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

Ababneh, Mutasem; Ayed, Mousab Yousef Al; Robert, Asirvatham Alwin; Dawish, Mohamed Abdulaziz Al

doi:10.2174/1573399815666190531093238

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Moreover, partly because it can also diagnose PAD in the case of MAC, this meta-analysis considered it a better screening tool than the measurement of ABI [53]. However, only a few studies examining the screening possibilities of PAD included the combined examination of ABI and TBI [54][55][56][57][58], and most of them involved only patients with diabetes [54][55][56][57]. Since the MESI mTablet unites the ABI and TBI measurements in one, easily operated device, the possibility of sequential measurements could facilitate more widespread use.…”

Section: Discussionmentioning

confidence: 99%

Screening for Peripheral Artery Disease Using an Automated Four-Limb Blood Pressure Monitor Equipped with Toe–Brachial Index Measurement

Fendrik,

Biró,

Endrei

et al. 2023

JCM

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Toe–brachial index (TBI) measurement helps to detect peripheral artery disease (PAD) in patients with incompressible ankle arteries due to medial arterial calcification, which is most frequently associated with diabetes. We aimed to evaluate how an automated four-limb blood pressure monitor equipped with TBI measurement could contribute to PAD screening. In 117 patients (mean age 63.2 ± 12.8 years), ankle–brachial index (ABI) measurement was performed using the Doppler-method and the MESI mTablet. TBI was obtained via photoplethysmography (MESI mTablet, SysToe) and a laser Doppler fluxmeter (PeriFlux 5000). Lower limb PAD lesions were evaluated based on vascular imaging. A significant correlation was found between Doppler and MESI ankle–brachial index values (r = 0.672), which was stronger in non-diabetic (r = 0.744) than in diabetic (r = 0.562) patients. At an ABI cut-off of 0.9, Doppler (AUC = 0.888) showed a sensitivity/specificity of 67.1%/97.4%, MESI (AUC 0.891) exhibited a sensitivity/specificity of 57.0%/100%; at a cut-off of 1.0, MESI demonstrated a sensitivity/specificity of 74.7%/94.8%. The TBI values measured using the three devices did not differ significantly (p = 0.33). At a TBI cut-off of 0.7, MESI (AUC = 0.909) revealed a sensitivity/specificity of 92.1%/67.5%. Combining MESI ABI and TBI measurements recognised 92.4% of PAD limbs. Using an ABI cut-off level of 1.0 and sequential TBI measurement increases the sensitivity of the device in detecting PAD. The precise interpretation of the obtained results requires some expertise.

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Section: Discussionmentioning

confidence: 99%

Screening for Peripheral Artery Disease Using an Automated Four-Limb Blood Pressure Monitor Equipped with Toe–Brachial Index Measurement

Fendrik,

Biró,

Endrei

et al. 2023

JCM

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“…[ 6 ] A cross sectional study of 91 diabetic foot ulcer patients in Saudi Arabia showed 21.8% of them had an abnormal ABI and recommended the use of ABI for screening purpose. [ 7 ] Association of different categories of ABI in a large group of type II diabetics over a period of 6 years showed a high incidence of mortality and acute myocardial infarction, suggesting the importance of preventive measures in such persons. [ 8 ] The prevalence of PAD has been recorded in various studies differently.…”

Section: Discussionmentioning

confidence: 99%

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

Mishra

2021

Journal of Family Medicine and Primary Care

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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.

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“…Pada subjek dengan sirkulasi arteri tungkai bawah normal, tekanan sistolik di pergelangan kaki biasanya 10-15 mmHg lebih tinggi daripada yang tercatat dari lengan karena kecepatan gelombang nadi, menghasilkan ABI > 1,10. Perhimpunan medis internasional besar merekomendasikan penghitungan ABI dengan membagi tekanan tertinggi di tungkai dengan tekanan tertinggi di lengan (Ababneh et al, 2020).…”

