Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement

Diabetes Res Clin Pract. 2013 Nov;102(2):112-6. doi: 10.1016/j.diabres.2013.10.006. Epub 2013 Oct 9.

Abstract

Aim: The aim of this study was to compare ankle brachial indices (APBI) with pedal waveforms utilizing the continuous wave Doppler in a population with diabetes mellitus.

Methods: A prospective study design was employed to investigate the ABPI in a cohort of 49 people with type 2 diabetes mellitus. ABPI assessment was completed using a portable handheld Doppler and ankle pressures of <0.9 were taken as suggestive of peripheral arterial disease (PAD). Arterial spectral waveforms in each foot were also recorded and compared to the ABPI readings.

Results: Inconsistencies were identified between ABPIs and waveform interpretations in the study population. Approximately 35% of subjects had inconsistencies between their ABPI result and waveform interpretation in their right or left foot.

Conclusions: Both ABPIs and Doppler waveforms should be used in the assessment of people with diabetes in order to screen for PAD. This would ensure an accurate assessment of PAD and would allow initiation of appropriate secondary risk factor control measures.

Keywords: Ankle brachial pressure index; Diabetes foot screening; Diabetes mellitus; Pedal waveform analysis; Peripheral arterial disease.

MeSH terms

  • Adult
  • Aged
  • Ankle Brachial Index*
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Angiopathies / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / physiopathology
  • Prospective Studies