Toe Brachial Index (TBI)

Toe Brachial Index (TBI) Testing is a vital diagnostic service offered at Lucknow Diabetic Foot and Wound Care Centre to assess blood circulation in the small arteries of the toes and feet. This test is especially important for diabetic patients with Peripheral Arterial Disease (PAD), where traditional Ankle Brachial Index (ABI) testing may give inaccurate results due to arterial calcification.

TBI enables early detection of impaired blood flow, which is essential for preventing diabetic foot ulcers, gangrene, and non-healing wounds.

Why TBI Matters in Diabetic Foot Care

Diabetes frequently leads to both nerve damage and vascular complications. In many long-term diabetic patients, arteries may become stiff or calcified, making ABI less reliable. TBI overcomes this limitation by measuring pressure in smaller digital arteries that are less likely to be calcified. This makes it particularly valuable for patients with:

- Advanced age
- Long-standing diabetes
- Chronic kidney disease
- History of vascular surgery or amputation

By identifying poor circulation early, we can intervene with targeted therapies, vascular procedures, and preventive foot care before complications become severe.

What Is Toe Brachial Index (TBI)?

TBI is a simple, noninvasive test that compares blood pressure in your big toe with that in your arm. A low TBI indicates poor circulation to the toes and feet—raising the risk of ulcers, infections, and delayed wound healing.

How the Test Is Conducted

- You lie in a relaxed position.
- Small cuffs are placed around your big toe and upper arm.
- A photoplethysmography (PPG) sensor or Doppler probe measures blood flow.
- TBI is calculated by dividing toe pressure by arm pressure.

The test is painless, takes less than 15 minutes, and gives valuable insights into peripheral circulation.

Who Should Undergo TBI Testing?

- Diabetic patients with chronic or non-healing foot ulcers
- Individuals with neuropathy but no ABI-detectable PAD
- Patients with cold toes, discoloration, or gangrene
- Those with abnormal ABI or known arterial calcification
- Patients being fitted for custom orthotics or diabetic footwear

Benefits of TBI Testing

- Accurate detection of impaired toe circulation
- Superior to ABI in high-risk or calcified patients
- Informs treatment strategies for diabetic wounds
- Helps in limb-saving decisions and planning
- Guides design of pressure-relieving orthotics and footwear
- Supports healing in conditions like varicose veins, ingrown toenails, or corns

Integrated Foot and Vascular Care

At Lucknow Diabetic Foot and Wound Care Centre, TBI testing is part of a holistic vascular diagnostic protocol. Combined with ABI, 3D foot scanning, and gait analysis, it helps our multidisciplinary team—including vascular surgeons, wound care nurses, and orthotists—develop personalized treatment plans that protect and restore foot health.

Protect Your Toes. Protect Your Life.

If you have diabetes or signs of poor circulation, early testing is essential. Book your TBI test today and take proactive steps toward preserving your vascular health and mobility with the help of our expert team.