Diabetic Macrovascular Disease

Authors

  • Dennis L. Eckels, DO, FAAFP, FACOFP Valley Ambulatory Health Center Seward, Pennsylvania

Abstract

Diabetic macrovascular disease, a significant contributor to the morbidity and mortality of individuals, is an occult problem which is frequently only identified after the occurrence of an ischemic event. Evaluating arterial pulsations of the foot using a hand held Doppler can suggest the presence or absence of peripheral vascular disease, therefore allowing more specific studies to be performed and appropriate interventions taken.

References

Center for Disease Control and Prevention, 2011 National Diabetes Fact Sheet, www. cdc.gov/diabetes/pubs/estimates/11.htm, accessed March 21, 2012.

Davis WA, Norman PE, Bruce DG, Davis TM. Predictors, consequences and costs of diabetes related lower extremity amputation complicating type 2 diabetes: the Fremantle Diabetes Study. Diabetologia 2006; 49:2634, p. 2639.

Belch JJ, Topol EJ, Agnelli G, et. al. Critical Issues in Peripheral Arterial Disease Detection and Management: a call to action. Arch Intern Med 2003; 163:884, p. 885.

Singh N, Armstrong DG, Lipsky BA. Preventing foot Ulcers in patients With Diabetes. JAMA 2005; 293:217, p. 217.

Belch, op. cit. p. 885.

Al-Delaimy WK, Merchant AT, Rimm EB, et. al., Effect of Type 2 Diabetes and Its Duration on the Risk of Peripheral Arterial Disease among Men. Am J Med 2004; 116:236, p. 239.

Steg PG, Bhatt DL, Wilson PW, et. al. One-Year Cardiovascular Event Rates in Outpatients with Atherothrombosis. JAMA 2007; 397:1197, p. 1204.

Olin JW, Kaufman JA, Bluemke DA, et. al. Atherosclerotic Vascular Disease Conference: Writing Group IV: Imaging. Circulation 2004; 109:2626, p. 2627.

Murabito JM, Evans JC, Larson MG, et. al. The Ankle Brachial Index in the Elderly and Risk of Stroke, Coronary Artery Disease, and Death. The Framingham Study. Arch Intern Med 2003; 163:1939, p. 1942.

McDermitt MM, Guralnik JM, Ferrucci L, et. al. Asymptomatic Peripheral Arterial Disease Is Associates With More Adverse Lower Extremity Characteristics Than Intermittent Claudication. Circulation 2008; 117:2484, p.2484

McDermitt, ibid. p. 2490.

Ramos R, Quesada M, Solanas P, et. al. Prevalence of Symptomatic and Asymptomatic Peripheral Arterial Disease and the Value of the Ankle-Brachial Index to Stratify Cardiovascular Risk. Eur J Vasc Endovasc Surg 2009; 38: 312, p. 309.

Hirsch AT, Haskal ZJ, Hertzer NR et. al. ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Artery Disease) Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; Trans Atlantic intersociety Consensus; and Vascular Disease Foundation. Circulation 2006; 113:e463, p.473.

Belch, op. cit. p. 886.

Khan NA, Rahim SA, Anand SS, et. al. Does the Clinical Examination Predict Lower Extremity Peripheral Arterial Disease? JAMA 2006; 295:536, p. 545.

McGee SR, Boyko EJ. Physical Examination and Chronic Lower-Extremity Ischemia: A critical Review. Arch Intern Med 1998; 158:1357, p. 8.

Singh, op. cit. p. 218.

American Diabetes Association. Standards of Medical Care in Diabetes – 2011. Diabetes Care 2011; 34 suppl 1:S11, p. S38.

United States Preventative Services Task Force. Guide to Clinical Preventive Services 2010-2011, Recommendations of the U.S. Preventative Services Task Force. Agency for Healthcare Research and Quality, http://www.USPreventiveServicesTaskForce.org, p. 91, accessed March 23, 2012.

Beckman JA, Jaff MR, Creager MA. The United States Preventive Services Task Force Recommendations on Screening for Peripheral Arterial Disease: More Harm Than Benefit? Circulation 2006; 114:861, p. 865.

Hiatt WR. Drug Therapy: Medical Treatment of Peripheral Arterial Disease and Claudication. N Engl J Med 2001; 344:1608, p. 3.

Khan, op. cit. p. 537.

Hiatt, op. cit. p. 5.

Doobay AV, Anand SS. Sensitivity and Specificity of the Ankle-Brachial Index to Predict Future Cardiovascular Outcomes : A Systematic Review. Arterioscler Thromb Vasc Biol 2005; 25: 1463, p. 1467.

Khan, op. cit. p. 539.

Khan, ibid. p. 542.

Downloads

Published

2014-09-04

How to Cite

Eckels, DO, FAAFP, FACOFP, Dennis L. “Diabetic Macrovascular Disease”. Osteopathic Family Physician, vol. 6, no. 5, Sept. 2014, https://ofpjournal.com/index.php/ofp/article/view/350.

Issue

Section

Review Articles
Received 2014-08-21
Accepted 2014-08-21
Published 2014-09-04