title: Plantar Pressure Changes and Correlating Risk Factors in Chinese Patients with Type 2 Diabetes: Preliminary 2-year Results of a Prospective Study.
abstract: BACKGROUND
  Plantar pressure serves as a key factor for predicting ulceration in the feet of diabetes patients. We designed this study to analyze plantar pressure changes and correlating risk factors in Chinese patients with type 2 diabetes.
  
  
  METHODS
  We recruited 65 patients with type 2 diabetes. They were invited to participate in the second wave 2 years later. The patients completed identical examinations at the baseline point and 2 years later. We obtained maximum force, maximum pressure, impulse, pressure-time integral, and loading rate values from 10 foot regions. We collected data on six history-based variables, six anthropometric variables, and four metabolic variables of the patients.
  
  
  RESULTS
  Over the course of the study, significant plantar pressure increases in some forefoot portions were identified (P < 0.05), especially in the second to forth metatarsal heads. Decreases in heel impulse and pressure-time integral levels were also found (P < 0.05). Plantar pressure parameters increased with body mass index (BMI) levels. Hemoglobin A1c (HbA1c) changes were positively correlated with maximum force (β = 0.364, P = 0.001) and maximum pressure (β = 0.366, P = 0.002) changes in the first metatarsal head. Cholesterol changes were positively correlated with impulse changes in the lateral portion of the heel (β = 0.179, P = 0.072) and pressure-time integral changes in the second metatarsal head (β = 0.236, P = 0.020). Ankle-brachial index (ABI) changes were positively correlated with maximum force changes in the first metatarsal head (β = 0.137, P = 0.048). Neuropathy symptom score (NSS) and common peroneal nerve sensory nerve conduction velocity (SCV) changes were positively correlated with some plantar pressure changes. In addition, plantar pressure changes had a correlation with the appearance of infections, blisters (β = 0.244, P = 0.014), and calluses over the course of the study.
  
  
  CONCLUSIONS
  We should pay attention to the BMI, HbA1c, cholesterol, ABI, SCV, and NSS changes in the process of preventing high plantar pressure and ulceration. Some associated precautions may be taken with the appearance of infections, blisters, and calluses.
authors.forename: Xuan
authors.initials: X
authors.lastname: Qiu
authors.forename: De-Hu
authors.initials: DH
authors.lastname: Tian
authors.forename: Chang-Ling
authors.initials: CL
authors.lastname: Han
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Zhan-Jian
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Zhen-Yun
authors.initials: ZY
authors.lastname: Mu
authors.affiliation: Department of Endocrinology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China.
authors.forename: Kuan-Zhi
authors.initials: KZ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D017719:Diabetic Foot / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012307:Risk Factors