Relationship Between Postprandial Blood Pressure And Lower Extremity Arterial Disease In Patients With Type 2 Diabetes Mellitus

Objective:To determine associated risk factors of T2DM with lower extremity arterial disease (LEAD); meanwhile, we hope to explore the relationship between postprandial blood pressure and LEAD in patients with T2DM.Method:73 patients with T2DM hospitalized at endocrinology department in our hospital were selected. ABI was used as diagnostic criteria to determine the presence of LEAD. The blood pressure and heart rate were measured at the end of the fasting period and then at 30, 60,90 and 120 minutes after breakfast. Several factors were analyzed including age, sex,course of disease, smoking or not, BMI, FPG,2hPG, HbA1c, FCP,2hCP, MAU, blood lipids, and chronic diabetic complications.Results:(1) LEAD was present in 22 among 73 patients with T2DM. All of the cases were suffered from the fall in blood pressure after breakfast. The postprandial blood pressure fallened from 30 to 90 minutes, it was the lowest at 60 minutes after breakfast and recovered to basic level after 120 minutes, the presence rate of postprandial hypotension (PPH) was 15.1%. (2) There were no significant difference in age, sex, course of disease, FPG, FCP,2hCP, BMI, LDL-C, HDL-C, smoking or not, with or without presence of hypertension and diabetic microvascular complications between the LEAD and Non-LEAD group(P>0.05). The level of HbAlc,2hPG, TC, TG were significantly higher in the LEAD than Non-LEAD group(P<0.05). (3) The magnitude of systolic blood pressure decline after food ingestion was significantly higher in the LEAD than Non-LEAD group (P<0.05), especially the LEAD complicatied with diabetic peripheral neuropathy and autonomic intestinal neuropathy (P<0.05). (4) The level of FPG,2hPG,HbA1c were significantly higher and HDL-C was significantly lower in the PPH than Non-PPH group (P<0.05). (5) There was negative correlation between ABI and the maximum magnitude of the decrease in postprandial systolic blood pressure (r=-0.286, P<0.05).Conclusion:The postprandial systolic blood pressure was significantly decreased in the elderly and the uncontroled patients with T2DM, and the diabetic patients complicatied with LEAD, diabetic peripheral neuropathy, diabetic autonomic intestinal neuropathy. The decreased magnitude of postprandial systolic blood pressure was correlation with LEAD.