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Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population
Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and t...
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| Published in: | Endocrinología, diabetes y nutrición. diabetes y nutrición., 2024-10, Vol.71 (8), p.340-347 |
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| creator | Rojas-Torres, Francis Infanzón-Talango, Héctor García-Ulloa, Ana Cristina Hernández-Jiménez, Sergio Rodríguez-Reyes, Gerardo |
| description | Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and the distribution of the PP observed in a sample of newly diagnosed patients with diabetes, adjusting for body mass index (BMI) groups (normal weight, overweight, grade I obesity, and grade II and III obesity).
A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.
Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (p |
| doi_str_mv | 10.1016/j.endien.2024.09.007 |
| format | article |
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A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.
Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (p<0.001) was observed between BMI and the peak PP of all anatomical regions assessed. After adjusting for BMI, significant differences (p<0.001) were seen between groups. The metatarsal region, particularly under the third metatarsal head, denoted the highest magnitudes across all BMI.
Periodic PP assessment is recommended to identify the distribution of high-pressure points along the plantar surface. However, as a preventive measure, it is suggested to encourage patients with diabetes and overweight or obesity to wear appropriate footwear and pressure-relief insoles to relieve high-pressure areas – often seen in these populations – to help prevent foot complications.
La presión plantar (PP) elevada constituye un factor de riesgo para desarrollar úlceras en el pie, aumento de la morbilidad y la mortalidad en los pacientes con diabetes. Dada la alta prevalencia de sobrepeso y obesidad en la población mexicana, este estudio tuvo como objetivo describir las magnitudes y la distribución de la PP observada en una muestra de pacientes recién diagnosticados con diabetes, ajustando por grupo de índice de masa corporal (IMC): normopeso, sobrepeso, obesidad grado I, y obesidad grados II y III.
Asistieron 250 voluntarios a un programa de atención integral para el manejo de la diabetes tipo 2, recibieron evaluaciones de los pies que incluyeron: evaluación vascular, neurológica, de alteraciones musculoesqueléticas y de la PP.
La neuropatía diabética y la enfermedad arterial periférica estuvieron presentes en el 21,6% y el 11,2% de los participantes. Las alteraciones músculoesqueléticas estuvieron presentes en el 70,8% de los participantes. Se observó una correlación positiva y significativa (p<0,001) entre el IMC y la PP máxima de todas las regiones anatómicas evaluadas. Después de ajustar por el IMC, se observaron diferencias significativas (p<0,001) entre los grupos. La región metatarsiana, particularmente debajo de la cabeza del tercer metatarsiano, denotó las magnitudes más altas en todas las categorías del IMC.
Se recomienda una evaluación periódica de la PP para identificar la distribución de los puntos de alta presión plantar. Sin embargo, como medida preventiva, se sugiere alentar a los pacientes con diabetes y sobrepeso u obesidad a utilizar calzado adecuado y plantillas para descargar las zonas de alta presión para prevenir complicaciones en los pies.</description><identifier>ISSN: 2530-0180</identifier><identifier>EISSN: 2530-0180</identifier><identifier>DOI: 10.1016/j.endien.2024.09.007</identifier><identifier>PMID: 39374996</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 - complications ; Diabetes tipo 2 ; Diabetic Foot - epidemiology ; Diabetic Foot - prevention & control ; Diabetic foot ulcer ; Diabetic Neuropathies - epidemiology ; Diabetic Neuropathies - prevention & control ; Female ; Foot ; Humans ; Male ; Mexico - epidemiology ; Middle Aged ; Obesity - complications ; Overweight - complications ; Peak plantar pressure ; Plantar pressure ; Presión plantar ; Presión plantar pico ; Pressure ; Type 2 diabetes mellitus ; Índice de masa corporal ; Úlcera diabética</subject><ispartof>Endocrinología, diabetes y nutrición., 2024-10, Vol.71 (8), p.340-347</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c287t-29b323bd97234b4f8a6072e2e44eb18f4c6d914dc30feca5b1ed60081669b7e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2530018024001008$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3535,27903,27904,45759</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39374996$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rojas-Torres, Francis</creatorcontrib><creatorcontrib>Infanzón-Talango, Héctor</creatorcontrib><creatorcontrib>García-Ulloa, Ana Cristina</creatorcontrib><creatorcontrib>Hernández-Jiménez, Sergio</creatorcontrib><creatorcontrib>Rodríguez-Reyes, Gerardo</creatorcontrib><title>Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population</title><title>Endocrinología, diabetes y nutrición.</title><addtitle>Endocrinol Diabetes Nutr (Engl Ed)</addtitle><description>Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and the distribution of the PP observed in a sample of newly diagnosed patients with diabetes, adjusting for body mass index (BMI) groups (normal weight, overweight, grade I obesity, and grade II and III obesity).
A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.
Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (p<0.001) was observed between BMI and the peak PP of all anatomical regions assessed. After adjusting for BMI, significant differences (p<0.001) were seen between groups. The metatarsal region, particularly under the third metatarsal head, denoted the highest magnitudes across all BMI.
