Chatwin, Katie E and Abbott, Caroline A and Rajbhandari, Satyan M and Orlando, Giorgio and Bowling, Frank L and Boulton, Andrew J M and Reeves, Neil D (2026) How much pressure causes a diabetic foot ulcer? : An 18-month prospective study investigating plantar pressure characteristics in the lead up to ulceration. Diabetes Research and Clinical Practice, 237: 113293. ISSN 0168-8227
Full text not available from this repository.Abstract
High plantar pressure is associated with diabetic foot ulcer (DFU) development; however, previous studies are limited to a 'snapshot' plantar pressure measurement taken at study onset or post-DFU healing. The aim of this prospective study was to provide a unique insight into sustained plantar pressures developed during the three months preceding ulceration. Forty-six patients with diabetic peripheral neuropathy and DFU history wore an intelligent insole system, which continuously assessed plantar pressure for 18-months or until ulceration. Sustained pressure parameters in the three months preceding DFU were compared between feet that developed DFU and those remaining ulcer-free, using multilevel binary logistic regression analysis. Twelve feet ulcerated, all under the forefoot. DFU feet experienced more minutes of sustained plantar pressure [19(95%CI,0.86-37, P = 0.04)] and more 'bouts' of sustained pressure [0.64(0.024-1.3, P = 0.042)] at the forefoot region during the three months preceding DFU, compared to ulcer-free feet. Plantar pressures during daily activities were continuously measured in the three months preceding DFU using an intelligent insole system, with a greater number of minutes and bouts of sustained plantar pressure preceding DFU development. Daily monitoring of sustained pressure areas, using insole systems, may prove useful for preventing DFU development.