Six-year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African-Americans

Aims To report the 6-year incidence of, and risk factors for, lower extremity arterial disease (LEAD) in African-Americans with Type 1 diabetes mellitus. Methods African-Americans (n = 483) with Type 1 diabetes were re-examined 6 years after an original visit. At both visits, patients underwent a structured clinical interview which included history of amputation or leg angioplasty because of poor circulation in lower extremities; ocular examination; masked grading of seven stereoscopic fundus photographs; and blood pressure measurements. Biological tests included blood and urine assays. Results Of the 483 patients who had a 6-year follow-up, 457 had no LEAD at the baseline examination. Of these 457 patients, 26 (5.7%) developed LEAD over the 6-year follow-up. Six-year incidence of LEAD was significantly associated with baseline older age (P = 0.0002) and longer duration of diabetes (P < 0.0001). Multiple logistic regression analysis showed that baseline longer duration of diabetes, male gender, higher systolic blood pressure, retinopathy severity, and presence of foot ulcers were significant and independent risk factors for incidence of LEAD. Conclusions Blood pressure control and prevention and treatment of foot ulcers may be helpful in reducing the morbidity associated with LEAD in African-Americans with Type 1 diabetes.