Diagnostic Tools to Establish the Presence and Severity of Peripheral Arterial Disease in People With Diabetes

NCT ID: NCT05009602

Last Updated: 2025-09-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

604 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-03-14

Study Completion Date

2024-02-28

Brief Summary

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In the UK there are over 7,000 leg amputations each year because of diabetes. The most important cause of this is poor circulation. The detection of poor circulation in patients with diabetes is difficult. A number of tests exist to detect poor circulation (known as peripheral arterial disease (PAD)). However, there is confusion as to which is the gold standard.

The DM PAD study aims to determine the diagnostic performance of index tests (audible handheld Doppler, visual handheld Doppler, ankle brachial pressure index (ABPI), exercise ABPI and toe brachial pressure index (TBPI)) for the diagnosis of PAD in patients with diabetes as determined by a reference test (CTA or MRA).

Detailed Description

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Conditions

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Diabetic Foot Peripheral Arterial Disease Diabetic Foot Ulcer Peripheral Vascular Diseases Peripheral Artery Disease Critical Limb Ischemia Critical Lower Limb Ischemia

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Participating Centre

To complete all index tests and reference scan

Toe Brachial Pressure Index (TBPI)

Intervention Type DIAGNOSTIC_TEST

TBPI will be measured using the photoplethysmography (PPG) method, employing an infrared sensor placed on the hallux and index finger.

Ankle Brachial Pressure Index (ABPI)

Intervention Type DIAGNOSTIC_TEST

A sphygmomanometer-cuff placed at the ankle and a handheld continuous wave Doppler device will be used to measure the systolic pressure of the dorsalis pedis and posterior tibial artery.

Exercise Ankle Brachial Pressure Index (ABPI)

Intervention Type DIAGNOSTIC_TEST

A sphygmomanometer-cuff placed at the ankle and a handheld continuous wave Doppler device will be used to measure the systolic pressure of the dorsalis pedis and posterior tibial artery, following the participant completing 50 consecutive repetitions of active dorsiflexion whilst standing.

Audible handheld Doppler

Intervention Type DIAGNOSTIC_TEST

Audible CW Doppler interrogation of the dorsalis pedis and posterior tibial artery.

Visual handheld Doppler

Intervention Type DIAGNOSTIC_TEST

Visual CW interrogation of the dorsalis pedis and posterior tibial artery was performed using the handheld Huntleigh Digital Dopplex device.

Podiatry Ankle Duplex scan (PAD-scan)

Intervention Type DIAGNOSTIC_TEST

Podiatry ankle duplex scan (PAD-scan) involves using an ultrasound machine to visualise the anterior and posterior tibial arteries at the ankle.

To be used in 3 participating centers only.

Interventions

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Toe Brachial Pressure Index (TBPI)

TBPI will be measured using the photoplethysmography (PPG) method, employing an infrared sensor placed on the hallux and index finger.

Intervention Type DIAGNOSTIC_TEST

Ankle Brachial Pressure Index (ABPI)

A sphygmomanometer-cuff placed at the ankle and a handheld continuous wave Doppler device will be used to measure the systolic pressure of the dorsalis pedis and posterior tibial artery.

Intervention Type DIAGNOSTIC_TEST

Exercise Ankle Brachial Pressure Index (ABPI)

A sphygmomanometer-cuff placed at the ankle and a handheld continuous wave Doppler device will be used to measure the systolic pressure of the dorsalis pedis and posterior tibial artery, following the participant completing 50 consecutive repetitions of active dorsiflexion whilst standing.

Intervention Type DIAGNOSTIC_TEST

Audible handheld Doppler

Audible CW Doppler interrogation of the dorsalis pedis and posterior tibial artery.

Intervention Type DIAGNOSTIC_TEST

Visual handheld Doppler

Visual CW interrogation of the dorsalis pedis and posterior tibial artery was performed using the handheld Huntleigh Digital Dopplex device.

Intervention Type DIAGNOSTIC_TEST

Podiatry Ankle Duplex scan (PAD-scan)

Podiatry ankle duplex scan (PAD-scan) involves using an ultrasound machine to visualise the anterior and posterior tibial arteries at the ankle.

To be used in 3 participating centers only.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Aged ≥18 years
* Known history of diabetes

Exclusion Criteria

* PAD status known on imaging
* Known history of PAD intervention
* CTA and MRA contraindications- renal impairment, pregnancy, contrast medium hypersensitivity/allergy, non-compatible implants (MRA only).
* Unable to provide appropriate informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Leicester

OTHER

Sponsor Role collaborator

University of Edinburgh

OTHER

Sponsor Role collaborator

Universidad de Granada

OTHER

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Usman Jaffer

Role: PRINCIPAL_INVESTIGATOR

Chief Investigator

Locations

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Mid and South Essex NHS Foundation Trust

Basildon, , United Kingdom

Site Status

Cardiff and Vale UHB

Cardiff, , United Kingdom

Site Status

University Hospitals of Derby and Burton NHS Foundation Trust

Derby, , United Kingdom

Site Status

NHS Greater Glasgow and Clyde

Glasgow, , United Kingdom

Site Status

Hull University Teaching Hospitals NHS Trust

Hull, , United Kingdom

Site Status

University Hospitals of Leicester NHS Trust

Leicester, , United Kingdom

Site Status

Central London Community Healthcare NHS Trust sites

London, , United Kingdom

Site Status

Chelsea and Westminster Hospital NHS Foundation Trust

London, , United Kingdom

Site Status

St George's University Hospitals NHS Foundation Trust

London, , United Kingdom

Site Status

Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status

Hammersmith and Fulham Partnership

London, , United Kingdom

Site Status

South Tees Hospitals NHS Foundation Trust

Middlesbrough, , United Kingdom

Site Status

Nottingham University Hospitals (NUH) NHS Trust

Nottingham, , United Kingdom

Site Status

Oxford University Hospitals NHS Foundation Trust

Oxford, , United Kingdom

Site Status

University Hospitals Plymouth NHS Trust

Plymouth, , United Kingdom

Site Status

University Hospitals Southampton NHS Foundation Trust

Southampton, , United Kingdom

Site Status

Worcestershire Acute Hospitals NHS Trust

Worcester, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Normahani P, Burgess L, Norrie J, Epstein DM, Kandiyil N, Saratzis A, Smith S, Khunti K, Edmonds M, Ahluwalia R, Coward T, Hartshorne T, Ashwell S, Shalhoub J, Pigott E, Davies AH, Jaffer U; DM PAD study investigators. Study protocol for a multicentre comparative diagnostic accuracy study of tools to establish the presence and severity of peripheral arterial disease in people with diabetes mellitus: the DM PAD study. BMJ Open. 2022 Nov 3;12(11):e066950. doi: 10.1136/bmjopen-2022-066950.

Reference Type DERIVED
PMID: 36328388 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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21CX7046

Identifier Type: -

Identifier Source: org_study_id

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