OBJECTIVE To investigate a possible beneficial effect of strict glycaemic control on all-cause mortality in patients with peripheral arterial disease and type 2 diabetes mellitus. METHODS A total of 367 mainly older peripheral arterial disease patients [age: 69 (62-78) years, 34% women, Fontaine stage I-II] were categorized according to glycaemic control, that is, (a) no type 2 diabetes mellitus, (b) strict glucose control (HbA1c < 53 mmol/mol) and (c) lenient glucose control (HbA1c ⩾ 53 mmol/mol) at inclusion and by mean HbA1c over the first study year. Mortality was analysed using Kaplan-Meier and Cox-regression analyses after 7 years. RESULTS The combination of type 2 diabetes mellitus and peripheral arterial disease reduced survival from 78.8% to 68.9% in comparison to patients without type 2 diabetes mellitus (p = 0.023). Patients with strict glucose control (75%) were associated with increased survival in comparison to patients with lenient glucose control (58.9%) stratified by mean HbA1c (p = 0.042). Baseline cardiovascular risk factors were similar in those type 2 diabetes mellitus patients. In this peripheral arterial disease cohort HbA1c (hazard ratio: 1.3, 1.04-1.63), age (hazard ratio: 1.7, 1.3-2.3) and C-reactive protein (hazard ratio: 1.5, 1.2-2.0) remained independent associates for mortality adjusted for cardiovascular risk factors and diabetes duration. CONCLUSION Older patients with peripheral arterial disease and type 2 diabetes mellitus still benefit from strict glucose control in a cohort of patients with similar distribution of cardiovascular risk factors.

中文翻译：

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周围动脉疾病和2型糖尿病：老年患者仍表现出血糖控制的生存获益。

目的探讨严格的血糖控制对周围动脉疾病和2型糖尿病患者全因死亡率的可能有益作用。方法总共367名主要由年龄较大的外周动脉疾病患者[年龄：69（62-78）岁，女性占34％，枫丹碱I-II期]根据血糖控制进行分类，即（a）没有2型糖尿病，（b）在入组时严格控制血糖（HbA1c <53 mmol / mol），（c）在纳入时进行宽大的葡萄糖控制（HbA1c⩾53 mmol / mol），平均HbA1c在第一个研究年度。7年后使用Kaplan-Meier和Cox回归分析法分析死亡率。结果与没有2型糖尿病的患者相比，2型糖尿病和周围动脉疾病的合并症将生存率从78.8％降低到68.9％（p = 0.023）。与按平均HbA1c分层的宽松血糖控制患者（58.9％）相比，严格控制血糖的患者（75％）与增加的生存率相关（p = 0.042）。在那些2型糖尿病患者中，基线心血管危险因素相似。在该外周动脉疾病队列中，HbA1c（危险比：1.3、1.04-1.63），年龄（危险比：1.7、1.3-2.3）和C反应蛋白（危险比：1.5、1.2-2.0）仍然是独立的相关因素，可以调节死亡率用于心血管危险因素和糖尿病病程。结论在心血管疾病危险因素分布相似的队列研究中，老年外周动脉疾病和2型糖尿病患者仍然受益于严格的血糖控制。