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Review
. 2024 Sep 20;16(9):e69808.
doi: 10.7759/cureus.69808. eCollection 2024 Sep.

A Review of Peripheral Artery Disease in Diabetic Patients in Sub-Saharan Africa

Ayoyimika O Okunlola  1 , Temitope O Ajao  2 , Abbas Karim  3 , Mwila Sabi  4 , Olayinka Kolawole  5 , Kenneth Ugwoke  6 , Manoj K Mahadevaswamysusheela  7
Affiliations
Review

A Review of Peripheral Artery Disease in Diabetic Patients in Sub-Saharan Africa

Ayoyimika O Okunlola et al. Cureus. .

Abstract

Peripheral artery disease (PAD) is an atherosclerotic occlusive disease of the lower extremities and is associated with an increased risk of amputation and cardiovascular events. The interplay between diabetes and PAD is complex, influenced by shared risk factors such as hypertension, dyslipidemia, and smoking. High rates of undiagnosed diabetes, coupled with barriers to accessing care, contribute to the complexity of managing PAD. Unique to the Sub-Sahara region is associations with communicable diseases such as human immunodeficiency virus and tuberculosis which further complicates the epidemiological landscape. Comprehensive management strategies, including lifestyle modifications, pharmacological interventions, and revascularization procedures, are essential. However, the region faces challenges such as inadequate healthcare infrastructure and high costs of treatment. This narrative review highlights the epidemiology of PAD in people with diabetes, the risk factors associated with PAD, the impact of PAD on the morbidity and mortality of individuals with diabetes, as well as the management of PAD in individuals with diabetes, with attention geared toward Sub-Saharan Africa These insights are critical for developing effective strategies to mitigate the burden of PAD in diabetes, especially in Sub-Saharan Africa. Further research is essential to understand the associations between diabetes and other diseases in the region.

Keywords: diabetes mellitus; non-communicable disease; peripheral arterial diseases; re-vascularization; sub-saharan africa.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Diagrammatic depiction of the disease mechanisms of peripheral arterial disease (PAD) in diabetes mellitus (DM).
Disease processes and their mechanisms are indicated in black and white type, respectively [5]. AGEs: advanced glycation end products; NO: nitric oxide; PAI-1: plasminogen activator inhibitor-1; ROS: reactive oxygen species; TGF-β transforming growth factor-beta; VSMC: vascular smooth muscle cell
See this image and copyright information in PMC

References

    1. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26:3333–3341. - PubMed
    1. Peripheral arterial disease in Sub-Saharan Africa: a review. Johnston LE, Stewart BT, Yangni-Angate H, Veller M, Upchurch GR Jr, Gyedu A, Kushner AL. JAMA Surg. 2016;151:564–572. - PubMed
    1. Peripheral artery disease in patients with diabetes: epidemiology, mechanisms, and outcomes. Thiruvoipati T, Kielhorn CE, Armstrong EJ. World J Diabetes. 2015;6:961–969. - PMC - PubMed
    1. Is atherosclerosis in diabetes and impaired fasting glucose driven by elevated LDL cholesterol or by decreased HDL cholesterol? Drexel H, Aczel S, Marte T, Benzer W, Langer P, Moll W, Saely CH. Diabetes Care. 2005;28:101–107. - PubMed
    1. Diabetes and peripheral artery disease: a review. Soyoye DO, Abiodun OO, Ikem RT, Kolawole BA, Akintomide AO. World J Diabetes. 2021;12:827–838. - PMC - PubMed