Peripheral Artery DiseasePAD is ano

Peripheral Artery Disease
PAD is another important vascular
complication of T1DM (Supplementary
Table 2). There are several components
of PAD, including occult disease,
assessed by ankle-brachial index, ex-
tremity arterial calcification, and lower-
extremity nontraumatic amputation. The
data available on PAD focus on amputa-
tion. The rate of nontraumatic amputation
in T1DM is high, occurring at 0.4–7.2% per
year (28). By 65 years of age, the cumu-
lative probability of lower-extremity am-
putation in a Swedish administrative
database was 11% for women with
T1DM and 20.7% for men (10). In this
Swedish population, the rate of lower-
extremity amputation among those with
T1DM was nearly 86-fold that of the gen-
eral population. Calcification of the ex-
tremity arteries was reported in 4.6% of
the EDC cohort, more commonly in men,
and in individuals .30 years of age (29).
Predictors of all types of PAD include in-
creasing age, male sex, history of foot le-
sions or ulcers, diastolic BP, low-density
lipoprotein cholesterol (LDL-C), glycosy-
lated hemoglobin (HbA1c), DM duration,
hypertension, albumin excretion rate, glo-
merular filtration rate (GFR), smoking sta-
tus, and retinopathy (10,28,30,31). In a
meta-analysis of 5 studies of T1DM pa-
tients, with each 1% increase in HbA1c
the risk of PAD increased by 18% (32). In-
terestingly, aggressive glycemic control to
lower the HbA1c did not appear to reduce
rates of peripheral arterial occlusion in
the DCCT/EDIC study but did reduce the
incidence of peripheral arterial calcifica-
tion (31).