Comparative Doppler ultrasound findings of foot arteries in patients with type 2 diabetes mellitus and normoglycaemic patients

Abstract

Aim of the Study: The aim of this study was to investigate lower extremity peripheral artery disease (LEPAD) in the foot arteries of patients with type 2 diabetes mellitus, with and without clinical symptoms of arterial insufficiency, using triplex Doppler ultrasound. Materials and Methods: Forty-seven consecutive adult subjects with type 2 diabetes mellitus (T2DM) and 47 age-matched and sex-matched non-diabetic controls were recruited (94 limbs each). Ankle-brachial index (ABI), fasting blood glucose assay, glycated haemoglobin assay and triplex sonography of the dorsalis pedis artery (DPA) and the distal posterior tibial artery (PTA) in both feet were performed. Results: The mean age of the subjects and controls were 60.21 ± 7.68 years and 56.81 ± 9.05 years ( P > 0.05). The mean duration of diabetes mellitus was 10.4 ± 5.8 years. Crampy calf pain was the most common presenting symptom. Twenty-one (22.3%) of the 94 limbs of T2DM subjects had an abnormal ABI. Abnormal triplex Doppler waveform was seen in more than half of the PTA (57/94; 60.6%) and DPA (55/94; 58.5%). Forty-one (43.6%) of the 94 diabetic limbs had plaques in the PTA, while plaques were present in the DPA of 52 (55.3%) diabetic limbs. Conclusion: LEPAD is common in T2DM with a higher prevalence on triplex Doppler sonography compared to ABI values.

Diabetic Foot Complications in Saudi Arabia: A Retrospective Study

“…PAD is another macrovascular complication of late diabetes [ 37 ]. Atherosclerotic disorders affecting the extra-coronary circulation are encompassed by the term PAD [ 40 ]. Lower extremity peripheral arterial disease (LEPAD) is PAD affecting the lower limb arteries [ 40 ].…”

“…Atherosclerotic disorders affecting the extra-coronary circulation are encompassed by the term PAD [ 40 ]. Lower extremity peripheral arterial disease (LEPAD) is PAD affecting the lower limb arteries [ 40 ]. Atherosclerosis occurs due to chronic inflammation and injury of the arterial wall [ 41 ].…”

“…Twenty-three percent (23/100) of the posterior tibial arteries had a biphasic Doppler mode, 5% (5/100) had a monophasic mode, and 6% (6/100) had no flow. The waveforms of each segment of the vascular tree can be used to locate any occlusions or stenosis [ 40 ]. Triphasic waveforms correspond to the three phases of a heartbeat (systole, diastole, elastic recoil) [ 40 ].…”

“…The waveforms of each segment of the vascular tree can be used to locate any occlusions or stenosis [ 40 ]. Triphasic waveforms correspond to the three phases of a heartbeat (systole, diastole, elastic recoil) [ 40 ]. A biphasic waveform indicates mild to moderate disease, while a monophasic waveform indicates significant disease [ 40 ].…”

Diabetic Plantar Foot Segmentation in Active Thermography Using a Two-Stage Adaptive Gamma Transform and a Deep Neural Network

“…Liquid crystal thermography is another low-cost technique that can provide rich color representations of entire plantar temperature distributions, but it only works when the plantar foot is in good contact with the thermochromic liquid crystals, and its response is slow [12]. Due to the limitations of these two techniques, the use of infrared thermography for non-contact, high-resolution, and rapid temperature measurements of diabetic feet has increased significantly in the past 10 years [13,15,16]. It should be noted that another diagnostic technique, Doppler ultrasonography, has been commercially available for monitoring peripheral vascular disease and other artery abnormalities that often occur in diabetic feet [16].…”