Non-invasive characterisation of angiopathy in the diabetic foot

A comparison between 19 consecutive insulin dependent diabetic patients with a history of or current foot ulcers, gangrene or infection, with 14 arteriosclerotic patients with advanced lower limb ischaemia was performed using measurements of ankle and great toe systolic blood pressure, forefoot skin perfusion pressure and pulse volume assessment. Although clinical examination was usually sufficient to distinguish different types of diabetic foot, the vascular laboratory often gave additional information about the vascular component of the diabetic foot. In this study, great toe systolic pressure appeared to be the best indicator of the degree of macroangiopathy. The role of microangiopathy in the development of diabetic foot remains uncertain. The major factor responsible for diabetic foot in addition to neuropathy seems to be macroangiopathy which is not different from that of arteriosclerotic occlusive disease.