[Risk factors for increased plantar pressure in type 2 diabetes].
Diabetic foot ulcers develop at high pressure sites, whereby causal factors for increased plantar pressure are insufficiently investigated. We clinically inspected the feet of 186 Type 2-diabetic patients and measured peripheral neuropathy and plantar pressure during walking. Subjects were assigned into a group with normal (n = 113) and elevated (n = 73) plantar pressure. In patients with elevated plantar pressure body weight was significantly increased (85.4 +/- 12.3 kg vs. 80.7 +/- 13.8), as was plantar pressure increased at the hallux (519 +/- 322 kPa vs. 346 +/- 154), at the metatarsal head I (MTH) I (442 +/- 270 vs. 235 +/- 95) and at the MTH II-V (788 +/- 277 vs. 446 +/- 145). The vibration perception threshold was significantly higher among these patients (21.8 +/- 11.0 Volt vs. 16.7 +/- 9.0), as was the prevalence of hyperkeratosis (69.9% vs. 43.4) and clawed toes (28.8% vs. 15.9). In a multiple regression analysis, hyperkeratosis (Beta = 0.25, p < 0.001) and body weight (Beta = 0.27, p < 0.001) were significant risk factors, but did not describe the whole variation of plantar pressure in the multivariate model. Limited joint mobility (LJM), which was not measured but estimated in the present study, was slightly more prevalent among patients with elevated plantar pressures (46.6 vs. 33.6%). It could be assumed, that LJM, if exactly measured, is a significant risk factor in a multivariate analysis, too.
Kästenbauer
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Ludwig Boltzmann Institut für Stoffwechselerkrankungen und Ernährung, Krankenhaus Wien-Lainz, Wolkersbergenstrasse 1, A-1130 Wien. KAT@3me.khl.magwien.gr.at
Sauseng
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D000368:Aged; D001835:Body Weight / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017719:Diabetic Foot / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000294:innervation; D006801:Humans; D008297:Male; D008465:Mechanoreceptors / Q000503:physiopathology; D008875:Middle Aged; D011312:Pressure / Q000009:adverse effects; D016059:Range of Motion, Articular / Q000502:physiology; D012044:Regression Analysis; D012307:Risk Factors; D012684:Sensory Thresholds / Q000502:physiology; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*
Risikofaktoren für einen erhöhten plantaren Druck bei Typ 2 Diabetes.