Comparison of ankle-brachial index (ABI) measured by an automated oscillometric apparatus with that by standard hand-held doppler in patients with Type-2 diabetes.

Shair Zaman Khan,Muhammad Saiful Haque,Asher Fawwad,Nazish Waris,Zahid Miyan,Awn Bin Zafar

doi:10.12669/pjms.35.4.30

Abstract

Objective:To compare the difference between an automated oscillometric ABI measurement as compared to standard hand-held doppler ABI in patients with Type-2 diabetes.Methods:This prospective study was conducted at foot clinic of Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), a tertiary care unit, Karachi-Pakistan. The duration of study was February 2018 to March 2018. Patients with Type-2 diabetes attending the outpatient department (OPD) of foot clinic, irrespective of their symptoms were included. Baseline demographic, anthropometric measurements and biochemical parameters were recorded. The ABI was calculated with both devices by an automated oscillometric machine and standard hand-held doppler with the same investigator.Results:Total of 93 patients with Type-2 diabetes, 18 (19.4%) females and 75(80.6%) males were recruited. Mean age was 54.67±9.59 years and mean systolic/diastolic blood pressure was 131.38±20.2/ 80.36±10.23mmHg. Most of the patients had poor glycemic control at presentation with a mean HbA1c of 9.56±2.44%. Mean standard handheld doppler ABI and automated oscillometric ABI was 1.28±1.08 and 1.07±0.23 for right foot (mean difference = 0.21; P= 0.075), and 1.14±0.45 and 1.1±0.25 for left foot (mean difference =0.04; P=0.434), respectively. Similarly, sensitivity and specificity between two modalities was observed 60% and 93.90% for right foot, meanwhile, 60% and 97.40% for left foot, respectively.Conclusion:An automated oscillometric method is comparable with standard handheld-doppler method. It is cost effective, convenient and less time consuming, can be widely used to measure ABI without special training.

Highlights

Peripheral arterial disease (PAD) is caused by partial or complete occlusion of limb arteries due to atherosclerosis
Total of 93 patients with Type-2 diabetes, 18 (19.4%) females and 75(80.6%) males were included during the study period
History of diabetes was found in 45(75%) and smoking habit in 5(8.3%) patients

Summary

Introduction

Peripheral arterial disease (PAD) is caused by partial or complete occlusion of limb arteries due to atherosclerosis. The concurrent occurrence of PAD was found to be markedly high in patients with Type-2 diabetes.[1] Patients having PAD are more likely to suffer with foot ulcers and amputations, myocardial infarction, stroke or death as compared to patients who do not.[2] Most of the individuals are asymptomatic and there is a slow and gradual progression of disease.[3] Data on prevalence and outcome of Middle-Eastern patients with PAD. In Pakistan, the prevalence of PAD in patients with Type-2 diabetes was 31.6%.3. The prevalence of PAD in American and Asian diabetic population was estimated to be 9.5% and 3.2-11.7%, respectivey.[1] In Pakistan, the prevalence of PAD in patients with Type-2 diabetes was 31.6%.3 While, the prevalence of PAD in American and Asian diabetic population was estimated to be 9.5% and 3.2-11.7%, respectivey.[1]

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