Factors influencing the presence of peripheral arterial disease among Thai patients with type 2 diabetes

Background: Little is known about factors predicting peripheral arterial disease (PAD) development in Thai type 2 diabetes patients. This study aims to identify factors related to PAD in type 2 diabetes and the best predictors for PAD development.

Methods and results: A case-control study was conducted in which 405 type 2 diabetes patients were recruited from four tertiary care hospitals in Bangkok, Thailand. Cases were type 2 diabetes patients with PAD who were compared to those without PAD. An ankle-brachial index (ABI) < 0.9 was used for PAD diagnosis. An ABI between 0.91 and 1.30 was used to define those without PAD. Demographic characteristics, the diabetes self-care activities score and chief complaints were measured. Thai type 2 diabetes patients with PAD were older (65.45 ± 12.2 years), had no formal schooling, and were more likely to be a local vendor than those without PAD (p < 0.05). Type 2 diabetes patients with PAD had diabetes longer than those without PAD (p < 0.05). Hypertension, coronary heart disease and chronic kidney disease were significantly more common in type 2 diabetes patients with PAD than those without PAD (p < 0.05). Age > 70 years, having coronary heart disease as a comorbid illness, and having a body mass index of 25–29.9 kg/m² were predictive for PAD development (all p < 0.05). These three variables explained 12.3% of the variance in the incidence of PAD among type 2 diabetes patients. The demographic and clinical factors were the best predictors for PAD development.

Conclusion: Thai type 2 diabetes patients who are elderly, have coronary heart disease as a comorbid condition, or have a normal weight should be considered at risk for PAD development.