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Morphofunctional characteristics of the foot in patients with diabetes mellitus and diabetic neuropathy
Authors:Yolanda García-Álvarez  José Luis Lázaro-Martínez  Esther García-Morales  Almudena Cecilia-Matilla  Javier Aragón-Sánchez  David Carabantes-Alarcón
Affiliation:Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Abstract:AimsTo determine the structural and biomechanical characteristics associated with the conditions diabetes mellitus and diabetic neuropathy.MethodsObservational study of 788 patients conducted between February 2007 and February 2009, which included subjects with and without diabetes mellitus who had no active ulcer at enrollment. Demographic variables and the general and specific history of diabetes mellitus were recorded. The patient's foot type according to the Foot Posture Index, joint mobility and deformity were recorded.ResultsNo associations were found between the different foot types (neutral, pronated and supinated) and the structural and demographic variables at a general level, except for the pronated foot that was associated with a higher body mass index, longer suffering from diabetes and the presence of neuropathy [p < 0.001, OR (95% CI): 6.017 (4.198–8.624); p < 0.001, OR (95% CI): 1.710 (1.266–2.309); p = 0.010, OR (95% CI): 0.759 (0.615–0.937), respectively].ConclusionsThe confluence of risk factors such as neuropathy, body mass index, duration of diabetes and limited joint mobility in patients with diabetes mellitus and pronated foot may be a high-risk anthropometric pattern for developing associated complications such as Charcot foot. A prospective analysis of these patients is required to define the risk for developing Charcot neuroarthropathy.
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