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Microvascular disease strongly predicts major peripheral arterial disease in T2D

Investigators sought to discover if macrovascular disease, microvascular disease or both predicted the development of peripheral arterial disease (PAD). They analysed a large cohort of participants in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) clinical trial who did not have PAD but did have documented risk factors. They found that microvascular disease, particularly a history of macroalbuminuria and retinal photocoagulation therapy, strongly predicts major PAD in people with type 2 diabetes, but macrovascular disease does not.

By Colin Kenny, GP, Dromore

PAD is a significant and common complication of type 2 diabetes, but it is not clear what the relationship is between other vascular diseases and PAD. Researchers analysed data from 10,624 patients with type 2 diabetes free from baseline PAD in the ADVANCE clinical trial. They investigated a primary composite outcome associated with PAD, defined as PAD-induced death, peripheral revascularisation, lower-limb amputation or chronic ulceration.

In the 5-year follow up, 5.8% of the cohort developed PAD. After careful adjustment for risk factors, only microvascular disease was significantly associated with PAD, with the highest risk observed in participants with a history of macroalbuminuria and retinal photocoagulation therapy. Macrovascular disease did not predict the development of PAD.

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