EVALUATION OF PERIPHERAL ARTERIAL DISEASE IN DIABETES MELLITUS PATIENTS WITH NORMAL ANKLE BRACHIAL INDEX USING SONOGRAPHIC AND DOPPLER PARAMETERS

Background: Peripheral arterial disease (PAD) is a signicant complication in diabetes mellitus (DM), often underdiagnosed in patients with normal ankle-brachial index (ABI). Doppler ultrasonography offers a non-invasive method to detect early PAD. This study evaluates the efcacy of sonographic and Doppler parameters in identifying PAD in DM patients with normal ABI and explores associations with diabetes duration. Methods: A cross-sectional study was conducted at S.S Institute of Medical Sciences & Research Centre from March 2023 to June 2025. Inputs were received from Shri Atal Bihari Vajpayee Medical College and Research Institution, Bangalore. We enrolled 150 DM patients with normal ABI (0.91–1.30). Doppler ultrasonography assessed lower limb arteries, measuring peak systolic velocity (PSV), waveform patterns, and stenosis severity. Inclusion criteria included DM patients aged ≥18 years with normal ABI. Exclusion criteria comprised prior vascular surgery or non-compressible arteries (ABI >1.30). Data were analysed using descriptive statistics and chi-square tests. Results: Of 150 patients, 62% had normal vessel patency, 26% had <50% stenosis, 10% had >50% stenosis, and 2% had occlusion. Monophasic waveforms were observed in 14% of cases, correlating with higher stenosis grades (p<0.001). Patients with >50% stenosis had a mean diabetes duration of 22.3 years, compared to 6.8 years in those with normal patency (p<0.05). PSV increased with stenosis severity (mean 405 cm/s for >75% stenosis). Conclusion: Doppler ultrasonography effectively detects PAD in DM patients with normal ABI, with abnormal ndings associated with longer diabetes duration.