Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: a prospective study

Aims This study analysed the effects of specially manufactured insoles on f oot pressures in diabetic patients during a 1-year prospective observation period. Methods We studied 81 type 2 diabetic patients without foot lesions. Using pedobarography three different regions of interest were examined: maximum p eak pressure (MPP) of the total foot area, heel region and head of metatars al bone I-III. Eighteen patients with high risk pressure (MPP of total foot 474 +/- 183 kPa; heel region 278 +/- 147 kPa, metatarsal 389 +/- 222 kPa) received optimal insole support. Sixty-three patients as a control group (M MP of total foot 367.7 +/- 157 kPa; heel 263.1 +/- 127 kPa, metatarsal 339. 9 +/- 171 kPa) received conventional footwear. Results After insole support a 30% pressure reduction of total foot MMP (47 4 +/- 183 kPa vs. 290 +/- 106 kPa) was achieved in the treatment group. Aft er 6 months (324 +/- 127 kPa) and 1 year (380 +/- 190 kPa) a pressure reduc tion was found. Between the 6- and 12-month controls plantar pressures agai n increased. In the control group a significant increase of ail peak pressu res occurred. Conclusions Early insole support is successful in reducing plantar pressure . A repeated adjustment should be performed every 6 months to prevent foot pressure increases. The comparison of foot pressure development between the two groups showed constant levels in the treatment group. In the control g roup a marked increase of the pressure values was found. Identification and subsequent support of patients with high ulceration risk may help to reduc e the high amputation rate.