Section: Pendahuluanunclassified

Cegah Amputasi Gangrene Penderita Diabetes Mellitus Tipe 2 Melalui Pemanfaatan Media Video Senam Kaki

et al. 2022

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ABSTRAK Diabetes mellitus (DM) menjadi masalah kesehatan di seluruh dunia, diperkirakan 462 juta orang (6,28% populasi dunia) terkena DMT2. Hiperglikemia kronik menyebabkan disfungsi endotel seperti kalsifikasi medial arteri yang menyebabkan gangguan sirkulasi dan syaraf di kaki. Ulkus DM yang terinfeksi menyebabkan gangrene sehingga berisiko amputasi apabila tidak ditangani. Ankle Brachial Index (ABI) untuk screening gangguan sirkulasi kaki. Strategi pencegahan mengurangi risiko ulkus, gangrene dan amputasi dapat menggunakan pendidikan kesehatan pada pasien terkait gaya hidup dan olah raga/senam. Angka kejadian DM tertinggi di Desa Karanggedang dibandingkan 10 desa lainnya di Kecamatan Sidareja. Sejumlah 61 orang DMT2 memiliki GDS > 200 mg/dl. Tujuan PKM ini yaitu meningkatkan kesadaran penderita DMT2 tentang gaya hidup yang baik, serta perbaikan sirkulasi perifer dengan perbaikan nilai ABI pada 2 kali pengkuran. Metode PKM ini menggunakan ceramah, diskusi, tanya jawab, wawancara, demonstrasi, redemonstrasi, dan menonton video senam kaki diabetes meliputi tahap persiapan hingga evaluasi sebanyak 14 kali pertemuan. Didapatkan hasil rata-rata peserta berumur 55,27 tahun, mayoritas memiliki hipertensi 9 (60%) orang, lama menderita DM 1-6 tahun, skala nyeri pre 5 (sedang) yang menurun 2 poin menjadi 3 (ringan), mengeluh baal pre 12 (80%) dan membaik menjadi 5 (33,5%) orang, kadar GDS pre 216,07 mg/dl menurun menjadi 185 mmg/dl, nilai ABI pre seluruh peserta 0,81 (abnormal) dan membaik seluruhnya saat post 1,12 (normal) yang signifikan secara statistik. Saran bagi penderita DMT2 di Desa Karanggedang agar tetap rutin melakukan senam kaki diabetes secara mandiri, dan bagi kader kesehatan aktif mengingatkan dan memotivasi penderita untuk melakukan senam kaki diabetes secara rutin. Kata kunci: senam kaki diabetes, ABI, gangren, amputasi. ABSTRACT Diabetes mellitus (DM) is a health problem worldwide, it is estimated that 462 million people (6.28% of the world's population) are affected by T2DM. Chronic hyperglycemia causes endothelial dysfunction such as calcification of the medial artery which causes circulatory and nerve disorders in the legs. Infected DM ulcers cause gangrene so there is a risk of amputation if untreated. Ankle Brachial Index (ABI) is used to screen for circulatory disorders in the legs. Prevention strategies to reduce the risk of ulcers, gangrene, and amputation can use health education in patients related to lifestyle and exercise/sports. The highest DM incidence was found in Karanggedang Village compared to 10 other villages in Sidareja District. A total of 61 DMT2 patients had GDS > 200 mg/dl. The purpose of this community service is to increase awareness of DMT2 sufferers about a good lifestyle, as well as to improve peripheral circulation by increasing the ABI value in 2 measurements. This community service method uses lectures, discussions, questions and answers, interviews, demonstrations, re-demonstrations, and watching videos of diabetic foot exercises starting from the preparation stage to evaluation for 14 meetings. The results showed that the average age of participants was 55.27 years, have hypertension 9 (60%) people, have suffered for 1-6 years, pre pain scale 5 (moderate) decreased by 2 points at the post becomes 3 (mild), pre numbness complaints 12 (80%) and improved to 5 (33.5%) people, pre levels blood glucose 216.07 mg/dl which decreased post levels blood glucose becomes 185 mg/dl, the pre-ABI of all participants was 0.81 (abnormal) and a statistically significant increase at all at post 1.12 (normal). Suggestions for DMT2 sufferers in Karanggedang Village to continue to regularly do diabetes foot exercises independently, and for care providers to always actively remind and motivate the sufferers to routinely do diabetic foot exercises. Keywords: diabetic foot exercise, ABI, gangrene, amputation.

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

Cited by 6 publications

References 24 publications

Screening for Peripheral Artery Disease Using an Automated Four-Limb Blood Pressure Monitor Equipped with Toe–Brachial Index Measurement

Screening for Peripheral Artery Disease Using an Automated Four-Limb Blood Pressure Monitor Equipped with Toe–Brachial Index Measurement

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

Cegah Amputasi Gangrene Penderita Diabetes Mellitus Tipe 2 Melalui Pemanfaatan Media Video Senam Kaki

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