title: Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement.
abstract: OBJECTIVE
  The aim of this study was to compare ankle brachial indices (APBI) with pedal waveforms utilizing the continuous wave Doppler in a population with diabetes mellitus.
  
  
  METHODS
  A prospective study design was employed to investigate the ABPI in a cohort of 49 people with type 2 diabetes mellitus. ABPI assessment was completed using a portable handheld Doppler and ankle pressures of <0.9 were taken as suggestive of peripheral arterial disease (PAD). Arterial spectral waveforms in each foot were also recorded and compared to the ABPI readings.
  
  
  RESULTS
  Inconsistencies were identified between ABPIs and waveform interpretations in the study population. Approximately 35% of subjects had inconsistencies between their ABPI result and waveform interpretation in their right or left foot.
  
  
  CONCLUSIONS
  Both ABPIs and Doppler waveforms should be used in the assessment of people with diabetes in order to screen for PAD. This would ensure an accurate assessment of PAD and would allow initiation of appropriate secondary risk factor control measures.
authors.affiliation: Diabetes Foot Research Group, University of Malta, Malta. Electronic address: Cynthia.formosa@um.edu.mt.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Formosa
authors.forename: Kevin
authors.initials: K
authors.lastname: Cassar
authors.forename: Alfred
authors.initials: A
authors.lastname: Gatt
authors.forename: Anabelle
authors.initials: A
authors.lastname: Mizzi
authors.forename: Stephen
authors.initials: S
authors.lastname: Mizzi
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Camileri
authors.forename: Carl
authors.initials: C
authors.lastname: Azzopardi
authors.forename: Clifford
authors.initials: C
authors.lastname: DeRaffaele
authors.forename: Owen
authors.initials: O
authors.lastname: Falzon
authors.forename: Stefania
authors.initials: S
authors.lastname: Cristina
authors.forename: Nachiappan
authors.initials: N
authors.lastname: Chockalingam
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies
keywords: Ankle brachial pressure index; Diabetes foot screening; Diabetes mellitus; Pedal waveform analysis; Peripheral arterial disease