Which complication of diabetes can be diagnosed by the ankle-brachial index

Diabetic Foot Clinic, Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece http://orcid.org/0000-0002-0423-1370
  • K. Pafili Diabetic Foot Clinic, Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece http://orcid.org/0000-0003-4293-3514
  • N. Papanas Diabetic Foot Clinic, Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece http://orcid.org/0000-0002-7320-785X
  • DOI:

    https://doi.org/10.22141/2224-0721.15.7.2019.186053

    Keywords:

    diabetes mellitus, ankle-brachial index, diagnosis, peripheral arterial disease

    Abstract

    Background. Diabetes mellitus (DM) remains one of the fastest growing and most challenging medical diseases today. The Ankle-Brachial Index (ABI) is the ratio of ankle systolic blood pressure divided by brachial systolic pressure. Generally, ABI has a high specificity and sensitivity for the diagnosis of peripheral arterial disease (PAD). In DM, ABI measurement is recommended by the American Diabetes Association for all subjects > 50 years old. The prevalence of an abnormal ABI is high in type 2 DM. An ABI ≥ 1.3 is associated with increased risk of cardiovascular disease and mortality in the general population, as well as with all-cause mortality in DM. The purpose of the study was to assess the potential association of a high ankle-brachial index with diabetes mellitus in a specific Greek population free from peripheral arterial disease. Materials and methods. Between July 2017 and August 2018, people over 30 years old with and without type 2 DM were examined. We included 240 subjects (118 men) with mean age 64.5 ± 14.6 years from Naxos island in Greece who did not have peripheral arterial disease (PAD). Of these, 144 had DM and 96 did not. DM duration was 10.6 ± 7.4 years. ABI was measured in all subjects. ABI was measured in the supine position after 5–10 minutes of rest, in normal room temperature (25 °C) after patients had taken off their shoes and socks. Results. We grouped ABI measurements into 4 groups: ABI 0.90–1.29; ABI 1.30–1.39; ABI 1.40–1.49; ABI > 1.50. ABI > 1.30 was seen in 44 % of participants with DM vs. 3.1 % of those without DM. There was a significant correlation (p < 0.001) between diabetes duration and ABI. Among participants with DM, those with ABI > 1.30 had DM duration of 14.2 ± 8.2 years, while those with ABI < 1.30 had DM duration of 8 ± 5 years. ABI was 0.21 (19 %) higher in DM vs. non-DM subjects (1.28 ± 0.20 vs. 1.07 ± 0.11, p < 0.001). Conclusions. A high ABI is more frequent in DM, PAD-free, Greek participants, especially among subjects with long-standing DM.

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    Published

    2021-09-01

    How to Cite

    Koufopoulos, G., Pafili, K., & Papanas, N. (2021). Correlation between type 2 diabetes mellitus and ankle-brachial index in a geographically specific Greek population without peripheral arterial disease. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 15(7), 517–522. https://doi.org/10.22141/2224-0721.15.7.2019.186053

    What is the ankle

    The ankle-brachial index test is a quick, simple way to check for peripheral artery disease (PAD). The disease occurs when narrowed arteries reduce the blood flow to the arms and legs. PAD can cause leg pain when walking. PAD also increases the risk of heart attack and stroke.

    What is ankle

    Background: The ankle--brachial index (ABI) is a simple, noninvasive, widely used test that detects peripheral arterial disease (PAD). In patients with diabetes, the ABI is notoriously unreliable and this is usually attributed to medial calcinosis, which stiffens the arteries and renders them poorly compressible.

    What does ABI indicate about the condition of a patient?

    Health care providers calculate ABI by dividing the blood pressure in an artery of the ankle by the blood pressure in an artery of the arm. The result is the ABI. If this ratio is less than 0.9, it may mean that a person has peripheral artery disease (PAD) in the blood vessels in his or her legs.

    Can lead to an of the ankle brachial pressure index in patients with diabetes?

    Diabetes mellitus results in atherosclerosis and calcification of peripheral arterial walls leading to false normal ankle-brachial index values. Therefore, healthcare practitioners should be careful not to misinterpret ankle-brachial index results among diabetic patients.