Burden of peripheral artery disease and risk factors among patients with diabetes mellitus in sub-Saharan Africa: a systematic review and meta-analysis.

Abstract

Background: Diabetes is a non-communicable disease that presents a substantial public health challenge on a global scale. Peripheral artery disease is a significant macrovascular problem in diabetes mellitus characterized by atherosclerotic narrowing of the artery in the lower extremities, leading to compromised distal perfusion, primarily caused by atherosclerosis, and resulting in impaired functional capacity. Although existing studies on, peripheral artery disease among patients with diabetes mellitus are available, the results have been inconsistent.

Objective: To determine the pooled burden and associated factors of peripheral artery disease among patients with diabetes mellitus in sub-Saharan Africa.

Methods: A systematic review and meta-analysis were performed following the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. To identify papers published in English up to August 10, 2024, the electronic databases of Medline, 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 peripheral artery disease. To test for heterogeneity between studies and publication bias, forest plots and funnel plots were used.

Results: This study revealed that the pooled prevalence of peripheral artery disease among patients with diabetes mellitus was 32.97% (95% CI 29.7, 36.24), reflecting the significant impact of diabetes mellitus on vascular health. Age (OR = 2.51, 95% CI = 3.41-12.09), increased level of low density lipoprotein (OR = 1.64, 95% CI = 1.05-13.09), BMI (OR = 3.03, 95% CI = 1.74-7.56), and illness duration exceeding 10 years (OR = 2.44, 95% CI = 1.12-5.13), were the significant predictors.

Conclusion: Despite the alarming prevalence of peripheral artery disease among patients with diabetes in sub-Saharan Africa, it remains underdiagnosed; therefore, increased awareness, proactive screening initiatives, and management strategies within the clinical setting are necessary.

Clinical trial number: Not applicable.

Prospero: CRD42024594577.