Correlation between toe brachial index and walking ability in peripheral arterial disease with type 2 diabetes mellitus

Abstract

Abstract Background The primary symptom of peripheral arterial disease (PAD) is intermittent claudication and the most common non-invasive diagnostic method is ankle brachial index. Peripheral arterial disease is usually accompanied by various other co-morbidities like type 2 diabetes mellitus, hypertension, and hypercholesterolemia. Literature suggests that when peripheral arterial disease is accompanied by type 2 diabetes mellitus, the ankle-brachial index can be falsely elevated due to medial calcification of the arteries. Therefore, an assessment of microcirculation using the toe brachial index is needed to diagnose PAD in these individuals. It has been well established that walking ability and ankle-brachial index are correlated in peripheral arterial disease. However, there is a dearth of literature on whether there is a correlation between toe brachial index (TBI) and walking ability. Therefore, the objective of the study is to find the correlation between toe brachial index and walking ability in type 2 diabetes mellitus with peripheral arterial disease. A total of 1485 participants were screened for the study, among which 133 met the inclusion criteria. Informed consent was obtained and the included participants were assessed for their demographic details. Toe brachial index was performed with the help of Doppler and 6-min walk test was performed to measure the claudication in the participants. Results In the present study of 133 participants, we found a strong positive correlation between toe brachial index and 6-min walk distance (r = 0.911 p value < 0.05). The walking ability is directly proportional to the TBI, i.e., the lesser the values of TBI, the lesser the walking distance covered in peripheral arterial disease with type 2 diabetes mellitus. Conclusion The present study concludes that there is a strong positive correlation between toe brachial index and 6-min walk distance.

Keywords

• Type 2 diabetes mellitus
• Peripheral arterial disease
• 6-min walk distance
• Toe brachial index
• Claudication pain