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Background: The burden of disease from diabetic foot ulcers linked to peripheral arterial disease (PAD) is complicated by limited resources in low- to middle-income countries (LMIC). This precludes the widespread use of sophisticated imaging methods. Screening for PAD can include the use of low-cost tests such as the ankle brachial index (ABI). A scoping review was performed to identify what is known about the use of ABI in screening for diabetes-related PAD in LMIC. Methods: LMIC were defined as per the International Diabetes Federation Atlas. The following databases were searched using a comprehensive search term: Cochrane Library, EbscoHost, PubMed, Web of Science, Science Direct, Scopus, and Google Scholar. A total of 400 records were gleaned. The publication abstracts were screened through several rounds to select only those in which ABI was used in the context of screening for PAD to prevent diabetic foot disease. Results: Twenty publications were included, from MLIC countries such as Brazil, Nigeria, Kenya, Uganda, South Africa, India, China, Singapore, Korea, Taiwan, Hong Kong, Indonesia, Thailand, and the Philippines. Ten ancilliary publications were identified. Conclusions: The widespread reporting and large scale use of ABI in PAD screening in Asia are evident, compared to fewer reports from Africa and South America. Many Asian publications report using faster, automated ABI equipment in conjunction with handheld Doppler evaluation of flow signals. Despite concerns regarding the potential for false elevations secondary to vessel calcification and non-compressibility, ABI remains a useful first encounter test in screening for PAD. Asian publications endorse and report the use of ABI firmly within the core clinical examination and consideration of other risk factors for PAD. No publications were found on large-scale use of automated ABI in the South African or greater African context of diabetic foot screening. [ABSTRACT FROM AUTHOR]

Background: Peripheral arterial disease (PAD) is an important marker of cardiovascular (CV) risk and the risk of PAD is markedly increased in patients with type 2 diabetes mellitus (T2DM). Consequently, early diagnosis and treatment of PAD in patients with T2DM are critically important to reduce the risk of CV events. The aim of this study was to determine the prevalence of asymptomatic PAD in patients with T2DM and to investigate the demographic and clinical associations of PAD among them. Methods: This cross-sectional study included 2423 diabetic patients >20 years old, who were regularly followed up at the regional diabetes clinic, Galle, Sri Lanka. Data were obtained using structured questionnaires for information on demographic characteristics and risk factors. Assessment of ankle-brachial pressure index (ABPI) was performed in all. PAD was diagnosed when ABPI was < 0.9 on either leg. Results: The overall prevalence of PAD was 15.3% with no significant age or gender difference. Patients with PAD had significantly higher systolic blood pressure (SBP) (127 vs 125 mmHg, P = 0.002) and diastolic blood pressure (DPB) (80 vs 78 mmHg, P = <0.001) and significantly lower estimated glomerular filtration rate (eGFR) (80 vs 84 ml/min, P = 0.007) than those without PAD. No significant relationships were found between the duration of diabetes mellitus, hypertension, dyslipidemia, and PAD. Conclusions: Prevalence of PAD was relatively high in the diabetic population of this study when compared with findings from other countries. There is a significant association of subclinical PAD with reduced eGFR among patients with T2DM. [ABSTRACT FROM AUTHOR]

Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9