SUMMARY
Atherosclerotic involvement of peripheral arteries is a common and often subclinical vascular complication in patients with type 2 diabetes mellitus and is associated with an increased risk of cardiovascular events. The aim of this study was to assess the relationship between the ankle-brachial index, as a subclinical marker of peripheral atherosclerosis, and cardiovascular risk factors, glycemic control, arterial hypertension, microalbuminuria, and sonographic parameters of lower limb arteries in patients with type 2 diabetes mellitus in the Azerbaijani population. Material and Methods. The study included 528 patients aged 30–69 years with type 2 diabetes mellitus. Patients were evaluated using questionnaire data, physical examination, glycated hemoglobin level, microalbuminuria, blood pressure measurements, and sonographic assessment of lower limb arteries. The ankle-brachial index was used as an objective indicator of peripheral artery disease, and an ABI value ≤0.9 was considered evidence of peripheral arterial involvement. Results. The mean ABI value was 1.061±0.009, while ABI<0.9 was detected in 27.2% of patients. Clinical signs of lower limb atherosclerosis were observed in 66.7% of patients. Inadequate glycemic control was associated with a higher frequency of ABI≤0.9 and more pronounced impairment of peripheral circulation. The severity of stenosis increased toward the distal arterial segments, with signs of decompensation mainly observed in the below-knee–ankle segment. Patients with arterial hypertension had significantly lower ABI values and a higher frequency of peripheral atherosclerosis compared with normotensive patients. Increasing microalbuminuria was also associated with a higher prevalence of peripheral atherosclerotic changes. Conclusion. In patients with type 2 diabetes mellitus, the ankle-brachial index may be used as a practical screening marker for peripheral artery disease and cardiovascular risk assessment.
Keywords: type 2 diabetes mellitus, Ramadan, fasting, hypoglycemia, DPP-4 inhibitors, insulin therapy, IDF/DAR score

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