Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review.

IF 3.8 3区 医学 Q2 Medicine
Diabetes Therapy Pub Date : 2024-09-01 Epub Date: 2024-07-18 DOI:10.1007/s13300-024-01606-6
Subodh Verma, Lawrence A Leiter, Kamal K Mangla, Nick F Nielsen, Yasemin Hansen, Marc P Bonaca
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Abstract

Type 2 diabetes (T2D) and lower-extremity peripheral artery disease (PAD) are growing global health problems associated with considerable cardiovascular (CV) and limb-related morbidity and mortality, poor quality of life and high healthcare resource use and costs. Diabetes is a well-known risk factor for PAD, and the occurrence of PAD in people with T2D further increases the risk of long-term complications. As the available evidence is primarily focused on the overall PAD population, we undertook a systematic review to describe the burden of comorbid PAD in people with T2D. The MEDLINE, Embase and Cochrane Library databases were searched for studies including people with T2D and comorbid PAD published from 2012 to November 2021, with no restriction on PAD definition, study design or country. Hand searching of conference proceedings, reference lists of included publications and relevant identified reviews and global burden of disease reports complemented the searches. We identified 86 eligible studies, mostly observational and conducted in Asia and Europe, presenting data on the epidemiology (n = 62) and on the clinical (n = 29), humanistic (n = 12) and economic burden (n = 12) of PAD in people with T2D. The most common definition of PAD relied on ankle-brachial index values ≤ 0.9 (alone or with other parameters). Incidence and prevalence varied substantially across studies; nonetheless, four large multinational randomised controlled trials found that 12.5%-22% of people with T2D had comorbid PAD. The presence of PAD in people with T2D was a major cause of lower-limb and CV complications and of all-cause and CV mortality. Overall, PAD was associated with poor quality of life, and with substantial healthcare resource use and costs. To our knowledge, this systematic review provides the most comprehensive overview of the evidence on the burden of PAD in people with T2D to date. In this population, there is an urgent unmet need for disease-modifying agents to improve outcomes.

Abstract Image

2 型糖尿病患者外周动脉疾病的流行病学和负担:系统性文献综述
2 型糖尿病(T2D)和下肢外周动脉疾病(PAD)是日益严重的全球性健康问题,与心血管(CV)和肢体相关的发病率和死亡率高、生活质量差、医疗资源使用和成本高有关。糖尿病是众所周知的 PAD 风险因素,而 T2D 患者发生 PAD 会进一步增加长期并发症的风险。由于现有的证据主要集中在整个 PAD 群体,因此我们进行了一项系统性综述,以描述 T2D 患者合并 PAD 的负担。我们在 MEDLINE、Embase 和 Cochrane 图书馆数据库中检索了 2012 年至 2021 年 11 月期间发表的包括 T2D 患者和合并 PAD 的研究,对 PAD 的定义、研究设计或国家没有限制。此外,我们还人工检索了会议论文集、收录出版物的参考文献列表以及已确定的相关综述和全球疾病负担报告。我们确定了 86 项符合条件的研究,其中大部分是在亚洲和欧洲进行的观察性研究,这些研究提供了有关 T2D 患者 PAD 的流行病学(62 项)、临床(29 项)、人文(12 项)和经济负担(12 项)的数据。最常见的 PAD 定义是踝肱指数值≤0.9(单独或与其他参数一起)。不同研究的发病率和流行率差异很大;然而,四项大型跨国随机对照试验发现,12.5%-22% 的 T2D 患者合并有 PAD。T2D 患者出现 PAD 是导致下肢和心血管并发症以及全因和心血管死亡的主要原因。总体而言,PAD 与生活质量低下以及大量医疗资源的使用和成本有关。据我们所知,该系统性综述是迄今为止最全面地概述有关肺动脉阻塞给糖尿病患者带来的负担的证据。在这一人群中,对改善病情药物的需求尚未得到满足。
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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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