High Ankle–Brachial Index Indicates Cardiovascular and Peripheral Arterial Disease in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is strongly associated with macrovascular complications, including peripheral arterial disease (PAD) and cardiovascular disease (CVD). The ankle–brachial index (ABI) is a simple non-invasive diagnostic tool used to detect peripheral arterial disease. While low ABI is well established as a marker of arterial obstruction, abnormally high ABI values may reflect arterial stiffness and medial arterial calcification, particularly in diabetic patients.

Aim: To evaluate the prevalence and clinical significance of high ankle–brachial index among patients with type 2 diabetes mellitus and its association with cardiovascular and peripheral arterial disease.

Methods: A prospective observational study was conducted at Patna Medical College and Hospital (PMCH), Patna, India, from April 2025 to November 2025. A total of 85 patients diagnosed with T2DM were included. ABI measurements were obtained using Doppler ultrasound and sphygmomanometry. Patients were categorized into low ABI (<0.9), normal ABI (0.9–1.3), and high ABI (>1.3) groups. Clinical data, cardiovascular risk factors, and presence of peripheral arterial disease were recorded. Statistical analysis was performed using SPSS version 25.

Results: Among the 85 patients studied, 22.4% exhibited high ABI values. Patients with high ABI demonstrated a significantly higher prevalence of cardiovascular disease (p = 0.01) and peripheral arterial disease symptoms (p = 0.02). Mean ABI values were significantly elevated in patients with cardiovascular disease compared with those without complications.

Conclusion: High ankle–brachial index is associated with increased risk of cardiovascular and peripheral arterial disease in patients with type 2 diabetes mellitus. Routine ABI screening may assist in early detection of vascular complications in diabetic populations.

Keywords: Ankle–brachial index, Type 2 diabetes mellitus, Peripheral arterial disease, Cardiovascular disease, Vascular calcification