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Cited by 429Peripheral Artery Disease ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetic Foot Ulcer Assessment and Management

UKPDS 59: Hyperglycemia and Other Potentially Modifiable Risk Factors for Peripheral Vascular Disease in Type 2 Diabetes

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Adler, Amanda I., Stevens, Richard J., Neil, Andrew, Stratton, Irene M., Boulton, Andrew J. M., Holman, Rury R., for the U.K. Prospective Diabetes Study Group·2002·Diabetes Care
DOI 10.2337/diacare.25.5.894
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Abstract

OBJECTIVE—To determine the role of hyperglycemia in prospective analyses of peripheral vascular disease (PVD) in type 2 diabetes, taking into account other potential risk factors. RESEARCH DESIGN AND METHODS—Potential risk factors for the development of PVD were examined in 3,834 of 5,102 individuals enrolled in the U.K. Prospective Diabetes Study (UKPDS) without PVD at diagnosis of diabetes, followed for 6 years, and for whom relevant data were available. PVD was defined as two of the following: ankle-arm blood pressure index <0.8, absence of both dorsalis pedis and posterior tibial pulses to palpation in one or both legs, and intermittent claudication. Logistic regression was used to estimate the association between potential risk factors measured 3–4 months after diagnosis of diabetes and incident PVD. The prevalence of PVD at 3-year intervals to 18 years was determined. RESULTS—Hyperglycemia, assessed as HbA1c, was associated with an increased risk for incident PVD, independent of other risk factors including age, increased systolic blood pressure, reduced HDL cholesterol, smoking, prior cardiovascular disease, peripheral sensory neuropathy, and retinopathy. Each 1% increase in HbA1c was associated with a 28% increased risk of PVD (95% CI 12–46), and each 10-mmHg increase in systolic blood pressure with a 25% increase in risk (95% CI 10–43). CONCLUSIONS—Hyperglycemia, as well as smoking, dyslipidemia, and blood pressure are potentially modifiable risk factors for the development of PVD.

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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 [237]

    The Results in the Analytical methods section (page unavailable) identify age, higher HbA1c and systolic blood pressure, lower HDL, current smoking, and prior cardiovascular disease as independent risk factors for incident PVD. The paper also reports increasing PVD prevalence with longer diabetes duration. It does not establish retinopathy or peripheral sensory neuropathy as independent risk factors; they remained in the model because removing them changed the estimate for prior cardiovascular disease. (LLM, conf=0.87)

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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 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 [226]

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Research works printed but not linked: 1

  1. Hosmer DW, Lemeshow S: Applied Logis- tic Regression. New York, John Wiley & Sons, 1989

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Authors
Adler, A. I., Stevens, R. J., Neil, A., Stratton, I. M., Boulton, A. J. M., Holman, R. R., & for the U.K. Prospective Diabetes Study Group
Affiliations
  • University of Oxford (GB)
  • University of Manchester (GB)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2002-05-01
Volume
25
Issue
5
Pages
894-899
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.25.5.894
OpenAlex
W2125588985
Cited by
429
References
3
Citations by year
2026: 8 · 2025: 17 · 2024: 17 · 2023: 18 · 2022: 24 · 2021: 21 · 2020: 15 · 2019: 24 · 2018: 18 · 2017: 15 · 2016: 15 · 2015: 10 · 2014: 21 · 2013: 11 · 2012: 30
FWCI
13.68
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Funders
Wellcome Trust
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
hyperglycemia, peripheral vascular disease, type 2 diabetes, HbA1c, systolic blood pressure, modifiable risk factors, intermittent claudication, smoking, dyslipidemia
MeSH terms
Adult, Aged, Blood Pressure, Diabetes Mellitus, Type 2, Female, United Kingdom, Glycated Hemoglobin, Humans, Hyperglycemia, Male, Middle Aged, Prospective Studies, Risk Factors, Prevalence, Logistic Models, Peripheral Vascular Diseases

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