Frequency of Risk Factor in Peripheral Arterial Disease in Diabetes

Abstract

Background: Peripheral arterial disease (PAD) is a common yet frequently under-recognized macrovascular complication of type 2 diabetes mellitus (T2DM) that increases risk of lower-limb morbidity and adverse cardiovascular outcomes. Objective, reproducible screening using the ankle–brachial index (ABI) can identify PAD, including asymptomatic disease, and may facilitate targeted risk-factor modification. Objective: To determine the prevalence of ABI-defined PAD and evaluate the frequency and association of key risk factors among adults with T2DM. Methods: This cross-sectional observational study was conducted in the Department of Medicine, Sandeman Provincial Hospital, Quetta, from January 6 to June 6, 2025. Adults (≥18 years) with T2DM of ≥6 months’ duration were enrolled. ABI was measured using a handheld Doppler ultrasound device; PAD was defined as ABI ≤0.9. Demographic and clinical variables including BMI, HbA1c, hypertension, smoking history, and family history of diabetes were recorded. Associations with PAD were tested using chi-square and t-tests, with crude odds ratios (ORs) and 95% confidence intervals (CIs) calculated; Pearson correlation assessed relationships with ABI. Results: Among 897 participants (56.5% female), mean age was 50.68±11.65 years and mean BMI 26.29±5.49 kg/m²; 68.7% had BMI ≥23 kg/m², 27.9% had hypertension, and 7.7% reported smoking. Mean ABI was 1.11±0.17 and PAD prevalence was 10.0% (90/897). PAD was associated with BMI ≥23 kg/m² (OR 2.68, 95% CI 1.49–4.83; p=0.001), hypertension (OR 1.85, 95% CI 1.18–2.90; p=0.007), and smoking (OR 3.08, 95% CI 1.68–5.66; p<0.001). HbA1c showed a weak inverse correlation with ABI (r=−0.070; p=0.036). Conclusion: ABI-defined PAD affected one in ten adults with T2DM and was strongly associated with obesity, hypertension, and smoking, supporting targeted ABI screening and aggressive risk-factor control in high-risk subgroups.