Periodic PP assessment is recommended to identify the distribution of high-pressure points along the plantar surface. However, as a preventive measure, it is suggested to encourage patients with diabetes and overweight or obesity to wear appropriate footwear and pressure-relief insoles to relieve high-pressure areas – often seen in these populations – to help prevent foot complications.
La presión plantar (PP) elevada constituye un factor de riesgo para desarrollar úlceras en el pie, aumento de la morbilidad y la mortalidad en los pacientes con diabetes. Dada la alta prevalencia de sobrepeso y obesidad en la población mexicana, este estudio tuvo como objetivo describir las magnitudes y la distribución de la PP observada en una muestra de pacientes recién diagnosticados con diabetes, ajustando por grupo de índice de masa corporal (IMC): normopeso, sobrepeso, obesidad grado I, y obesidad grados II y III.
Asistieron 250 voluntarios a un programa de atención integral para el manejo de la diabetes tipo 2, recibieron evaluaciones de los pies que incluyeron: evaluación vascular, neurológica, de alteraciones musculoesqueléticas y de la PP.
La neuropatía diabética y la enfermedad arterial periférica estuvieron presentes en el 21,6% y el 11,2% de los participantes. Las alteraciones músculoesqueléticas estuvieron presentes en el 70,8% de los participantes. Se observó una correlación positiva y significativa (p<0,001) entre el IMC y la PP máxima de todas las regiones anatómicas evaluadas. Después de ajustar por el IMC, se observaron diferencias significativas (p<0,001) entre los grupos. La región metatarsiana, particularmente debajo de la cabeza del tercer metatarsiano, denotó las magnitudes más altas en todas las categorías del IMC.
Se recomienda una evaluación periódica de la PP para identificar la distribución de los puntos de alta presión plantar. Sin embargo, como medida preventiva, se sugiere alentar a los pacientes con diabetes y sobrepeso u obesidad a utilizar calzado adecuado y plantillas para descargar las zonas de alta presión para prevenir complicaciones en los pies.</description><subject>Adult</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes tipo 2</subject><subject>Diabetic Foot - epidemiology</subject><subject>Diabetic Foot - prevention & control</subject><subject>Diabetic foot ulcer</subject><subject>Diabetic Neuropathies - epidemiology</subject><subject>Diabetic Neuropathies - prevention & control</subject><subject>Female</subject><subject>Foot</subject><subject>Humans</subject><subject>Male</subject><subject>Mexico - epidemiology</subject><subject>Middle Aged</subject><subject>Obesity - complications</subject><subject>Overweight - complications</subject><subject>Peak plantar pressure</subject><subject>Plantar pressure</subject><subject>Presión plantar</subject><subject>Presión plantar pico</subject><subject>Pressure</subject><subject>Type 2 diabetes mellitus</subject><subject>Índice de masa corporal</subject><subject>Úlcera diabética</subject><issn>2530-0180</issn><issn>2530-0180</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAUhS1ERau2b4CQl2wmvXY8ScwCCVWlrVTEBtaWf26mHmXiYDsz7cPwrvV0BsSKheW7-M45uvcQ8p5BxYA1V-sKR-dxrDhwUYGsANo35Iwva1gA6-DtP_MpuUxpDQC8FsuWs3fktJZ1K6Rszsjvm6dpCNGPKzoNesw60iliSnNE6nzK0Zs5-zBSP9JJ5xKZE935_EhH3A3PhdGrMSR0-8lgxvSJ3m-mwVu9lyXah1heyHQeLL6ab4vH0VGPNGwx7tCvHjP9hk9FVnLCNA-v8gty0ush4eXxPyc_v978uL5bPHy_vb_-8rCwvGvzgktT89o42ZYVjeg73UDLkaMQaFjXC9s4yYSzNfRo9dIwdA1Ax5pGmhahPicfD75TDL9mTFltfLI4lItgmJOqGRNsWQ7YFVQcUBtDShF7NUW_0fFZMVD7btRaHbpR-24USFW6KbIPx4TZbND9Ff1pogCfDwCWPbceo0q2mFh0PqLNygX__4QX5oKmPQ</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Rojas-Torres, Francis</creator><creator>Infanzón-Talango, Héctor</creator><creator>García-Ulloa, Ana Cristina</creator><creator>Hernández-Jiménez, Sergio</creator><creator>Rodríguez-Reyes, Gerardo</creator><general>Elsevier España, S.L.U</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202410</creationdate><title>Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population</title><author>Rojas-Torres, Francis ; Infanzón-Talango, Héctor ; García-Ulloa, Ana Cristina ; Hernández-Jiménez, Sergio ; Rodríguez-Reyes, Gerardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c287t-29b323bd97234b4f8a6072e2e44eb18f4c6d914dc30feca5b1ed60081669b7e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes tipo 2</topic><topic>Diabetic Foot - epidemiology</topic><topic>Diabetic Foot - prevention & control</topic><topic>Diabetic foot ulcer</topic><topic>Diabetic Neuropathies - epidemiology</topic><topic>Diabetic Neuropathies - prevention & control</topic><topic>Female</topic><topic>Foot</topic><topic>Humans</topic><topic>Male</topic><topic>Mexico - epidemiology</topic><topic>Middle Aged</topic><topic>Obesity - complications</topic><topic>Overweight - complications</topic><topic>Peak plantar pressure</topic><topic>Plantar pressure</topic><topic>Presión plantar</topic><topic>Presión plantar pico</topic><topic>Pressure</topic><topic>Type 2 diabetes mellitus</topic><topic>Índice de masa corporal</topic><topic>Úlcera diabética</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rojas-Torres, Francis</creatorcontrib><creatorcontrib>Infanzón-Talango, Héctor</creatorcontrib><creatorcontrib>García-Ulloa, Ana Cristina</creatorcontrib><creatorcontrib>Hernández-Jiménez, Sergio</creatorcontrib><creatorcontrib>Rodríguez-Reyes, Gerardo</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrinología, diabetes y nutrición.