THE DISTRIBUTION OF PERIPHERAL VASCULAR-DISEASE IN A DUTCH CAUCASIAN POPULATION - COMPARISON OF TYPE-II DIABETIC AND NONDIABETIC SUBJECTS

Objectives: To study the distribution of peripheral vascular disease a nd the relationship to diabetes. Design: Prospective population based study of Dutch caucasian inhabitants. Methods: From a total of 10 500 subjects aged between 50 and 75 years, 2484 Caucasian inhabitants were screened with respect to their glucose tolerance. Subjects using oral antidiabetic agents or insulin were classified directly as having dia betes mellitus. The other participants were screened using two oral gl ucose tolerance tests and classified using WHO criteria. A group of 17 3 people with diabetes and a representative age/sex stratified sample of 288 non-diabetic subjects were seen in the vascular laboratory. Car otid artery disease was investigated with Duplex scanning, arm and leg artery obstructions with real time frequency analysis of-continuous w ave Doppler signals and indirect blood pressure measurements. Results: Comparing diabetic with non-diabetic subjects, we found significantly more obstructions of the carotid arteries (8.7 vs. 2.8%), arm arterie s (2.3 vs. 0%), as well as leg arteries (31.8 vs. 18.4%). The same hol ds if only the crural artery obstructions were compared (23.7 vs. 16.0 %). Two of the four diabetic subjects with arm artery obstructions had retrograde vertebral flow, three of them had carotid artery obstructi ons as well, and three also had leg artery obstructions. More than hal f of the subjects with a carotid artery obstruction also had leg arter y obstructions. Conclusions: peripheral vascular disease is common in diabetes, but most are asymptomatic.