Diabetes linked to peripheral artery disease

Adults with elevated HbA1c levels - an indicator of poor glucose control – have an increased risk of reduced blood flow to the legs, a condition known as peripheral arterial disease (PAD). Researchers from the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland conducted a study among 1,894 middle-aged adults with diabetes, the risk of hospitalization related to PAD increased with increasing tertiles of HbA1c level, as did the risk of intermittent claudication - a cramping leg pain that occurs in patients with PAD. Specifically, patients in the second and third tertiles of HbA1c level were 53 percent and 64 percent more likely, respectively, to have PAD than those with the lowest HbA1c. The researchers note that trends toward higher risk of PAD with higher HbA1c level were evident for all manifestations of PAD, regardless of whether or not diabetes had been diagnosed. The results suggest that poor (blood sugar) control, as indicated by elevated HbA1c levels in individuals with diabetes, is associated with an increased risk of PAD independently of other known risk factors. This association was particularly strong for the symptomatic, more severe manifestations of PAD, including intermittent claudication and PAD-related hospitalizations. The findings suggest that efforts to improve glycemic control in persons with diabetes may substantially reduce the risk of PAD development.