Using the ankle-brachial index to predict outcomes for patients with type 2 diabetes

This study aimed to investigate how good the ankle-brachial index (which measures differences in blood pressure between the arm and the ankle) is at determining outcomes in patients with type 2 diabetes. The study found that a low ankle-brachial index was related to a higher risk of heart and blood vessel disease, nerve damage in fingers and feet, and early death in patients with type 2 diabetes.

The ankle-brachial index (ABI) is a method used to see if a patient has blocked arteries due to peripheral artery disease, where arteries get blocked by hardening and fat build-up. The blood pressure of the patient is taken at the ankle, and at the upper arm. If the blood pressure in the arm is lower than the blood pressure in the leg it means that there may be blocked arteries. This is called a low ABI. Untreated type 2 diabetes can cause damage to blood vessels which can result in problems with blood pressure. This is why it is important to know how the ABI is related to complications of type 2 diabetes.

There were 688 patients in this study. All of them had been diagnosed with type 2 diabetes and were followed up for ten years on average. Their ABI was measured, and in the following ten years, any complications and death were recorded. The patients with a low ABI were older, did less physical activity, had been diagnosed with type 2 diabetes for longer, and had more diabetes complications than those with a higher ABI.

Patients with a low ABI (less than 0.90) were 2.1 times more likely to die in the ten years after the study started than those with an ABI over 0.90. Those with a low ABI were 2.7 times more likely to die from a cardiovascular (heart and blood vessel disease) reason than those with a high ABI. Those with a low ABI were 2.5 times more likely to have a heart attack or stroke than those with a high ABI. Those with a low ABI were 2.1 times more likely to lose feeling in their feet and fingers due to nerve damage, than those with a high ABI.

The study found that a low ABI was associated with a higher chance of heart and vessel disease, nerve damage in the fingers and feet, and death compared to a high ABI.

This study was medium sized, therefore will be fairly accurate. This study examined how well the ABI could determine cardiovascular issues, but not other issues. Potential problems such as loss of kidney function and issues with eyesight, which are common problems in patients with type 2 diabetes, were not able to be predicted.

Discuss this test with your doctor and see if it might be useful for you to find out your ankle-brachial index.