Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes

Nidhi Jain; Manyoo A. Agarwal; Diana Jalal; Ayotunde O. Dokun

doi:10.3390/jcm9092809

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Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes

Journal article

Open access

Peer reviewed

Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes

Nidhi Jain, Manyoo A. Agarwal, Diana Jalal and Ayotunde O. Dokun

Journal of clinical medicine, Vol.9(9), pp.1-10

08/31/2020

DOI: 10.3390/jcm9092809

PMCID: PMC7563979

PMID: 32878057

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Abstract

Background: Limited data exist comparing how type 1 diabetes mellitus (DM) and type 2 DM may have differential effects on peripheral artery disease (PAD) severity. We aimed to study the association of type of DM with the procedure utilized in hospitalizations with a diagnosis of PAD. Methods: We used the national inpatient sample databases from 2003 to 2014 to identify hospitalizations with a diagnosis of PAD and type 1 or type 2 DM. Logistic regression was utilized to evaluate the association between type of DM and procedure utilized (amputation-overall, major, endovascular revascularization, surgical revascularization). Results: We identified 14,012,860 hospitalizations with PAD diagnosis and DM, 5.6% ( n = 784,720) had type 1 DM. The patients with type 1 DM were more likely to present with chronic limb-threatening ischemia (CLTI) (45.2% vs. 32.0%), ulcer (25.9% vs. 17.7%), or complicated ulcer (16.6% vs. 10.5%) (all p < 0.001) when compared to those with type 2 DM. Type 1 DM was independently and significantly associated with more amputation procedures (adjusted odds ratio = 1.12, 95% confidence interval [CI] I 1.08 to 1.16, p < 0.001). Overall, in-hospital mortality did not differ between the individuals with type 1 and type 2 DM. The overall mean (95% CI) length of stay (in days) was 6.6 (6.5 to 6.6) and was significantly higher for type 1 DM (7.8 [7.7 to 8.0]) when compared to those with type 2 DM (6.5 [6.4 to 6.6]). Conclusion: We observed that individuals with PAD and type 1 DM were more likely to present with CLTI and ulcer and undergo amputation when compared to those with PAD and type 2 diabetes. Further studies are needed to better understand the underlying mechanisms behind these findings and to identify novel interventions to reduce the risk of amputation in patients with type 1 DM.

amputation

HCUP

NIS

outcomes

peripheral artery disease

procedure

type 1 diabetes

type 2 diabetes

Details

Title: Subtitle: Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes
Creators: Nidhi Jain - Torrance Memorial Medical Center
Manyoo A. Agarwal - University of Tennessee Health Science Center
Diana Jalal - Roy J. and Lucille A. Carver College of Medicine
Ayotunde O. Dokun - Roy J. and Lucille A. Carver College of Medicine
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.9(9), pp.1-10
DOI: 10.3390/jcm9092809
PMID: 32878057
PMCID: PMC7563979
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: MDPI
Grant note: DOI: 10.13039/100000009, name: National Institutes of Health, award: R01 HL130399
Language: English
Date published: 08/31/2020
Academic Unit: Molecular Physiology and Biophysics; Fraternal Order of Eagles Diabetes Research Center; Nephrology; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984297494802771

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