A study led by the Diabetes Foot Research Group of the University of Malta highlights that healthcare professionals should be cautious when conducting vascular foot assessments and that both ABPIs and Doppler waveforms should be used in the assessment of patients with diabetes in order to screen for peripheral arterial disease (PAD). Early diagnosis and treatment of PAD in patients with diabetes is crucial.
The study, entitled‘Dangers revealed by misdiagnosed peripheral arterial disease using Ankle Brachial Pressure Index (ABPI) measurements’ was published in the peer reviewed journal, Diabetes Research and Clinical Practice.
It demonstrates that the ABPI in patients with diabetes is frequently normal even in the presence of arterial disease and that these cases can be identified through abnormal Doppler waveforms. Combining Doppler waveforms and measurement of ABPIs in patients with diabetes yields more reliable results without significantly increasing time required for testing. The authors recommend that both modalities should be used in patients with diabetes and when these do not concur, further evaluation should be performed.
The results of the study will lead to an accurate assessment of peripheral arterial disease and would allow initiation of appropriate secondary risk factor control measures. Data provided by this study can help design rational strategies to further improve the service provision for correct detection of PAD which can result in improved quality of care for patients living with PAD.
The Diabetes Foot Research Group is currently committed to conduct ‘state-of-the art’ research in the area of diabetes
The University of Malta in collaboration with Staffordshire University, UK, is currently conducting research on diabetes and its management. In Malta, the Diabetes Foot Research Group is led by Alfred Gatt as chairman, together with other researchers from the Faculty of Health Sciences, Faculty of Engineering and Faculty of Medicine and Surgery. His group has established collaborative networks in various countries to promote research in the area of diabetic foot care.
With the emerging rise in both diabetes and its complications, the Diabetes Foot Research Group is currently committed to conduct ‘state-of-the art’ research in the area of diabetes in order to reduce the burden of diabetes foot complications. Thus, the Diabetes Foot Research Group is conducting other research in the field of diagnostics, utilising an infra-red camera to determine the prognosis of diabetic patients with vascular disease.
The group has also embarke on a research project entitled ‘Thermal imaging for peripheral vascular disease monitoring in diabetics’ (TIPMID).
The aim of this project is to investigate the utilisation of thermography as a diagnostic and prognostic tool in order to assess vascular perfusion in the high risk foot. Stage one of this study has been concluded and a paper was published in a peer-reviewed journal International Journal of Vascular Medicine.
Three full-time researchers are currently recruiting participants and collecting data for phase two of the study. This research project is financed by the Malta Council for Science and Technology through the National Research & Innovation Programme 2013.
It is hoped that within the next two years, a validated clinical tool will be produced that should prove to be highly effective in the management of diabetic foot disease for persons living with diabetes worldwide.