Screening for peripheral vascular disease in patients with type 2 diabetes in Malta in a primary care setting

Abstract

Peripheral vascular disease (PVD) is strongly associated with type 2 diabetes. PVD assessment and diagnosis are often neglected in primary care office visits, and ankle/brachial pressure index (ABPI) examinations are seldom performed for PVD detection. The purpose of this study was to evaluate the occurrence of PVD in a primary care setting using ABPI in patients with type 2 diabetes in Malta. A retrospective study was conducted on a cohort of 243 patients with type 2 diabetes to address various issues. As part of this large study, data from ABPI measurements collected using a portable hand-held Doppler with ankle pressures of <0.8 suggestive of PVD were extracted. Twenty-six per cent of the sample had to be referred for further vascular assessment following this screening programme due to their critical vascular status. Furthermore, at the time of examination, approximately 7% of the patients had an ABPI of less than 0.8 in both left and right extremities. A significant proportion of Maltese patients with type 2 diabetes who visit primary care present with vascular insufficiency. The use of ABPI should be considered as an added measurement in order to facilitate early detection and treatment and reduce the burden of PVD in this high-risk population.