A Study On Ankle Brachial Index As A Predictor Of Peripheral Vascular Disease In Type 2 Diabetes Mellitus Patients Attending A Tertiary Care Hospital

Peripheral vascular disease (PVD) is a common problem that affects 20 % of population over the age of 60 years.PVD is one of the macro vascular complications of Type 2 Diabetes mellitus and considered as a major risk factor (or equivalent) for Myocardial Infarction.It is difficult to diagnose PVD in diabetic patients without proper investigations due to co-existing sensory neuropathy delaying clinical manifestations of the disease.The ankle-brachial pressure index (ABPI) is a simple, bedside, non-invasive, objective, and highly reproducible test that can establish the diagnosis of PVD.The ABPI is not only a marker of unrecognized PVD, but also a predictor of generalized atherosclerosis.ABPI measurement provides a simple, repeatable, non-invasive, effective method to assess the vascular status in diabetics.The main goal of the study is, to estimate the prevalence of PVD among Diabetic patients using Ankle Brachial Index and Colour Doppler Ultrasonography, to determine the diagnostic accuracy of Ankle Brachial Index in detecting Peripheral Vascular Disease among the study participants and to compare Ankle Brachial Index and Colour Doppler Ultrasonography in diagnosing Peripheral Vascular Disease.Pretested and Predesigned, Semi-structured questionnaire was used as study tool.Content validity was obtained from field experts and by extensive literature review.The prevalence of Peripheral Vascular Disease in our study participants based on Ankle Brachial Index and Color Doppler Ultrasonogram was 40% and 45% respectively.Ankle Brachial Index had strong predicting accuracy to identify Peripheral Vascular disease, having obtained the, area under curve of 0.863 and also have good diagnostic accuracy having the Sensitivity, Specificity, Positive Predictive Value of 80.8 %, 92.1%, 89.1 % and 85.4 % respectively.The accuracy of Right Brachial Index was higher than Left Brachial index in identifying Peripheral Vascular Disease.Thus, Ankle Brachial Index, can definitely be used in place of Color Doppler Ultrasonogram in a setting where the facility is unavailable and can be used as an effective screening procedure in identifying Peripheral Vascular Disease.