DIFFERENCES IN JOINT MOBILITY AND FOOT PRESSURES BETWEEN BLACK-AND-WHITE DIABETIC-PATIENTS

Limited joint mobility is common in diabetes and is related to high fo ot pressures and foot ulceration. We have examined the differences in joint mobility and foot pressures in four groups matched for age, sex, and duration of diabetes: 31 white diabetic, 33 white non-diabetic, 2 4 black diabetic, and 22 non-diabetic black subjects. Joint mobility w as assessed using a goniometer at the fifth metacarpal, first metatars al, and subtalar joints. In-shoe and without shoes foot pressures were measured using an F-Scan system. Neuropathy was evaluated using clini cal symptoms (Neuropathy Symptom Score), signs (Neuropathy Disability Score), and Vibration Perception Threshold. There was no difference be tween white and black diabetic patients in Neuropathy Symptom Score, N europathy Disability Score, and Vibration Perception Threshold. Subtal ar joint mobility was significantly reduced in white diabetic patients (22 +/- 7 degrees) compared to white controls (26 +/- 4 degrees, blac k diabetic patients (25 +/- 5 degrees), and black controls (29 +/- 7 d egrees), and increased in black controls compared to white controls an d black diabetic patients (level of statistical significance p < 0.05) . Without shoes foot pressures were higher in white diabetic patients (8.31 +/- 400 kg cm(-2)) compared to white controls (6.81 +/- 2.31 kg cm(a2)), black diabetic patients (6.2 +/- 2.53 kg cm(-2)) and black co ntrols (5.00 +/- 1.24 kg cm(-2)) and lower in black controls compared to white and black diabetic patients (p< 0.05 in all cases). We conclu de that racial differences exist in joint mobility and foot pressures between black and white subjects. Thus, in black diabetic patients the joint mobility, although reduced compared to black healthy subjects, is increased when compared to white diabetic patients. This contribute s to lower foot pressures, comparable to non-diabetic white subjects a nd probably reduces the risk of foot ulceration in black diabetic pati ents.