Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

Curr Diabetes Rev. 2020;16(3):270-277. doi: 10.2174/1573399815666190531093238.

Abstract

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018.

Materials and methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients' medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the "χ2" test.

Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI.

Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

Keywords: Ankle-brachial index; clinical utility; diabetes; foot ulcers; peripheral arterial disease; toe brachial index..

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle Brachial Index*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Angiopathies / diagnosis*
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / physiopathology
  • Diabetic Foot / etiology
  • Diabetic Foot / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / etiology
  • Peripheral Arterial Disease / physiopathology
  • Saudi Arabia