Impact of type 2 diabetes mellitus on hemodynamic and morphology of foot arteries: A duplex ultrasound evaluation

Background: Type-2 Diabetes Mellitus (T2DM) is a significant health condition that is becoming more prevalent worldwide. Uncontrolled diabetes can lead to various complications, including peripheral artery disease (PAD). Duplex ultrasonography is critical to identify the stage of the disease and the patient suitability for treatment procedures. Purpose: to assess Doppler blood flow parameters and morphologic alterations of dorsalis pedis artery (DPA) and posterior tibial artery (PTA) in T2DM. Materials and methods: A cross-sectional single-center study was conducted in Khartoum State. One hundred adult diabetic patients with average ankle-brachial index and reasonable glycemic control were selected randomly and enrolled in the study. Their age ranged from 27 to 86 years. A Duplex ultrasound examination was performed using a high-frequency ultrasound probe to assess the Doppler indices, arterial diameters, and wall thickness of the DPA and PTA. The data were analyzed using SPSS program version 23. Results: Increased duration of type-2 diabetes cause a significant increase in arterial wall thickness and pulsatility index (PI) of the DPA and PTA; (p-value < 0.05). The PI values decreased significantly in diabetic patients with trophic skin foot changes (p-value < 0.001), while the blood resistive index (RI) increased significantly in these patients (p-values < 0.01). Despite the reasonable glycemic control, a positive linear relationship was found between glycosylated hemoglobin (HA1c) levels and RI values of both DPA and PTA (R2 0.642). Conclusion: The study concluded that in type 2 diabetes with reasonable glycemic control, the arterial wall thickness of DPA and PTA increased as the duration of diabetes increased. The PI values of DPA and right PTA increased significantly with the increased time of the disease. The RI increased, and PI decreased in a subgroup with trophic skin changes. There is a positive linear relationship between glycosylated hemoglobin (HA1c) levels and RI values of both DPA and PTA