Key result
Type 2 diabetes was associated with significantly increased wall thickness in the right dorsalis pedis artery (0.58 mm vs 0.38 mm, p<0.001) compared to healthy controls, indicating early preclinical arterial changes.
Why the study?
Type 2 diabetes mellitus is a growing global health problem, and this study aimed to assess hemodynamic and morphological parameters in diabetic foot arteries compared with asymptomatic controls.
Does triplex ultrasound detect preclinical hemodynamic and morphological changes in foot arteries in well-controlled Type 2 Diabetes patients compared to healthy controls?
Cross-Sectional (n=200)
No
Does triplex ultrasound detect preclinical hemodynamic and morphological changes in foot arteries in well-controlled Type 2 Diabetes patients compared to healthy controls?
Absolute Event Rate: 0.58% vs 0.38%
p-value: p=<0.001
Triplex ultrasound detects preclinical arterial wall thickening and increased flow resistance in well-controlled Type 2 diabetes patients, which correlates with HbA1c levels.
Hypothesis-generating for triplex ultrasound in diabetes; prospective validation needed before clinical adoption.
BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus (T2DM) is a significant health problem that is becoming more prevalent worldwide. This study aimed to assess hemodynamic and morphological parameters in diabetic patients' foot arteries and compare them to those obtained in asymptomatic control group. MATERIALS AND METHODS: This is a cross-sectional case-control study. B-mode ultrasound, color Doppler, and pulse wave Doppler were conducted to assess the dorsalis pedis arteries (DPAs) and posterior tibial arteries (PTAs). The morphological, total vascular diameter, wall thickness, and flow Doppler indices were measured. A total of 200 hundred participants were selected randomly using a random sampling technique. One hundred diabetic patients and 100 non-diabetic persons were determined. RESULTS: In diabetic patients, the overall grayscale diameter and wall thickness of foot arteries were statistically significantly larger than the asymptomatic group in the right DPA (p<0.01), left DPA (p<0.001), right PTA (p<0.001), and left PTA (p<0.001). In the diabetic group, the level of hemoglobin A1c (HbA1c) was positively correlated with blood flow resistive index (RI) in the right DPA (r=0.839; p<0.001), left DPA (r=0.801; p<0.001), right PTA (r=0.801; p<0.001), and left PTA (r=0.801; p<0.001). No significant differences were noted in both groups in blood flow Doppler parameters - pulsatility index (PI) and resistive index (RI). CONCLUSION: Overall grayscale diameters of foot arteries are larger in the diabetes group than in the control group, indicating arterial wall thickening as an early indicator of diabetes-related alterations. PI of both DPA and RI of right DPA were increased in diabetic patients more than the control group. The level of glycosylatedhemoglobin A1c (HbA1c) was strongly linked with the blood flow resistive index in diabetes patients.
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Ali et al. (2022) conducted a cross-sectional in Type 2 Diabetes Mellitus (n=200). Type 2 Diabetes Mellitus vs. Asymptomatic non-diabetic subjects was evaluated on Right DPA wall thickness (mm) (p=<0.001). Type 2 diabetes was associated with significantly increased wall thickness in the right dorsalis pedis artery (0.58 mm vs 0.38 mm, p<0.001) compared to healthy controls, indicating early preclinical arterial changes.
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