Abstract
Peripheral arterial disease (PAD) is a common diabetes-related chronic complication. An unmet need for limb salvage is an effective tool to identify the presence of PAD. Various strategies have been used to assess PAD in patients with diabetes. However, no universal consensus has been yet reached. Babaei et al. investigated the diagnostic accuracy of different non-invasive methods namely Plethysmographic-and-Doppler derived ankle brachial index, toe brachial index, and Pulse volume waveform analysis to identify PAD in people with type 2 diabetes mellitus (T2DM). The aim of this commentary is to discuss the current advances on evaluation of PAD in people with T2DM.
Highlights
Peripheral arterial disease (PAD) is a prevalent form of atherosclerotic vascular disease in type 2 diabetes mellitus (T2DM)
The diagnostic accuracy of Ankle- brachial index (ABI) is lower in patients with diabetes compared to the nondiabetic individuals due to the medial artery calcification (MAC) [4,5]
It is recommended by the European Society of Cardiology (ESC) and the American Heart Association (AHA) to be used for further assessment in patients suspected to PAD with normal or high ABI [28,29]
Summary
Peripheral arterial disease (PAD) is a prevalent form of atherosclerotic vascular disease in type 2 diabetes mellitus (T2DM). Doppler-based ABI is a time-consuming and operator-dependent procedure [3] To overcome these limitations, other non-invasive screening tools such as automated plethysmographybased ABI (ABIPLE), toe brachial index (TBI), and pulse volume wave (PVW) analysis have been proposed [3,6]. The studies investigating the diagnostic performance of these non-invasive tools for detection of PAD were conducted in different populations using various standard methods leading to inconclusive results [6,7,8]. The generalization of the results and implication of the cut-off points for screening of PAD in patients with diabetes is yet to be investigated in more similar populations. The aim of this commentary is to evaluate this study and discuss updates in this research emphasizing the necessity for conducting more precise similar studies to explore the best screening tool with the most appropriate cut-off value for detecting PAD in patients with T2DM
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