If an ulcer has not progressed despite optimal treatment and ankle brachial pressure index is less than 0.5 or the Doppler waveform is damped and either TcPo2 is less than 30 mmHg or toe pressure is less than 30 mmHg, then angiography should ideally be carried out. It is difficult to state when intervention should be carried out as this varies from patient to patient. However, the recommendations of the American Diabetes Association state that
further investigations should be started after 4 weeks with standard treatment.
Non-invasive procedures should be used first to examine the peripheral circulation and to detect areas of stenosis and occlusion. Transfemoral angiography with angioplasty can then be used as a definitive localized invasive procedure.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...