Detection of peripheral arterial disease [PAD] in diabetics using ankle brachial index [ABI]

ABSTRACT

To evaluate the Ankle Brachial Index [ABI] in the detection of peripheral arterial disease [PAD] among diabetic patients. Diabetic clinic of PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Cross sectional descriptive. This pilot study included 95 diabetic patients with ages 40 years or above and duration of the disease was more than 5 years. Detailed history including treatment was documented. During examination systolic blood pressure in the right and left arms [Brachial Pressure] was measured and documented. Systolic Blood Pressure in both ankles was measured using ultrasound Doppler probe [Huntleigh Super Doppler - II]. Left and right ABI were obtained by dividing brachial systolic pressure with ankle systolic pressure. A ratio of 0.9 or above was taken as normal. The study included 95 patients [15 males and 80 females] with mean age 51.90 +/- 9.49 years and mean 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 and 0.937] with ABI and correlation was highly significant [p < 0.047 and 0.008]. Blood sugar and lipid levels were not significantly correlated with ABI. The results conclude the detection of high percentage [60.08] of abnormal ABI in this group of patients. Ankle brachial index, a non-invasive and simple technique, may be used to screen the detection of PAD and diabetic foot