Ethnic differences in plantar pressures in diabetic patients with peripheral neuropathy

Solano, Maria P.; Prieto, L. M.; Varon, Joseph; Moreno, M.; Boulton, Andrew J.M.

doi:10.1111/j.1464-5491.2008.02381.x

Cited by 16 publications

(6 citation statements)

References 13 publications

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“…Contrary to previous research [3,4], the Mā ori diabetic group exhibited significantly higher peak pressures than the NZC group at the central forefoota region prone to ulceration in diabetic populations largely due to high and repetitive loading [12]. The Mā ori diabetic group exhibited pressures at the central forefoot in excess of a threshold that may indicate an increased risk of ulceration [13], suggesting that they were more prone to ulceration at this region than their [ ( F i g .…”

Section: Discussioncontrasting

confidence: 77%

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The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot

et al. 2012

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Section: Discussioncontrasting

confidence: 77%

“…It is well established that there is increased risk of foot morbidity in diabetic populations, and differences in foot structure and function have been shown between ethnicities. Where comparisons have been made, diabetic Caucasians have exhibited greater plantar pressures and less pliable feet than other ethnicities [3,4].…”

Section: Introductionmentioning

confidence: 98%

The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot

et al. 2012

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“…4 Ethnic differences in PPs have been reported in diabetic patients with DPN. Solano et al 5 found that dynamic PP is lower in Hispanic diabetic patients with DPN compared to their Caucasian counterparts.…”

Section: Introductionmentioning

confidence: 98%

Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

Fawzy

Arafa

Wakeel

et al. 2014

Clin Med Insights Endocrinol Diabetes

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BACKGROUNDDiabetic foot ulceration is a preventable long-term complication of diabetes. In the present study, peak plantar pressures (PPP) and other characteristics were assessed in a group of 100 Egyptian patients with diabetes with or without neuropathy and foot ulcers. The aim was to study the relationship between plantar pressure (PP) and neuropathy with or without ulceration and trying to clarify the utility of pedobarography as an ulceration risk assessment tool in patients with diabetes.SUBJECTS AND METHODSA total of 100 patients having diabetes were selected. All patients had a comprehensive foot evaluation, including assessment for neuropathy using modified neuropathy disability score (MNDS), for peripheral vascular disease using ankle brachial index, and for dynamic foot pressures using the MAT system (Tekscan). The studied patients were grouped into: (1) diabetic control group (DC), which included 37 patients who had diabetes without neuropathy or ulceration and MNDS ≤2; (2) diabetic neuropathy group (DN), which included 33 patients who had diabetes with neuropathy and MNDS >2, without current or a history of ulceration; and (3) diabetic ulcer group (DU), which included 30 patients who had diabetes and current ulceration, seven of those patients also gave a history of ulceration.RESULTSPP parameters were significantly different between the studied groups, namely, forefoot peak plantar pressure (FFPPP), rearfoot peak plantar pressure (RFPPP), forefoot/rearfoot ratio (F/R), forefoot peak pressure gradient (FFPPG) rearfoot peak pressure gradient (RFPPG), and forefoot peak pressure gradient/rearfoot peak pressure gradient (FFPPG/RFPPG) (P < 0.05). FFPPP and F/R were significantly higher in the DU group compared to the DN and DC groups (P < 0.05), with no significant difference between DN and DC. FFPPG was significantly higher in the DU and DN groups compared to the DC group (P < 0.05). RFPPP and FFPPG/RFPPG were significantly higher in the DU and DN groups compared to the DC group (P < 0.05) with no significant difference between the DN and DU groups (P > 0.05). FFPPP, F/R ratio, FFPPG, and FFPPG/RFPPG correlated significantly with the severity of neuropathy according to MNDS (P < 0.05). These same variables as well as MNDS were also significantly higher in patients with foot deformity compared to those without deformity (P < 0.05). Using the receiver operating characteristic analysis, the optimal cut-point of PPP for ulceration risk, as determined by a balance of sensitivity, specificity, and accuracy was 335 kPa and was found at the forefoot. Multivariate logistical regression analysis for ulceration risk was statistically significant for duration of diabetes (odds ratio [OR] = 0.8), smoking (OR = 9.7), foot deformity (OR = 8.7), MNDS (OR = 1.5), 2-h postprandial plasma glucose (2 h-PPG) (OR = 0.9), glycated hemoglobin (HbA1c) (OR = 2.1), FFPPP (OR = 1.0), and FFPPG (OR = 1.0).CONCLUSIONIn conclusion, persons with diabetes having neuropathy and/or ulcers have elevated PPP. Risk of ulceration was highly a...

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“…Plantar callus forms under weightbearing areas as a consequence of dry skin (autonomic dysfunction), insensitivity, and repetitive moderate stress from high foot pressures. However, more recent data suggest that this increased risk in Hispanics is not related to elevated foot pressures as these are actually lower in this group (Solano et al, 2008). 3.…”

Section: Other Risk Factors For Diabetic Foot Ulcerationmentioning

confidence: 84%

Diabetic neuropathy and foot complications

Boulton

2014

Handbook of Clinical Neurology

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Ethnic differences in plantar pressures in diabetic patients with peripheral neuropathy

Cited by 16 publications

References 13 publications

The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot

The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot

Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

Diabetic neuropathy and foot complications

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