PMID- 32878057
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201028
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 9
IP  - 9
DP  - 2020 Aug 31
TI  - 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.
LID - 10.3390/jcm9092809 [doi]
LID - 2809
AB  - 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.
FAU - Jain, Nidhi
AU  - Jain N
AD  - Torrance Memorial Physician Network, Torrance, CA 90505, USA.
FAU - Agarwal, Manyoo A
AU  - Agarwal MA
AD  - Department of Internal Medicine, University of Tennessee Health Science Center, 
      Memphis, TN 38163, USA.
AD  - Division of Cardiovascular Medicine, University of California Los Angeles, Los 
      Angeles, CA 90095, USA.
FAU - Jalal, Diana
AU  - Jalal D
AUID- ORCID: 0000-0002-1975-8650
AD  - Division of Nephrology, Department of Medicine, Carver College of Medicine, 
      University of Iowa, Iowa, IA 52242, USA.
FAU - Dokun, Ayotunde O
AU  - Dokun AO
AD  - Division of Endocrinology and Metabolism, Department of Medicine, Carver College 
      of Medicine, University of Iowa, Iowa, IA 52242, USA.
LA  - eng
GR  - R01 HL130399/NH/NIH HHS/United States
PT  - Journal Article
DEP - 20200831
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC7563979
OTO - NOTNLM
OT  - HCUP
OT  - NIS
OT  - amputation
OT  - outcomes
OT  - peripheral artery disease
OT  - procedure
OT  - type 1 diabetes
OT  - type 2 diabetes
COIS- The authors declare no conflict of interest.
EDAT- 2020/09/04 06:00
MHDA- 2020/09/04 06:01
PMCR- 2020/08/31
CRDT- 2020/09/04 06:00
PHST- 2020/07/13 00:00 [received]
PHST- 2020/08/16 00:00 [revised]
PHST- 2020/08/28 00:00 [accepted]
PHST- 2020/09/04 06:00 [entrez]
PHST- 2020/09/04 06:00 [pubmed]
PHST- 2020/09/04 06:01 [medline]
PHST- 2020/08/31 00:00 [pmc-release]
AID - jcm9092809 [pii]
AID - jcm-09-02809 [pii]
AID - 10.3390/jcm9092809 [doi]
PST - epublish
SO  - J Clin Med. 2020 Aug 31;9(9):2809. doi: 10.3390/jcm9092809.