Type 2 Diabetes Mellitus Status with Ankle-Brachial Index among Patients with Diabetic Foot Ulcer at Universitas Airlangga Hospital, Surabaya
Downloads
Highlights:
- ABI was not influenced by diabetic status due to potential confounders.
- A more severe form of diabetic ulcer was associated with a lower ABI value.
Abstract
Introduction: Diabetic foot ulcer (DFU) is one of the most significant complications of uncontrolled type 2 diabetes mellitus (T2DM) that may affect a patient's prognosis and quality of life. This study aimed to identify the association between diabetic status, DFU severity, and other clinical factors with ankle-brachial index (ABI) score and category.
Methods: This was a cross-sectional study under a consecutive sampling frame conducted from 1 November 2022 to 31 January 2023 at Universitas Airlangga Hospital, Surabaya. Primary data for ABl were measured from T2DM patients with DFU in the Thoracic and Cardiovascular Polyclinic. Meanwhile, secondary clinical data were collected from the Department of Internal Medicine based on the inclusion and exclusion criteria specified in the patient's medical records. The International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26 was utilized for the statistical analysis.
Results: Out of 30 included patients, 63.33% had uncontrolled diabetic status, and the average ABI score was 0.999 ± 0.19. DFU severity was significantly associated with the ABI score and ABI category. Patients indicated with angioplasty exhibited a markedly lower ABI score than those without (mean 0.32 vs 1.01; p < 0.001). Indication of angioplasty was the only clinical factor significantly associated with a lower ABI score (p < 0.001).
Conclusion: The status of T2DM was unrelated to ABI. Future research is recommended to advance the understanding of peripheral artery disease in diabetic foot ulcer patients.
Wibawa AS, Novida H, Faizi M, et al. Risk Factor Related to Mortality of Diabetic Ketoacidosis Patients in Dr. Soetomo General Hospital Surabaya. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2020; 11: 36–40. [Journal]
Bestari IL. Characteristics of Patients with Type 2 Diabetes Mellitus at Surabaya Haji General Hospital. Indones J Public Heal 2020; 15: 286–294. [Journal]
Ministry of Health of the Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Hasil Riset Kesehatan Dasar Tahun 2018. Kementrian Kesehat RI 2018; 53: 1689–1699.
Rizqiyah H, Soleha TU, Hanriko R, et al. Pola Bakteri Ulkus Diabetikum pada Penderita Diabetes Melitus di RSUD Dr. H. Abdul Moeloek. Major Med J Lampung Univ 2020; 9: 128–135. [Journal]
Ong C. Characteristic of Chronic Complications in Type 2 Diabetic Patient based on Asian Perspective. Curr Intern Med Res Pract Surabaya J 2022; 3: 13–15. [Journal]
McClary KN, Massey P. Ankle Brachial Index. Treasure Island (FL), 2023. [PubMed]
Aulia P, Rasjad C, Seweng A, et al. Correlation of Ankle Brachial Index (ABI) with Degrees of Diabetic Ulcer. Int J Med Rev Case Reports 2019; 3: 1. [Journal]
Cuschieri S. The STROBE Guidelines. Saudi J Anaesth 2019; 13: S31–S34. [PubMed]
Aravindakshan MR, Maity SK, Paul A, et al. Distinct Pathoclinical Clusters among Patients with Uncontrolled Type 2 Diabetes: Results from a Prospective Study in Rural India. BMJ Open Diabetes Res Care 2022; 10. [PubMed]
Shah P, Inturi R, Anne D, et al. Wagner's Classification as a Tool for Treating Diabetic Foot Ulcers: Our Observations at a Suburban Teaching Hospital. Cureus 2022; 14: e21501. [PubMed]
Aboyans V, Ricco JB, Bartelink MLEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in Collaboration with the European Society for Vascular Surgery (ESVS): Document Covering Atherosclerotic Disease of Extracranial Carotid and Vertebral, Mesenteric, Renal. Eur Heart J 2018; 39: 763–816. [Journal]
Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135: e686–e725. [Journal]
Nie NH, Bent DH, Hull CH. Statistical Package for the Social Sciences (SPSS), https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-26 (2018).
