Endocrine Abstracts

Introduction: Diabetes mellitus (DM) is an endocrine disease characterised by metabolic abnormalities and long-term complications. Achilles tendon (AT) play an important role in foot biomechanics. We aimed to investigate the effect of DM on the AT, which may contribute to the long-term complications in the foot–ankle complex.

Materials and methods: 78 diabetic patients with (35 cases) or without (43 cases) diabetic foot ulcers were recruited from Endocrinology Clinic. Thirty-three age, gender, and BMI matched non-diabetic healthy individuals with no history of Achilles tendinopathy were selected among hospital staff as controls. All participants underwent ultrasonography and sonoelastography of their ATs for evaluating AT thickness (ATT) and stiffness (ATS). Each patient was also tested for fasting plasma glucose (FPG) and HbA1c as a measure of diabetes control. Other chronic complications were also evaluated in all diabetic patients.

Results: The AT was significantly thicker in the diabetic patients with diabetic foot ulcers compared to diabetics without any ulcer and the controls (P<0.001). The ATT correlated with the BMI (r=0.224, P=0.04) and age (r=0.419, P=0.001). HbA1c, FPG, and duration of diabetes were higher for diabetic patients with foot ulcers. We observed that the ATT values were positively correlated with neuropathy (P=0.001), retinopathy (P=0.001), nephropathy (P=0.006), peripheral arterial disease (P=0.001), and coronary arterial disease (P=0.005) in diabetic patients without foot ulcers. But this correlation wasn’t detected for diabetic patients with foot ulcers. ATS decreased in the diabetic patients with diabetic foot ulcers.

Conclusion: Diabetic patients with diabetic foot ulcers have softer and thicker AT then the other diabetics and healthy controls. This is the first study reported that research sonoelastosonography of AT of diabetic patients.