Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men
Abstract
Purpose To assess the relation between the duration of diabetes and the risk of peripheral arterial disease among men. Methods A total of 48,607 men in the Health Professionals Follow-up Study who returned a questionnaire in 1986 were followed for 12 years. Peripheral arterial disease (intermittent claudication or surgery for peripheral arterial diseases in the lower extremities) was ascertained by biennial questionnaire and confirmed by medical record review. Diabetes status and other cardiovascular risk factors were also ascertained by biennial questionnaire. Results During follow-up (534,588 person-years), we documented 387 cases of peripheral arterial disease. After adjusting for cardiovascular risk factors, the relative risk of developing peripheral arterial disease among men with diabetes compared with men without diabetes was 2.61 (95% confidence interval [CI]: 1.98 to 3.45). Compared with men without diabetes, the relative risk of peripheral arterial disease among men with diabetes increased with duration of disease, even after adjusting for cardiovascular risk factors: 1.39 (95% CI: 0.82 to 2.36) for 1 to 5 years of diabetes, 3.63 (95% CI: 2.23 to 5.88) for 6 to 10 years, 2.55 (95% CI: 1.50 to 4.32) for 11 to 25 years, and 4.53 (95% CI: 2.39 to 8.58) for >25 years of diabetes (P for trend Conclusion These results indicate that duration of type 2 diabetes is associated strongly with the risk of developing peripheral arterial disease.
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Risk factors associated with an increased risk for PAD in people with diabetes include age, smoking, hypertension, dyslipidemia, worse glycemic management, longer duration of diabetes, neuropathy, and retinopathy as well as a prior history of cardiovascular disease.
“Risk factors associated with an increased risk for PAD in people with diabetes include age, smoking, hypertension, dyslipidemia, worse glycemic management, longer duration of diabetes, neuropathy, and retinopathy as well as a prior history of cardiovascular disease (237,238).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [238]
Risk factors associated with an increased risk for PAD in people with diabetes include age, smoking, hypertension, dyslipidemia, worse glycemic management, longer duration of diabetes, neuropathy, and retinopathy as well as a prior history of CVD.
“Risk factors associated with an increased risk for PAD in people with diabetes include age, smoking, hypertension, dyslipidemia, worse glycemic management, longer duration of diabetes, neuropathy, and retinopathy as well as a prior history of CVD (226,227).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [227]
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10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Das, S. R., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s010 · Cited by 339 · see citing works
Socioeconomic and hospital-related predictors of amputation for critical limb ischemia
Henry, A. J., Hevelone, N. D., Belkin, M., & Nguyen, L. L. (2011) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2010.08.077 · Cited by 175 · see citing works
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s010 · Cited by 107 · see citing works
- Authors
- Al-Delaimy, W. K., Merchant, A. T., Rimm, E. B., Willett, W. C., Stampfer, M. J., & Hu, F. B.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2004-02
- Volume
- 116
- Issue
- 4
- Pages
- 236-240
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2025882468
- Cited by
- 143
- References
- 2
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 11 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 2 · 2015: 11 · 2014: 11 · 2013: 4 · 2012: 10
- FWCI
- 5.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- National Heart, Lung, and Blood Institute (R01HL035464, HL35464)
- National Cancer Institute (CA-55075)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Keywords
- type 2 diabetes, diabetes duration, peripheral arterial disease, intermittent claudication, men, cardiovascular risk factors, lower limb surgery, Health Professionals Follow-up Study
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 2, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Smoking, Time Factors, Survival Rate, Confidence Intervals, Peripheral Vascular Diseases
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