The distribution of peripheral vascular disease in a Dutch Caucasian population: comparison of type II diabetic and non-diabetic subjects

Abstract

Objectives: To study the distribution of peripheral vascular disease and the relationship to diabetes.

Design: Prospective population based study of Dutch caucasian inhabitants.

Methods: From a total of 10,500 subjects aged between 50 and 75 years, 2484 Caucasian inhabitants were screened with respect to their glucose tolerance. Subjects using oral antidiabetic agents or insulin were classified directly as having diabetes mellitus. The other participants were screened using two oral glucose tolerance tests and classified using WHO criteria. A group of 173 people with diabetes and a representative age/sex stratified sample of 288 non-diabetic subjects were seen in the vascular laboratory. Carotid artery disease was investigated with Duplex scanning, arm and leg artery obstructions with real time frequency analysis of continuous wave Doppler signals and indirect blood pressure measurements.

Results: Comparing diabetic with non-diabetic subjects, we found significantly more obstructions of the carotid arteries (8.7 vs 2.8%), arm arteries (2.3 vs 0%), as well as leg arteries (31.8 vs. 18.4%). The same holds if only the crural artery obstructions were compared (23.7 vs 16.0%). Two of the four diabetic subjects with arm artery obstructions had retrograde vertebral flow, three of them had carotid artery obstructions as well, and three also had leg artery obstructions. More than half of the subjects with a carotid artery obstruction, also had leg artery obstructions.

Conclusions: Peripheral vascular disease is common in diabetes, but most are asymptomatic.