Investigation and analysis of lower extremity arterial disease in hospitalized elderly type 2 diabetic patients.
Xiang Lu, Jiao Sun, Jiao-Jiao Bai and 2 others
PMID 31406800WHAT IT FOUND
Among 237 hospitalized older adults with type 2 diabetes, 43% had lower limb arterial disease.
Microalbuminuria and abnormal vibration sense were independently linked, so ankle-brachial index and urine checks may flag high risk.
Key findings
01Among 237 hospitalized older adults with type 2 diabetes, 102 had lower extremity arterial disease by ankle-brachial index, including 69 with mild stenosis, 28 with moderate stenosis, and 5 with severe stenosis.
02Microalbuminuria and vibratory sensory neuropathy remained independently associated with lower extremity arterial disease after adjustment.
03More severe stenosis was associated with older age, lower BMI, lower peak velocity, lower HDL-C, and more microalbuminuria.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was done in one hospital in Shanghai and included only hospitalized older adults with type 2 diabetes, so it may not apply to younger or community-based patients. It measured associations at one time, so it cannot show that microalbuminuria, vibration loss, BMI, HDL-C, or age caused LEAD. Patients with an ankle-brachial index above 1.3 were excluded because of possible arterial rigidity, so the results do not cover people with noncompressible arteries. Only 5 patients had severe stenosis, so conclusions about severe disease are limited. The study did not report ulcers, amputations, cardiovascular events, or follow-up outcomes, so it cannot show that screening changes prognosis.
Declared interests
No conflicts of interest were declared. The study was funded by Shanghai Municipal Commission of Health and Family Planning, Key Developing Disciplines (2015ZB0501) and Project of Shanghai Science and Technology Commission (16411971300).
The easy way to misread this
Do not conclude that ankle-brachial index screening or monitoring microalbuminuria and vibration sense prevents lower limb ulcers or amputations. The study measured associations in hospitalized older adults with type 2 diabetes and did not follow patients to see whether these findings changed outcomes.