Exploring the Prevalence and Risk Factors of Peripheral Artery Disease in Type 2 Diabetes Patients in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Kirubel Eshetu Haile^1*Atitegeb Amsalu¹Gizachew Ambaw Kassie¹Yordanos Sisay Asgedom¹Gedion Asnake Azeze²Amanuel Yosef gebrekidane¹

• ¹College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Southern Nations, Nationalities, and Peoples' Region, Ethiopia
• ²Faculty of Health Sciences, Hawassa University, Hawassa, Ethiopia

Type 2diabetes and lower-extremity peripheral artery disease 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 T2DM residing in sub-Saharan Africa.Objective: To determine the pooled prevalence and associated factors of peripheral artery disease among patients with type 2diabetes mellitus in sub-Saharan Africa.A systematic review and meta-analysis were 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 November 8, 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 peripheral artery disease.This study revealed that the pooled prevalence of peripheral artery disease among patients with T2DM was 35.7% (95% CI 28.7, 42.7) reflecting the significant impact of DM on vascular health with statistically significant heterogeneity observed between studies (I 2 = 94.9 %, P < 0.001). Age, elevated low density lipoprotein, elevated 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.Clinical Implication: the 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 T2DM patients.