Doppler study of peripheral blood flow in lower extremity of diabetic patients with or without ischemic symptoms in tertiary centre


  • Shashank Shekhar Tripathi Department of Surgery, MLN Medical College, Allahabad, Uttar Pradesh, India
  • Rahul Singh Department of Surgery, MLN Medical College, Allahabad, Uttar Pradesh, India
  • Ankur Tripathi Department of Surgery, MLN Medical College, Allahabad, Uttar Pradesh, India
  • Himansha Pandey Department of Surgery, MLN Medical College, Allahabad, Uttar Pradesh, India



Doppler, Diabetes, Ischemia, Non-ischemia


Background: Doppler ultrasonic velocity detector which is least expensive and most versatile instrument. This technique is particularly helpful to establish the diagnosis of vascular insufficiency in clinically suspected cases of vascular disease and to predict the therapeutic results and follow up.

Methods: The present study was conducted in MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India. Patients of either sex suffering from diabetes with or without ischemic symptoms, who presented themselves. Study consisted of 50 subjects, which were matched by age, sex and all physical characteristics. Among the 50 subjects, 20 were suffering from diabetes and had ischemic symptoms like intermittent or rest pain and gangrene. Another set of 20 patients in this study group were of diabetes without any ischemic symptoms. Remaining 10 patients were controls i.e., they were comparable in physical characteristics like age, sex, height and weight. They had never smoked neither had any vascular disease.

Results: In this study, peak incidence of diabetic foot lesion was 6th decade and about 20% of female patient had foot lesion. In this study, the mean duration of disease in diabetic with ischemic symptoms was 9.6 years, while in asymptomatic group it was 6.9 years. It showed that as duration of disease increases, there is more probability for appearance of ischemic symptoms and foot involvement.

Conclusions: In diabetics without ischemic symptoms, most of the doppler wave patterns are triphasic and biphasic, while in diabetics with ischemic symptoms biphasic and monophasic waves are predominantly seen.

Author Biography

Shashank Shekhar Tripathi, Department of Surgery, MLN Medical College, Allahabad, Uttar Pradesh, India

General Surgery

Junior Resident


Alexiadou K, Doupis J. Management of diabetic foot ulcers. Diabetes Therapy. 2012;3(1):4.

Rhodes BA, Bader P, Stolz K, White RI, Siegel ME. Assessment of peripheral vascular disease in patients with diabetes: Two case studies. Diab. 1976;25(4):307-14.

Sharan J, Mukherjee S. Clinical observation of diabetic foot in Rohilkhand region, Uttar Pradesh, India. Inter Surg J. 2017;4(3):961-5.

Joslin EP, Root H.R, White P. Treatment of Diabetes Mellitus. Diabetes. 9th ed. Philadelphia lea and Febiger; 1952: 262.

Krishnan S, Nicholls SC. Chronic venous insufficiency: clinical assessment and patient selection. In: Seminars in interventional radiology. New York, NY; Thieme-Med: 2005; 22(03): 169-177.

Oakley W, Catterall RC, Martin MM. Aetiology and management of lesions of the feet in diabetes. Brit Med J. 1956;2(4999):953.

Moore JM, Frew ID. Peripheral vascular lesion in diabetes mellitus. Brit Med J. 1965;2(5452):19.

Goldenberg S, Alex M, Joshi RA, Blumenthal HT. Nonatheromatous peripheral vascular disease of the lower extremity in diabetes mellitus. Diab. 1959;8(4):261-73.

Keiding NR, Root HF, Marble A. Importance of control of diabetes in prevention of vascular complications. J Am Med Assoc. 1952;150(10):964-9.

Janka HU, Standl E, Mehnert H. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors: screening with the Doppler ultrasonic technique. Diab Care. 1980;3(2):207-13.

Bell ET. Atherosclerotic gangrene of the lower extremities in diabetic and nondiabetic persons. Am J Clin Pathol. 1957;28(1):27-36.

Huljev D, Rasić Z. The role of color doppler sonography in the diagnosis of atherosclerotic changes in arteries of the lower extremities. Lijecnicki vjesnik. 1994;116(7-8):198-204.

Pinto F, Lencioni R, Napoli V, Petrucci R, Vignali C, Armillotta N, Bartolozzi C. Peripheral ischemic occlusive arterial disease: comparison of color Doppler sonography and angiography. J Ultrasound Med. 1996;15(10):697-704.

Di CS, Di FG, Cina A, Pedicelli A, Cotroneo AR. The diabetic foot: role of color-Doppler US. Rays. 1997;22(4):562-78.

Rudy A, Epstein SH. Review of one hundred cases of Diabetic Neuropathy followed from one to ten years. J Clin Endocrinol. 1945;5(2):92-8.

Porter JM, Swain ID, Shakespeare PG. Measurement of limb blood flow by electrical impedance plethysmography. Ann R Coll Surg Engl. 1985 May;67(3):169-72.

Franklin DL, Schlegel W, Rushmer RF. Blood flow measured by Doppler frequency shift of back-scattered ultrasound. Sci. 1961;134(3478):564-5.






Original Research Articles