The importance of foot pressure in diabetes

Foot pressure assessment refers to the study of pressure fields acting between the plantar surface of the foot and a supporting surface using typically electronic sensors. Individuals with both type 1 and type 2 diabetes are at risk of developing diabetic peripheral neuropathy (loss of peripheral sensory and motor function), which predisposes them to the development of plantar foot ulcers (open wounds). Foot pressure assessments have been extensively utilized to investigate the outcomes of biomechanical features in individuals with diabetes related foot complications termed the "high-risk" foot. Thus, the application of foot pressure measurements in individuals with diabetes includes monitoring patients for risk of ulceration, determining pressure off-loading capacities, and investigating the mechanical factors responsible for foot ulceration and ulcer healing. The ideal application of foot pressure would be to utilize measurements to predict sites of potential ulceration, prior to ulcer occurrence, and to effectively guide pressure off-loading of ulcerated sites to progress wound healing. Althoughthese two applications represent the overall importance of foot pressure assessments within the field of diabetes, such applications have limited use due to various reasons. The aim of this chapter is to provide the reader with an overview of foot pressure assessment in relation to diabetes mellitus and describe the factors which influence foot pressure assessments. In doing this, we hope to provide a focused discussion of the relevance of foot pressures in diabetes mellitus, utilizing the most up-to-date literature on the topic.