</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rojas-Torres, Francis</au><au>Infanzón-Talango, Héctor</au><au>García-Ulloa, Ana Cristina</au><au>Hernández-Jiménez, Sergio</au><au>Rodríguez-Reyes, Gerardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population</atitle><jtitle>Endocrinología, diabetes y nutrición.</jtitle><addtitle>Endocrinol Diabetes Nutr (Engl Ed)</addtitle><date>2024-10</date><risdate>2024</risdate><volume>71</volume><issue>8</issue><spage>340</spage><epage>347</epage><pages>340-347</pages><issn>2530-0180</issn><eissn>2530-0180</eissn><abstract>Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and the distribution of the PP observed in a sample of newly diagnosed patients with diabetes, adjusting for body mass index (BMI) groups (normal weight, overweight, grade I obesity, and grade II and III obesity).
A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.
Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (p<0.001) was observed between BMI and the peak PP of all anatomical regions assessed. After adjusting for BMI, significant differences (p<0.001) were seen between groups. The metatarsal region, particularly under the third metatarsal head, denoted the highest magnitudes across all BMI.
Periodic PP assessment is recommended to identify the distribution of high-pressure points along the plantar surface. However, as a preventive measure, it is suggested to encourage patients with diabetes and overweight or obesity to wear appropriate footwear and pressure-relief insoles to relieve high-pressure areas – often seen in these populations – to help prevent foot complications.
La presión plantar (PP) elevada constituye un factor de riesgo para desarrollar úlceras en el pie, aumento de la morbilidad y la mortalidad en los pacientes con diabetes. Dada la alta prevalencia de sobrepeso y obesidad en la población mexicana, este estudio tuvo como objetivo describir las magnitudes y la distribución de la PP observada en una muestra de pacientes recién diagnosticados con diabetes, ajustando por grupo de índice de masa corporal (IMC): normopeso, sobrepeso, obesidad grado I, y obesidad grados II y III.
Asistieron 250 voluntarios a un programa de atención integral para el manejo de la diabetes tipo 2, recibieron evaluaciones de los pies que incluyeron: evaluación vascular, neurológica, de alteraciones musculoesqueléticas y de la PP.
La neuropatía diabética y la enfermedad arterial periférica estuvieron presentes en el 21,6% y el 11,2% de los participantes. Las alteraciones músculoesqueléticas estuvieron presentes en el 70,8% de los participantes. Se observó una correlación positiva y significativa (p<0,001) entre el IMC y la PP máxima de todas las regiones anatómicas evaluadas. Después de ajustar por el IMC, se observaron diferencias significativas (p<0,001) entre los grupos. La región metatarsiana, particularmente debajo de la cabeza del tercer metatarsiano, denotó las magnitudes más altas en todas las categorías del IMC.
Se recomienda una evaluación periódica de la PP para identificar la distribución de los puntos de alta presión plantar. Sin embargo, como medida preventiva, se sugiere alentar a los pacientes con diabetes y sobrepeso u obesidad a utilizar calzado adecuado y plantillas para descargar las zonas de alta presión para prevenir complicaciones en los pies.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>39374996</pmid><doi>10.1016/j.endien.2024.09.007</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Body Mass Index Cross-Sectional Studies Diabetes Mellitus, Type 2 - complications Diabetes tipo 2 Diabetic Foot - epidemiology Diabetic Foot - prevention & control Diabetic foot ulcer Diabetic Neuropathies - epidemiology Diabetic Neuropathies - prevention & control Female Foot Humans Male Mexico - epidemiology Middle Aged Obesity - complications Overweight - complications Peak plantar pressure Plantar pressure Presión plantar Presión plantar pico Pressure Type 2 diabetes mellitus Índice de masa corporal Úlcera diabética |
| title | Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population |
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