Cultura

Family Medicine–Led Early Detection Of Diabetic Peripheral Arterial Disease: A Multidisciplinary Approach Involving Nursing, Ultrasound–Doppler, And Pharmacy

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Hani Ruhail K Alanazi, Maha Thamer Almutairy, Ebtisam Awadh Alotaibi, Amwaj Qassem Aqahtani, Mariyyaha Mahdi Alanazi
Nessreen Muhammad Salem Algushiry, Amerah Ayedah Alenazi, Mohammed Abdurahman Alshneabr, Fatima Hadi Mohammad Mujurdi, Sharifa Hadi Mohammad Mujurdi

Abstract

Background: Diabetic peripheral arterial disease (PAD) is a prevalent yet frequently underdiagnosed macrovascular complication of diabetes mellitus. The condition often progresses silently due to atypical symptom presentation and coexisting diabetic neuropathy, leading to delayed diagnosis and increased risks of foot ulcers, lower-limb amputations, and cardiovascular morbidity. Family medicine, as the first point of contact in primary health care, plays a critical role in early identification and coordination of preventive strategies.

Objective: This study aimed to examine the role of family medicine in the early detection of diabetic peripheral arterial disease through a multidisciplinary approach involving nursing assessment, ultrasound–Doppler diagnostics, and pharmacy-based risk management.

Methods: A descriptive cross-sectional study was conducted among healthcare professionals working in family medicine–led and affiliated primary care settings. Participants included family physicians, nurses, radiology professionals, and pharmacists. Data were collected using a structured, self-administered questionnaire assessing knowledge of diabetic PAD, routine screening practices, utilization of ultrasound–Doppler imaging, and pharmacy-related interventions for cardiovascular risk reduction. Descriptive statistical analysis was applied.

Results: The findings demonstrated generally high awareness of diabetic PAD risk factors among participants; however, recognition of asymptomatic and early-stage disease was inconsistent. Routine foot inspection was widely practiced, while referral for ultrasound–Doppler assessment was less consistently implemented. Ultrasound–Doppler imaging was strongly perceived as a valuable tool for detecting subclinical PAD beyond clinical examination alone. Pharmacists played a key role in medication optimization and cardiovascular risk management, though their involvement in PAD-specific screening pathways remained limited.

Conclusion: Family medicine–led early detection of diabetic peripheral arterial disease is most effective when supported by a structured multidisciplinary approach integrating nursing surveillance, ultrasound–Doppler diagnostics, and pharmacy services. Strengthening interprofessional collaboration and standardizing screening pathways within primary care may improve early diagnosis and reduce diabetes-related vascular complications.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty