A Cross-Sectional Study to Evaluate the Prevalence of Peripheral Arterial Disease in Diabetic Patients with or without Diabetic Retinopathy in a South Indian Population at a Tertiary Care Centre

Abstract

Importance: Peripheral arterial disease (PAD) and diabetic retinopathy represent microvascular complications of diabetes mellitus, yet their association remains underexplored in the Indian population.

Objective: To determine the prevalence of PAD in diabetic patients with or without diabetic retinopathy and to correlate with associated risk factors.

Design, Setting, and Participants: Cross-sectional study conducted in a tertiary care centre in South India (September–December 2025). A total of 120 patients with type 2 diabetes mellitus aged ≥40 years with disease duration of 10–15 years were enrolled using systematic random sampling.

Main Outcomes and Measures: Primary outcome was PAD prevalence assessed using ankle-brachial index (ABI) ≤0.9 and Doppler studies. Secondary outcomes included retinopathy severity and cardiovascular risk factors.

Results: Among 120 participants (mean age 58.7 [SD 10.2] years; 70 [58.3%] men; mean diabetes duration 12.4±6.8 years), 85 (70.8%) had diabetic retinopathy. Overall PAD prevalence was 42.5% (51/120; 95% CI, 33.7%–51.6%). PAD prevalence was significantly higher in patients with retinopathy than those without (47.1% vs 31.4%; P = .003). PAD prevalence increased with retinopathy severity from 31.4% (no retinopathy) to 70.0% (PDR; P < .001 for trend). Diabetic retinopathy independently increased the risk of PAD (OR, 1.89; 95% CI, 1.15–3.11; P = .012); severe NPDR or PDR showed stronger association (OR, 3.24; 95% CI, 1.85–5.67; P < .001).

 Conclusions and Relevance: PAD prevalence is significantly higher in diabetic patients with retinopathy, particularly those with advanced disease. Systematic PAD screening in type 2 diabetic patients with microvascular complications is warranted to enable early intervention and reduce cardiovascular morbidity.