Relationship of planter pressure and glycemic control in type 2 diabetic patients with and without neuropathy |
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Authors: | Mohammed R Halawa Yara M Eid Rana A El-Hilaly Mona M Abdelsalam Amr H Amer |
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Institution: | 1. Department of Endocrinology and Metabolism, Faculty of Medicine, Ain Shams University Hospitals, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt;2. Department of Endocrinology and Metabolism, Faculty of Medicine, Ain Shams University Hospitals, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt;3. Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University Hospitals, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt;4. Department of Endocrinology and Metabolism, Faculty of Medicine, Ain Shams University Hospitals, Ramsis Street, Abbassia Square, Cairo, 11591, Egypt;5. Resident in National institute of Diabetes and Endocrinology, 16 Kaser el-Einy Street, Al-Sayda Zeinab, Cairo, Egypt |
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Abstract: | IntroductionFoot disease is a common complication of type 2 diabetes that can have tragic consequences. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot.AimTo examine Relationship of Planter Pressure and Glycemic Control in Type 2 Diabetic Patients with and without Neuropathy.Materials and methodsThe study was conducted on 50 type 2 diabetic patients and 30 healthy volunteers. BMI calculation, disease duration, Hemoglobin A1c and presence of neuropathy (by history, foot examination and DN4 questionnaire) were recorded. Plantar pressure was recorded for all patients using the Mat-scan (Tekscan, Inc.vers. 6.34 Boston USA) in static conditions (standing) and dynamic conditions (taking a step on the Mat-scan). Plantar pressures (kPa) were determined at the five metatarsal areas, mid foot area, medial and lateral heel areas and medial three toes.ResultsStatic and dynamic plantar pressures in both right and left feet were significantly higher in diabetic with neuropathy group than in control group in measured areas (P < 0.05). Static and dynamic pressures in right and left feet were significantly higher in diabetic with neuropathy group than in diabetic without neuropathy group in measured areas (P < 0.05). On comparison between controls and diabetic without neuropathy group there was a significant difference in plantar pressures especially in metatarsal areas (P < 0.05). No significant correlations were present between the studied variables age, disease duration, BMI and HbA1c and plantar pressures in all studied areas.ConclusionPersons with diabetic neuropathy have elevated peak plantar pressure (PPP) compared to patients without neuropathy and control group. HbA1c% as a surrogate for glycemic control had no direct impact on peak planter pressure, yet it indirectly impacts neuropathy evolution through out disease duration eventually leading to the drastic planter pressure and gait biomechanics changes. |
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Keywords: | BMI body mass index DN4 Douleur neuropathique 4 questionnaire score M1 first metatarsal area M2 second metatarsal area M3 third metatarsal area M4 fourth metatarsal area M5 fifth metatarsal area MF mid foot area MH medial heel LH lateral heel areas T1 T2 T3 T4 T5 five toe areas Diabetes Diabetic neuropathy Plantar pressure |
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