The Ankle-Brachial Index (ABI) is a ratio of highest systolic blood pressure (BP) in the leg (ankle) and highest systolic pressure in the arm (brachial) when taken in the supine position. It is a recommended screening approach for peripheral arterial disease (PAD) in patients with diabetes.1 In fact, both atherosclerotic PAD and medial artery calcification are vascular disease states captured by an ABI evaluation. ABI is a prognostic marker for cardiovascular disease events and functional outcomes such as diabetic foot ulceration and amputations.