Screening people with type 2 diabetes using the ankle-brachial index (ABI) could help to detect those who are most at risk of developing cardiovascular events and diabetic foot ulcer, new research suggests.
The Taiwanese study set out to determine the predictive factors for the occurrence of diabetic foot ulcer and cardiovascular events in ABI examinations.
The ABI is used to document the presence of lower-extremity peripheral arterial disease (PAD) and in those with diabetes, it is often checked to assess the vascular risk for PAD.
The team from Chang Gung Memorial Hospital enrolled 482 people with type 2 diabetes who received ABI and brachial-ankle pulse wave velocity (ba-PWV) examinations from 2010 to 2017.
They examined a number of factors including:
- PAD symptoms
- Family history of chronic diseases
- Monofilament testing
- Foot ulcer status.
Their results showed: “There were 104 (22%) patients (mean age, 67.8 years) with the ABI <1.0. These patients with low ABI (ABI<1.0) had a significantly older age (p=0.001), higher delta PWV (p<0.001), higher rates of stroke (p=0.007), myocardial infarction (p=0.016), and foot ulcer (p=0.039). In a multivariable analysis model, the adjusted odds ratio (aOR) for myocardial infarction, stroke, and foot ulcers associated with low ABI were 1.219 (0.397-3.743, p=0.729), 1.204 (0.556-2.610, p=0.638), and 2.712 (1.199-6.133, p=0.017), respectively. The patients with low PWV (PWV<1400 cm/s) were significantly younger (p<0.001) and had a lower rate of hypertension (p<0.001), and higher percentages of stroke (p=0.027) and dialysis (p=0.041) family history.”
The researchers went on to conclude that low ABI was associated with cardiovascular events and diabetic foot ulcer in people with type 2 diabetes.