Achilles tendon and plantar fascia in recently diagnosed type II diabetes: role of body mass index

Abstract

Previous research has shown that plantar fascia and Achilles tendon thickness is increased in diabetes. The aims of present study were to assess whether tendon changes can occur in the early stages of the disease and to evaluate the extent of the influence of body mass index (BMI). The study population included 51 recent-onset type II diabetic subjects, who were free from diabetic complications, divided according to BMI into three groups (normal weight, overweight, and obese). Eighteen non-diabetic, normal-weight subjects served as controls. Plantar fascia and Achilles tendon thickness was measured by means of sonography. The groups were well balanced for age and sex. In all the diabetic subjects, plantar fascia and Achilles tendon thickness was increased compared to the controls (p < 0.001, p = 0.01, p = 0.003, respectively). A significant relationship was found between plantar fascia thickness and BMI values (r = 0.749, p < 0.0001), while the correlation between BMI and Achilles tendon was weaker (r = 0.399, p = 0.004). This study shows that plantar fascia and Achilles tendon thickness is increased in the early stages of type II diabetes and that BMI is related more to plantar fascia than Achilles tendon thickness. Further longitudinal studies are needed to evaluate whether these early changes can overload the metatarsal heads and increase the stress transmitted to plantar soft tissues, thus representing an additional risk factor for foot ulcer development.

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

“…Assessment by title and abstract excluded 1058 papers. Full text assessment of the remaining 135 reduced the yield to 33 papers 11 13–15 24 27 29–35 37–56. Reference list checking of these 33 papers identified a further two papers26 57 for inclusion, PubMed related articles identified one paper;23 citation tracking did not identify any papers.…”

Acquired midfoot deformity and function in individuals with diabetes and peripheral neuropathy

“…Our lack of difference in thickness between those with DM and controls mirrors a growing body of research which inconsistently finds thicker Achilles tendons in those with DM compared to controls. 17, 18, 38, 43-47 It is likely that changes in tendon size are impacted by more than presence or absence of DM. This is particularly true as we considered our a priori hypothesis regarding the posterior tibialis tendon and its relationship to deformity.…”

The Musculoskeletal Manifestations of Type 2 Diabetes Mellitus in a Kashmiri Population

“…These subjects could definitely have had glucose intolerance or mild type 2 diabetes mellitus for a significant length of time before diabetes is diagnosed. [20] It was reported that patients with type 2 diabetes had greater impairments in mobility and more difficulties performing basic activities of daily living (ADL) than similarly aged nondiabetic persons. [21,22] This leads to loss of independence, and it may predict future hospitalization, institutionalization, and death.…”