IDF21-0364 Relationship between glycaemic control, peripheral arterial disease and cardiovascular risks in type 2 diabetes

Background: Peripheral arterial disease (PAD) is one of the macrovascular complications of diabetes (DM), and it is a major risk factor for non-healing ulcers, gangrene and amputations in people with diabetes. Hyperglycaemia has been shown to contribute more to development of microvascular than macrovascular complications. Aim: In this study, we examined the relationship between glycaemic control, PAD, and risk factors for cardiovascular diseases in people with type 2 diabetes (T2DM). Method: A cross-sectional study involving patients with T2DM, recruited consecutively from the Diabetes Out-Patient clinic of the Obafemi Awolowo University Teaching Hospital (OAUTHC), South-West, Nigeria. Ethical approval was obtained from the Ethics and Research Committee of OAUTHC, and written consent was obtained from participants. Salient history was taken, blood pressure, and anthropometric measurements were done while observing standard protocols. Ankle-brachial index (ABI) measurement was done, and a value ≤0.9 defines PAD. Blood samples were collected for glycated haemoglobin (HbA1c), and lipid profiles. Optimal glycaemic control was defined as HbA1c value <7%. Statistical analyses were performed using the SPSS 21 edition and statistical significance was set at p value <0.05. Results: This study comprised 125 adult Nigerians with mean age of 56.00±7.87years. Majority of them were females (59.2%). Fifty-one (40.8%) participants achieved optimal glycaemic control. PAD occurred among 28 (22.4%) participants, with 85.7% of them having elevated HbA1c, compared with 14.3 % with optimal HbA1c (p = 0.001). Mean HbA1c was significantly higher among those with PAD (8.98±2.52%) compared with those without PAD (7.58±1.81%) (p = 0.009). Patients with elevated HbA1c had significantly higher BMI, WC, TC, and LDL compared with those with normal HbA1c (Table 1).Table 1Mean cardio-metabolic variables among participants with optimal and elevated HBA1cParameter Optimal HbA1c Elevated HbA1c p valueAge 55.94 ± 8.03 56.04 ± 7.80 0.946BMI 26.89 ± 3.82 28.65 ± 5.37 0.034Waist Circumference (cm) 93.34 ± 10.46 97.99 ± 12.84 0.028Waist-to-hip ratio 0.94 ± 0.07 0.96 ± 0.09 0.178SBP (mmHg) 133.23 ± 16.54 134.00 ± 19.46 0.811DPB (mmHg) 82.92 ± 10.16 83.23 ± 12.99 0.865TC (mmHg) 4.06 ± 0.91 4.51 ± 1.07 0.013HDL (mmol/L) 0.98 ± 0.19 1.01 ± 0.18 0.387LDL (mmol/L) 2.63 ± 0.72 2.95 ± 0.85 0.027Triglycerides (mmol/L) 1.03 ± 0.33 1.04 ± 0.31 0.852BMI – body mass index; SBP – systolic blood pressure; DBP – diastolic blood pressure; HDL – high density lipoprotein, LDL – low density lipoprotein Open table in a new tab BMI – body mass index; SBP – systolic blood pressure; DBP – diastolic blood pressure; HDL – high density lipoprotein, LDL – low density lipoprotein HbA1c showed negative, statistically significant correlation with ABI (r = -0.194; p = 0.030), and positive statistically significant correlation with TC (r = 0.194; p = 0.030) LDL (r = 0.233; p = 0.009), WC (r = 0.199; p = 0.026), BMI (r = 0.203; p = 0.023). There was no statistically significant correlation between HbA1c and HDL, triglycerides or SBP. Discussion: T2DM patients with elevated HbA1c levels are more likely to have PAD compared with patients with normal HbA1c. There is an inverse relationship between HbA1c and ABI, suggesting increased severity of PAD with hyperglycaemia. Hyperglycaemia is also associated with obesity and dyslipidaemia