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dc.contributor.authorAdams, O Peter
dc.contributor.authorHerbert, Joseph R
dc.contributor.authorUnwin, Nigel
dc.contributor.authorHowitt, Christina
dc.date.accessioned2022-06-01T23:30:36Z
dc.date.available2022-06-01T23:30:36Z
dc.date.issued2022
dc.identifier.issn1176-6344
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337674
dc.description.abstractBackground: Peripheral arterial disease (PAD) is a risk factor for amputation and systemic atherosclerotic disease. Barbados has a high diabetes prevalence, and 89% of diabetes-related hospital admissions are for foot problems. Foot examination is infrequent in Barbados primary care. The prevalence and potential risk factors for PAD in people with diabetes in Barbados were studied. Methods: Multistage probability sampling was used to select a representative population sample of people ≥25 years of age with known diabetes or fasting blood glucose ≥7 mmol/L or HbA1c ≥6.5%. We administered the Edinburgh claudication questionnaire and assessed the ankle brachial pressure index (ABI) and Doppler waveform in both dorsalis pedis and posterior tibial arteries. Participants were classified into categories based on ABI as follows: PAD ≤0.90 in any leg; borderline 0.91 to 0.99 in one leg and the other not ≤0.90 or >0.4; normal 1.00 to 1.40 in both legs; and non-compressible >1.40 in one leg and the other not ≤0.9. Waveforms crossing the zero-flow baseline were categorised as normal. Multivariable logistic regression assessed the associations of potential risk factors with PAD. Results: Of 236 participants (74% response rate, 33% male, median age 58.6 years), 51% had previously diagnosed diabetes. Of nine people with symptoms of definite or atypical claudication, four had PAD and one had non-compressible arteries. ABI prevalence (95% CI) was PAD 18.6% (13.8, 24.6), borderline 21.9% (16.6, 28.4), normal 55.5% (49.4, 61.5) and non-compressible 3.9% (1.6, 9.3). Increasing age and female gender were independently associated with PAD. Over 80% of normal legs (ABI 1.00 to 1.40) had normal posterior tibial and dorsalis pedis waveforms, while only 23% legs with PAD (ABI ≤0.90) had normal waveforms in both arteries (Kappa = 0.43). Conclusion: Asymptomatic PAD is common in people with diabetes and requires ABI screening to detect it. Female gender is associated with PAD.
dc.description.sponsorshipFunding was through grants from the Peter Moores Barbados Trust and the Ministry of Health and Wellness, Barbados
dc.publisherInforma UK Limited
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.titlePeripheral Arterial Disease Prevalence in a Population-Based Sample of People with Diabetes on the Caribbean Island of Barbados.
dc.typeArticle
dc.publisher.departmentMrc Epidemiology Unit
dc.date.updated2022-06-01T08:04:45Z
prism.publicationNameVasc Health Risk Manag
dc.identifier.doi10.17863/CAM.85080
dcterms.dateAccepted2022-05-16
rioxxterms.versionofrecord10.2147/VHRM.S364993
rioxxterms.versionVoR
dc.contributor.orcidAdams, O Peter [0000-0002-6707-6769]
dc.contributor.orcidHerbert, Joseph R [0000-0002-1827-8612]
dc.contributor.orcidUnwin, Nigel [0000-0002-1368-1648]
dc.contributor.orcidHowitt, Christina [0000-0003-0002-4734]
dc.identifier.eissn1178-2048
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-05
cam.depositDate2022-06-01
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement


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Attribution-NonCommercial 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial 4.0 International