Endocrine Abstracts

Introduction: The peripheral arterial disease is a serious complication of diabetes. Although frequent, it is often underestimated in our diabetic patients.

Goal of the Study: The aim of our study is to verify the validity of ABI measurement in the screening of PAD in diabetic patients.

Patients and Methods: Retrospective, descriptive and analytical study taking place over a period of 3 years, including 120 diabetics, where doppler ultrasound was performed in the face of suggestive symptoms or as part of an arterial assessment. The measurement of the ABI was carried out in all our patients. Data entry and statistical analysis was done using IBM SPSS software.

Results: The average age of our patients was 57.3 years, where type 2 diabetes predominated in 83.4% of cases with an average duration of evolution of 17 years, the average HbA1c was 9.8%. The major risk factors for atherosclerosis found in our patients were dyslipidemia in 43.3%, hypertension in 28.3%, obesity in 26.6% and smoking in 16.6%. The trophic disorders were objectified in 31.6% of our patients and the pulses were weakly perceived in 35.8% of the patients, 40% of the patients reported intermittent claudication. The ankle brachial index was measured in both limbs with an average ABI of 0.94, it was pathological in 66.6%. An ABI < 0.9 was found in 51.6% of patients and an ABI > 1.3 in 15%. The PAD objectified corresponding to a pathological arterial Doppler ultrasound was 84.1%. Atheromatous overload was objectified in 39.1%, 9.1% had arterial stenosis and 15.8% had arterial mediacalcosis. A significant relationship was found between the ABI and the doppler ultrasound of the lower limbs with a P=0.003. For the validity of the IPS, the sensitivity was 72.3% and the specificity was 63.2%, the PPV was 91% and the NPV was 30%.

Conclusion: Given its silent nature, peripheral arterial disease is often underdiagnosed in diabetics, resulting in a delay in diagnosis and management. The ankle brachial index remains a reliable way to detect and assess the severity of PAD.