Detection of Peripheral Arterial Disease (PAD) in Diabetics using Ankle Brachial Index (ABI)

Abstract

Objective:

To evaluate the Ankle Brachial Index (ABI) in the detection of peripheral arterial disease (PAD)among diabetic patients.Setting: Diabetic clinic o f PMRC Research Centre, Fatima Jinnah Medical College, Lahore.

Study Design:

Cross sectional descriptive.

Subjects & Methods:

This pilot study included 95 diabetic patients with ages 40 years or above and durationof the disease was more than 5 years. Detailed history including treatment was documented. Duringexamination systolic blood pressure in the right and left arms (Brachial Pressure) was measured & documented.Systolic Blood Pressure in both ankles was measured using ultrasound Doppler probe (Huntleigh SuperDoppler - II). Left and right ABI were obtained by dividing brachial systolic pressure with ankle systolicpressure. A ratio of 0.9 or above was taken as normal.

Results:

The study included 95 patients (15 males and 80 females) with mean age 51.90 ± 9.49 years andmean duration of diabetes 13.23 ± 5.83 years. Smoking was observed in 53.30%, hypertension in 57.89%and 71.57% had dyslipidemia. ABI ratio was mildly abnormal in 52.68%, moderately abnormal in 7.38%while it was normal in 38.94% cases. Duration of thedisease was negatively correlated (r = - 0.650 & 0.937)with ABI & correlation was highly significant (p < 0.047 & 0.008). Blood sugar and lipid levels were notsignificantly correlated with ABI.

Conclusions:

The results conclude the detection ofhigh percentage (60.08) of abnormal ABI in this groupof patients. Ankle brachial index, a non-invasive and simple technique, may be used to screen the detectionof PAD and diabetic foot.