An Evaluation of the Efficacy of Methods Used in Screening for Lower-Limb Arterial Disease in Diabetes

Lower-limb peripheral arterial occlusive disease (PAOD) is a common cause of hospital admission among patients with diabetes. The authors conducted a study of 130 limbs in 68 patients with and without diabetes mellitus to evaluate the accuracy of methods used to screen for PAOD and peripheral neuropathy, including foot pulses and the ankle-brachial or toebrachial pressure index, and Doppler waveform analysis. They determined that the screening tools of foot pulses, toebrachial pressure index and qualitative waveform analysis were highly sensitive screening methods in patients as long as peripheral neuropathy was not present. Qualitative waveform analysis and the toe-brachial index were more effective in high-risk limbs with detectable peripheral neuropathy.