Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

BACKGROUND: India is considered the diabetes capital of the world. As per current practice, most of the diabetes patients go to primary care physicians for their monitoring and follow up. One of the dreaded complications of long-term diabetes is peripheral arterial disease. METHODS: A cross-sectional observational study was conducted in a diabetes workshop. Totally, 48 patients were selected who satisfied the inclusion criteria. All were subjected to ankle-brachial index measurement (ABI) and doppler ultrasound was done to assess patency of the lower extremity arteries. The results were compared. The ankle-brachial index of less than 0.99 was considered abnormal. RESULTS: Out of a total of 48 included patients 26 patients had normal ABI and 22 patients were found to have abnormal ABI. Out of those with normal ABI, 2 patients had features of peripheral arterial disease proved by doppler, whereas 3 patients with abnormal ABI had no feature of peripheral arterial disease in doppler. MedCalc software was used for statistical comparison. CONCLUSION: In the selected diabetic population prevalence of peripheral arterial disease was found to be 56.25%. Measurement of ABI was found to be quite a sensitive and specific method for diagnosing peripheral arterial disease of diabetics.