Co-existing diabetes and peripheral vascular disease have increased susceptibility to plantar ulceration. Therapeutic insoles reduce plantar pressure, but the effect on transcutaneous tissue oxygenation (TcpO2) is unknown. This study examines the effect of gel-filled Liqua Care® therapeutic insoles on plantar pressure, and foot TcpO2, in at-risk individuals with diabetes and peripheral vascular insufficiency.
Research design and methods
Ankle brachial pressure index (ABPI) in both lower limbs was measured in patients attending the diabetes centre for complication screening; 21 individuals with ABPI <0.9 and no active ulceration were invited to participate in the study. TcpO 2 was measured at the apex of the great toes both before, and after a 2-week period of Liqua Care® insole use. Recordings of in-shoe pressure measurements without, and with the therapeutic insole were made to ascertain any regional redistribution of plantar pressures (forefoot, midfoot and hindfoot).
Results
A mean reduction in peak forefoot pressure of 54.7 kPa (95% confidence interval (CI) 31.7—77.8 kPa, p<0.01) was observed. Mean great toe TcpO2 increased by 2.92 mmHg (95% CI 0.87—4.97 mmHg, p<0.01).
Conclusions
These insoles may prevent new and recurrent pedal ulceration in at-risk patients with diabetes and peripheral vascular disease.
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