Ankle Brachial Index As A Monitor of Diabetes Type 2 Microvascular Complications

Abstract
Background: Peripheral Artery Disease (PAD) has been linked with diabetic microvascular complications. However, many patients do not show typical symptoms. Ankle-Brachial Index (ABI) is reported to be a simple and useful method to estimate cardiovascular risks.
Aim of Study: To determine whether Ankle-brachial index could be a useful monitor of development of micro vascular complications in type 2 diabetes.
Patients and Methods: A cross sectional study included 93 patients, classified into two groups: Group I (control group) consistsed of 10 healthy individuals. Group II (patient group): Consisted of 83 diabetes type 2 patients diagnosed according to ADA criteria; who were further subdivided according to presence or absence of microvascular complications into two groups: Group IIA: 10 diabetics without microangiopathy and Group IIB: 73 Diabetics with microangiopathy. All the study members were subjected to clinical evaluation, fundus exam-ination, serial measurement of blood pressure, fasting & postprandial blood glucose, HbA1c, serum creatinine, urinary albumin and ABI.
Results: Our results showed significant higher BMI and lower ABI in diabetic groups compared to control (p<0.05); where fasting blood glucose, postbrandial blood glucose, HbA1c and serum creatinine were significantly elevated diabetic groups compared to control (p<0.05). A significant negative correlations (p<0.000) between BMI, HbA1c and duration of DM with ABI. The incidance of microvacular complications (retinopathy, nephropathy & neuropathy) was significantly higher (p 0.00) in complicated diabetic group (Group IIB) compared to control and IIA groups. The average ABI was significantly lower (p<0.05) among complicated diabetic group (Group IIB) regarding retinopathy (proliferative & non proliferative), nephropathy (micro & macroalbuminria) and neuropathy (mild, moderate & sever).
Conclusion: Low ABI is common in patients with T2D. The ABI is a simple, reproducible, and cost-effective screening test for diagnosing microvascular complications in diabetes type 2 patients. ABI screening should be performed in diabetic population for early evaluate of microvascular complications.