Haile Kirubel Eshetu, Amsalu Atitegeb Alebachew, Kassie Gizachew Ambaw, Asgedom Yordanos Sisay, Azeze Gedion Asnake, Gebrekidan Amanuel Yosef
School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Front Clin Diabetes Healthc. 2025 Jul 21;6:1563984. doi: 10.3389/fcdhc.2025.1563984. eCollection 2025.
Type 2 diabetes and lower-extremity peripheral artery disease (PAD) are growing global health problems associated with considerable cardiovascular 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, which further increases the risk of long-term complications. The primary aim of this systematic review was to ascertain the aggregated prevalence of PAD among individuals diagnosed with type 2 diabetes mellitus (T2DM) residing in sub-Saharan Africa.
The aim of this study was to determine the pooled prevalence and associated factors of PAD among patients with T2DM in sub-Saharan Africa.
A systematic review and meta-analysis was performed in alignment with the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. To identify papers published in English up to 8 November 2024, the electronic databases of Medline, Web of Science, Science Direct, Excerpta Medica Database, Cochrane Library, African Journals Online, and Google Scholar were searched. A random-effects model was employed to estimate the pooled prevalence and associated factors of PAD.
This study revealed that the pooled prevalence of PAD among patients with T2DM was 35.7% [95% confidence interval (CI) 28.7, 42.7], reflecting the significant impact of DM on vascular health with statistically significant heterogeneity observed between studies ( = 94.9%, < 0.001). Age, elevated low-density lipoprotein, elevated body mass index (BMI), and diabetes illness duration exceeding 10 years were the significant predictors.
The aggregate burden of PAD in individuals with T2DM within the sub-Saharan African region is estimated at 35.7%, suggesting that a considerable segment of the sub-Saharan population has been impacted. Epidemiological studies utilizing precise assessment tools can enhance the early detection and prevention of PAD in T2DM and improve the certainty of findings.
There is a need for integrated care approaches that prioritize the screening and management of PAD in individuals with T2DM. Given the high prevalence and associated complications, healthcare providers should implement routine PAD assessments in diabetes care protocols. Future research should focus on longitudinal studies that explore the causal relationships between risk factors and the development of PAD in patients with T2DM.
https://www.crd.york.ac.uk/prospero, identifier CRD42024611838.
2型糖尿病和下肢外周动脉疾病（PAD）是日益严重的全球性健康问题，与相当高的心血管及肢体相关发病率和死亡率、生活质量差以及高医疗资源使用和成本相关。糖尿病是PAD的一个众所周知的危险因素，这进一步增加了长期并发症的风险。本系统评价的主要目的是确定撒哈拉以南非洲地区被诊断为2型糖尿病（T2DM）的个体中PAD的总体患病率。
本研究的目的是确定撒哈拉以南非洲地区T2DM患者中PAD的合并患病率及相关因素。
按照系统评价和Meta分析的首选报告项目制定的指南进行系统评价和Meta分析。为了识别截至2024年11月8日发表的英文论文，检索了Medline、科学网、科学Direct、医学文摘数据库、Cochrane图书馆、非洲期刊在线和谷歌学术等电子数据库。采用随机效应模型估计PAD的合并患病率及相关因素。
本研究显示，T2DM患者中PAD的合并患病率为35.7%[95%置信区间（CI）28.7，42.7]，这反映了糖尿病对血管健康的重大影响，各研究间观察到具有统计学意义的异质性（I² = 94.9%，P < 0.001）。年龄、低密度脂蛋白升高、体重指数（BMI）升高以及糖尿病病程超过10年是显著的预测因素。
撒哈拉以南非洲地区T2DM患者中PAD的总体负担估计为35.7%，这表明撒哈拉以南相当一部分人口受到了影响。利用精确评估工具的流行病学研究可以加强T2DM中PAD的早期检测和预防，并提高研究结果的确定性。
需要采取综合护理方法，将T2DM患者中PAD的筛查和管理作为优先事项。鉴于高患病率及相关并发症，医疗服务提供者应在糖尿病护理方案中实施常规PAD评估。未来的研究应侧重于探索T2DM患者危险因素与PAD发生之间因果关系的纵向研究。
