Vascular profile in Malaysian patients with diabetic foot complications

Abstract

The early and perhaps ongoing misconception that the ischemic component of diabetic foot complications is due to microvascular occlusive disease, only creatable by amputation has made foot complications one of the most feared complications of diabetes. Recent studies in Western populations have challenged the place of microvascular disease and favour macrovascular disease in the pathogenesis of the diabetic foot. A study was performed to evaluate the place and extent of macrovascular arterial occlusive disease in Malaysian diabetic patients with foot complications utilizing non-invasive means of arterial pulse examination, arterial Doppler ultrasound examination and measurement of ankle brachial index. Arterial pulse and Doppler examination were abnormal in a higher proportion of the limbs with the foot lesion compared to that of the contralateral limb. There was however no difference in the mean ankle brachial index between the limbs with the foot lesion and the contralateral limbs. These findings suggest that there is some degree of macrovascular arterial occlusive disease affecting Malaysian patients with diabetic foot complications and chat ankle brachial indices may be spuriously elevated even in the presence of ischaemia.