Modifications of Plantar Fat Pad in Diabetic Patients with or without Diabetic Foot Ulcer

Abstract

Introduction: In patients with diabetic foot there is a significant reduction in the dimensions of the plantar adipose corpuscles; therefore, it is possible to evaluate this situation quantitatively using B-mode ultrasound.

Objective: To determine the modifications of the plantar fat pad in diabetic patients with or without diabetic foot ulcer.

Methods: An observational, prospective, open, case-control, nonrandomized and prospective study was carried out, corresponding to the period between January 2021 and January 2024. The sample consisted of 65 diabetics, who, depending on the presence or absence of foot ulcers, were subdivided into two groups: study group A, composed of 36 patients with diabetic foot ulcers, and a control group B, with 29 diabetics without foot ulcers. Those with pathological conditions at foot level, which could interfere with the evaluation, were excluded.

Results: The reduction figures corresponding to plantar fat pad thickness (measured in millimeters), according to topography, show that the greatest difference between the patient with diabetic foot ulcer in relation to the diabetic without ulcer takes place in the calcaneus, but also occurs in the rest of the standing tripod (first and fifth metatarsal). These result in statistically significant differences.

Conclusions: In the patient with diabetic foot ulcer, there is a reduced plantar fat pad thickness, which could be recognized as a predictor of ulceration risk.