diabetic patients in the coming years.
Source: PubMed
Peripheral arterial disease in diabetic patients selected from a primary care setting: implications for nursing practice
Authors: Khattab, A.D., Ali, I.S. and Rawlings, B.
Journal: Journal of Vascular Nursing
Volume: 23
Pages: 139-148
ISSN: 1062-0303
DOI: 10.1016/j.jvn.2005.09.005
Abstract:Although the care of patients with diabetes is increasingly provided in primary care, there is relatively little information on the prevalence and long-term progression of asymptomatic peripheral arterial disease (PAD) in diabetic populations selected from primary care settings. The aims of this study were to investigate prevalence and progression of PAD in 146 diabetic patients, and to compare mortality with 113 nondiabetic controls over a 7-year period. The prevalence of PAD in individual pedal arteries varied between 28.6% in the right posterior tibial artery to 48.8% in the left peroneal artery. During the 7-year period, 34.25% of the diabetic subjects died, and 17.5% moved to other locations. Of the remaining 70 patients, 35 (50%) showed no change in ankle-brachial index and 35 (50%) did show change. Comparison of risk factors between those who did and did not show evidence of progression revealed (1) a strong, significant, independent association between hyperglycemia (measured by plasma HbA1c) and progression of PAD among the diabetic population; and (2) a strong association between progression of the disease and family history of diabetes and ischemic vascular disease. There was a high death rate (34.25%) among the diabetic group, which was greater than for the age- and sex-matched nondiabetic controls (13.2%) drawn from the same practice. This high mortality was significantly related (P < .001) to the presence of PAD identified during first-year assessment. Once PAD develops in association with diabetes the long-term prognosis is poor and carries a high mortality rate mainly because of cardiovascular and cerebrovascular diseases. Both progression and mortality were significantly related to poor diabetic control. The role of the primary care nurse in assessing such patients by using Doppler-assisted measurements is one that should be expanded with the massive increase in the number of diabetic patients in the coming years.
Source: Manual
Preferred by: Ahmed Khattab
Peripheral arterial disease in diabetic patients selected from a primary care setting: Implications for nursing practice.
Authors: Khattab, A.D., Ali, I.S. and Rawlings, B.
Journal: Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
Volume: 23
Issue: 4
Pages: 139-148
eISSN: 1532-6578
ISSN: 1062-0303
DOI: 10.1016/j.jvn.2005.09.005
Abstract:Although the care of patients with diabetes is increasingly provided in primary care, there is relatively little information on the prevalence and long-term progression of asymptomatic peripheral arterial disease (PAD) in diabetic populations selected from primary care settings. The aims of this study were to investigate prevalence and progression of PAD in 146 diabetic patients, and to compare mortality with 113 nondiabetic controls over a 7-year period. The prevalence of PAD in individual pedal arteries varied between 28.6% in the right posterior tibial artery to 48.8% in the left peroneal artery. During the 7-year period, 34.25% of the diabetic subjects died, and 17.5% moved to other locations. Of the remaining 70 patients, 35 (50%) showed no change in ankle-brachial index and 35 (50%) did show change. Comparison of risk factors between those who did and did not show evidence of progression revealed (1) a strong, significant, independent association between hyperglycemia (measured by plasma HbA1c) and progression of PAD among the diabetic population; and (2) a strong association between progression of the disease and family history of diabetes and ischemic vascular disease. There was a high death rate (34.25%) among the diabetic group, which was greater than for the age- and sex-matched nondiabetic controls (13.2%) drawn from the same practice. This high mortality was significantly related (P < .001) to the presence of PAD identified during first-year assessment. Once PAD develops in association with diabetes the long-term prognosis is poor and carries a high mortality rate mainly because of cardiovascular and cerebrovascular diseases. Both progression and mortality were significantly related to poor diabetic control. The role of the primary care nurse in assessing such patients by using Doppler-assisted measurements is one that should be expanded with the massive increase in the number of diabetic patients in the coming years.
Source: Europe PubMed Central