Region-Specific Association Between Heel Pad Thickness and Peak Plantar Pressure in Diabetic Peripheral Neuropathy

Abstract

Objective: The aims of this research was to assess the correlation between peak plantar pressure and heel pad thickness in individuals with diabetic peripheral neuropathy. Material and Methods: A cross-sectional analytical observational research including 21 individuals with peripheral neuropathy and type 2 diabetes mellitus was carried out. The maximal plantar pressure in four distinct locations of the foot—the hindfoot, the midfoot, the forefoot, and the hallux were measured using a Pedar-X device. To find out how thick the heel pad was, ultrasonography was used. We used correlation analysis to find out how the variables were related to one another. Results: The average peak plantar pressure was within the normal range in every area, with the hindfoot showing the highest values. Similarly, the thickness of the heel pads was within the typical range and did not change noticeably between the right and left feet. With the exception of the right hindfoot, where a robust positive correlation between heel pad thickness and peak plantar pressure was seen (r = 0.650, p = 0.002), no significant associations were found in other plantar sites. Conclusion:  Heel pad thickness is not a universal predictor of peak plantar pressure in patients with diabetic peripheral neuropathy. The relationship appears to be region-specific and influenced by multiple factors. Dynamic plantar pressure assessment may provide more clinically relevant information for identifying ulcer risk. These findings support a multifactorial approach in evaluating and preventing diabetic foot complications.