Sayilan S, Çetinkaya E, Karandere F. The Relationship between the Ankle-Brachial Index and Glycemic Control in Patients with Diabetes Mellitus. Ann Med Health Sci Res 2021; 11 2021: 1492–1495. [ResearchGate]
Silaban R, AZ R, Astuti A. Korelasi Kadar Glukosa Darah dengan Nilai ABI pada Diabetes Melitus Tipe II. REAL Nurs J 2021; 4: 89–96. [Journal]
American Diabetes Association Professional Practice Committee. Glycemic Targets: Standards of Medical Care in Diabetes”2022. Diabetes Care 2021; 45: S83–S96. [Journal]
Nurvita R, Nuswantoro D, Prajitno JH. Correlation between Physical Activity and Fasting Blood Glucose in Patient with Type 2 Diabetes Mellitus. Curr Intern Med Res Pract Surabaya J 2022; 3: 40–42. [Journal]
Ilo A, Romsi P, Mäkelä J. Infrared Thermography and Vascular Disorders in Diabetic Feet. J Diabetes Sci Technol 2020; 14: 28–36. [PubMed]
Renovaldi D, Afrijiyah RS. Karakteristik Klinis dan Skor Ankle Brachial Index (ABI) pada Lansia di Panti Sosial Tresna Werdha Budi Mulia 3 Jakarta Selatan. Muhammadiyah J Geriatr 2022; 3: 9–16. [Journal]
Kartikadewi A, Setyoko S, Wahab Z, et al. Ankle Brachial Index pada Penderita Diabetes dan Non Diabetes, dan Hubungannya dengan Aktivitas Fisik dan Perilaku Merokok. J Kedokt dan Kesehat 2022; 18: 57–68. [Journal]
Kapoor R, Ayers C, Visotcky A, et al. Association of Sex and Height with a Lower Ankle Brachial Index in the General Population. Vasc Med 2018; 23: 534–540. [PubMed]
Marumo M, Ebara S, Nishibe I, et al. Relationships of Age and Gender with Ankle-Brachial Systolic Pressure Index and Cardio-Ankle Vascular Index in Patients with Diabetes Mellitus. Int J Gerontol 2018; 12: 32–36. [ScienceDirect]
Suyanto S. Hubungan antara Umur dan Nilai Ankle Brakhial Indeks pada Penderita Diabetes Melitus. J Ilmu Keperawatan dan Kebidanan 2020; 11: 205–209. [Journal]
Mok Y, Ishigami J, Lutsey PL, et al. Peripheral Artery Disease and Subsequent Risk of Infectious Disease in Older Individuals: The ARIC Study. Mayo Clin Proc 2022; 97: 2065–2075. [PubMed]
Chahrour MA, Habib JR, El Moheb MN, et al. Incidence and Predictors of Surgical Site Infection Complications in Diabetic Patients undergoing Lower Limb Amputation. Ann Vasc Surg 2022; 81: 343–350. [PubMed]
Nadir M, Khan MQ, Ahmed MI, et al. Infective Agents in Diabetic Foot Ulcers and Their Sensitivity Patterns. J Rawalpindi Med Coll 2021; 25. [ResearchGate]
Huang YY, Lin CW, Yang HM, et al. Survival and Associated Risk Factors in Patients with Diabetes and Amputations Caused by Infectious Foot Gangrene. J Foot Ankle Res 2018; 11: 1. [PubMed]
Dewi GAAIK, Wibisono S, Pawana IPA. Risk Factors for Lower Extremity Amputation in Diabetic Foot Ulcer Patients: A Case-Control Study. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2020; 11: 83–85. [Journal]
Paskiewicz A, Wang FM, Yang C, et al. Ankle-Brachial Index and Subsequent Risk of Severe Ischemic Leg Outcomes: The ARIC Study. J Am Heart Assoc 2021; 10: e021801. [PubMed]
Aljarrah Q, Allouh MZ, Husein A, et al. Transmetatarsal Amputations in Patients with Diabetes Mellitus: A Contemporary Analysis from an Academic Tertiary Referral Centre in a Developing Community. PLoS One 2022; 17: e0277117. [PubMed]
Sherif M. Angioplasty and Stenting for Peripheral Arterial Disease of the Lower Limbs. Eur Soc Cardiol; 16, https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Angioplasty-and-stenting-for-peripheral-arterial-disease-of-the-lower-limbs (2018).
Fagher K, Löndahl M. The Combined Impact of Ankle-Brachial Index and Transcutaneous Oxygen Pressure on Mortality in Patients with Type 2 Diabetes and Foot Ulcers. Acta Diabetol 2021; 58: 1359–1365. [PubMed]
Sasaki M, Mitsutake Y, Ueno T, et al. Low Ankle Brachial Index Predicts Poor Outcomes Including Target Lesion Revascularization during the Long-Term Follow Up after Drug-Eluting Stent Implantation for Coronary Artery Disease. J Cardiol 2020; 75: 250–254. [PubMed]
Copyright (c) 2024 Hana Anisah, Danang Himawan Limanto, Satriyo Dwi Suryantoro, Budi Utomo, Putu Bagus Dharma Permana
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions
3. The formal legal aspect of journal publication accessibility refers to Creative Commons Atribution-Share Alike 4.0 (CC BY-SA).