posted 09/26/02
Changes that take place in the
tissue and bone structure of the feet of people with diabetes have been
identified by researchers at the Washington University School of Medicine in St.
Louis.
The understanding of
these changes can improve prevention and treatment of foot ulcers, a common
complication of diabetes and the leading cause of lower-extremity amputations in
the United States.
The study appears in a
recent issue of the Journal of Bone and Joint Surgery.
The researchers
evaluated the forefoot structure of 32 people, 16 with diabetes with previous
foot ulcers and 16 control subjects. The researchers looked for differences
between the feet of the two groups.
Computed tomography
was used to display a three-dimensional image that allowed the researchers to
identify and measure internal and external soft tissue, bone structure and joint
disease.
Soft tissue change is
a primary cause of diabetic ulcers. The researchers found that people with
diabetes had much lower muscle density on the soles of their feet.
They found that
overweight people in the control group also had less dense muscle tissue on
their soles, but that relationship between body weight and sole muscle density
wasn't found in the people with diabetes.
So, while obesity does
cause changes in the forefoot, those changes aren't as great as those caused by
diabetes, the study says.
Bone changes are another key element in diabetes-related food ulcers. Weight-bearing pressure on the foot is altered by changes in the joints caused by low muscle density in the soles. People with diabetes also had more joint disease than those in the control group.
Source: Diabetes In
Control Dot Com: American Academy of Orthopaedic Surgeons, 09-15-2002.