Sonographic Assessment of Heel Pad Thickness in Patients With Poorly Controlled Diabetes

Udoh, Benjamin Effiong; Archibong, Bassey E.; Egong, Akpama E.

doi:10.1177/8756479319856283

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…The mean HPT of males in the study done by Udoh et al . [ 21 ] among healthy Nigerians was 14.3 ± 1.24 mm while that of the females was 12.14 ± 1.26 mm which were similar to what was obtained in the index study where the average HPT in the nondiabetic males and females participants measured 14.6 ± 1.71 mm and 13.7 ± 1.06 mm respectively.…”

Section: Discussionsupporting

confidence: 85%

“…This is similar to what was found in the index study ( P = 0.9633) but incongruent to the findings by Udoh et al . [ 21 ] where analysis of variance showed that there was a significant difference between the value of HPT obtained from the male subjects and those obtained from the females. This could be due to the difference in the subject sample size and probably because the study was carried out among healthy Nigerians only.…”

Section: Discussionmentioning

confidence: 99%

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Sonographic evaluation of the heel pad thickness in diabetics in Nigeria

et al. 2022

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Background: Diabetes mellitus is a chronic disease process affecting millions of people worldwide. Its prevalence is forecasted to reach a value of 7.7% by 2030. It carries severe morbidities and even mortality. Hyperglycemia and increased formation of advanced glycosylation end products causes the majority of soft tissue changes seen among diabetics. The effects are observed particularly in the heel pad and plantar fascia where thinning or thickening, fibre disorganization, calcification and hypoechoic foci are among the changes seen. Methods: This cross-sectional descriptive study was carried out at the Department of Radiology, OAUTHC, Ile Ife, Osun state, Southwest Nigeria. 40 years old and above subjects with Type 2 diabetes mellitus were recruited from the diabetic clinic of the institution and Ultrasound evaluation of the heel fat pad and plantar fascia were subsequently performed for those who met the criteria using ultrasound machine equipped with a 7.5- 12.0 MHz high frequency linear array transducer. Results: The mean heel pad thickness on the right feet was greater than that of the left in the study subjects. There was statistical significant difference in the heel fat pad thickness of diabetic subjects and the control group, in both feet. ( P =0.000). The heel pad thickness is higher in diabetic subject than in non-diabetic control subjects. However, there was no statistical significant difference in the right and left heel fat pad thickness of the participants of this study ( P value 0.6062). Only HPT was a statistically significant predictor of foot ulcers among other variables after binary regression was computed. Using Spearman's rank correlation to test the relationship between the BMI of diabetic subjects and mean heel pad thickness, it revealed a moderate positive correlation, with good statistically significance (Spearman's rho = 0.4397, P =0.0000). The relationship between the BMI of diabetic subjects and mean plantar fascia thickness showed a weak positive correlation, with good statistical significance (Spearman's rho = 0.2635, P =0.0008). Conclusion: The duration of diabetes mellitus did not determine the heel pad thickness and plantar fascia thickness. The findings in the study suggested that history of foot ulcer in the diabetic predispose them to have reduce HPT and further foot ulcers. Sonographic measurement of heel pad thickness can therefore be an additional imaging modality to evaluate and be used in the management of the diabetic patients' feet.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Sonographic evaluation of the heel pad thickness in diabetics in Nigeria

et al. 2022

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“…Moreover, from the close‐up photographs that exist of bound feet (Fig. B , D , asterisk), it appears that the adipose pad in the heel could be unusually thick compared to its normal thickness in females, as reported to be about 12 mm . Compensatory thickening of the heel fat pad has also been observed to occur within 2 years following a foot trauma that reduces mobility of the ankle .…”

Section: Discussionmentioning

confidence: 89%

“…1B, D, asterisk), it appears that the adipose pad in the heel could be unusually thick compared to its normal thickness in females, as reported to be about 12 mm. (31) Compensatory thickening of the heel fat pad has also been observed to occur within 2 years following a foot trauma that reduces mobility of the ankle. (32) It follows that soft tissue adaptation compensates for the deficiency of the shock-dampening function of the bones of the foot.…”

Section: Discussionmentioning

confidence: 99%

Functional Adaptation of the Calcaneus in Historical Foot Binding

Reznikov

Phillips

Cooke

et al. 2017

Journal of Bone and Mineral Research

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The normal structure of human feet is optimized for shock dampening during walking and running. Foot binding was a historical practice in China aimed at restricting the growth of female feet for aesthetic reasons. In a bound foot the shock-dampening function normally facilitated by the foot arches is withdrawn, resulting in the foot functioning as a rigid extension of the lower leg. An interesting question inspiring this study regards the nature of adaptation of the heel bone to this nonphysiological function using the parameters of cancellous bone anisotropy and 3D fabric topology and a novel intertrabecular angle (ITA) analysis. We found that the trabecular microarchitecture of the normal heel bone, but not of the bound foot, adapts to function by increased anisotropy and preferred orientation of trabeculae. The anisotropic texture in the normal heel bone consistently follows the physiological stress trajectories. However, in the bound foot heel bone the characteristic anisotropy pattern fails to develop, reflecting the lack of a normal biomechanical input. Moreover, the basic topological blueprint of cancellous bone investigated by the ITA method is nearly invariant in both normal and bound foot. These findings suggest that the anisotropic cancellous bone texture is an acquired characteristic that reflects recurrent loading conditions; conversely, an inadequate biomechanical input precludes the formation of anisotropic texture. This opens a long-sought-after possibility to reconstruct bone function from its form. The conserved topological parameters characterize the generic 3D fabric of cancellous bone, which is to a large extent independent of its adaptation to recurrent loading and perhaps determines the mechanical competence of trabecular bone regardless of its functional adaptation.

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“…

The incidence of diabetes mellitus (DM) is growing rapidly worldwide, [1][2][3] with the global estimate at 171 million as of 2020. 4 In Nigeria, more than 30% of the elite population including decision makers are diabetic, 5,6 and the risk of developing associated complications and mortality is higher with poorer hyperglycemia control. 7 Several studies have been tailored toward early diagnosis and mitigation of complications of DM.

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confidence: 99%

Sonographic Optic Nerve Diameter and Clinical Biomarkers in Patients With Poorly Controlled Diabetes: A Comparative Analysis With Nondiabetic Subjects

Udoh

Erim

Archibong

et al. 2021

Journal of Diagnostic Medical Sonography

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Objective: The study assessed optic nerve diameter (OND) and clinical biomarkers in patients with poorly controlled diabetes compared with healthy nondiabetic volunteers. Materials and Methods: There were 1320 adult participants recruited to the study. The cohort was divided into 600 Type 2 diabetic (DM II) patients and 720 apparently healthy, nondiabetic volunteers. The OND was measured using a high-resolution dedicated ultrasound device (Sonoace 5500; Medicol, Medison, Miami, FL, USA) with a 10-MHz linear array transducer. Subjects were examined in a supine position with their eyes closed. Three measurements of the OND were taken and the average recorded. Hemoglobin A1c concentration and lipid profiles were determined using Bio-Rad Diamat analyzer (Bio-Rad, Hercules, CA). Body mass index and age were matched for both cohorts for comparativeness. Results: The mean OND of the DM II patients was 3.10 ± 0.14 mm (range of 2.6–4.0 mm), which was significantly ( P < .05) lower than the control volunteers (4.22 ± 0.15 mm). The OND demonstrated a negative significant correlation with HA1c, duration of diabetes and low-density lipoprotein cholesterol level ( P < .05). Lipid profiles, blood urea, serum creatinine, and hemoglobin A1c showed statistical difference between diabetics and control subjects. Conclusion: Poorly controlled DM II patients may have significantly narrower OND than nondiabetic patients. This imaging biomarker has the potential to transform visual care for DM II patients.

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Sonographic Assessment of Heel Pad Thickness in Patients With Poorly Controlled Diabetes

Cited by 5 publications

References 37 publications

Sonographic evaluation of the heel pad thickness in diabetics in Nigeria

Sonographic evaluation of the heel pad thickness in diabetics in Nigeria

Functional Adaptation of the Calcaneus in Historical Foot Binding

Sonographic Optic Nerve Diameter and Clinical Biomarkers in Patients With Poorly Controlled Diabetes: A Comparative Analysis With Nondiabetic Subjects

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