Those with diabetes mellitus have a significantly increased risk for falls. This is  due to the development of the sensory neuropathy which reduces the sensory input the foot which is important for balance. This lack of sensation is also important in the development of a lot of foot complications. A number of techniques are used to reduce the pressures under the ball of the foot to treat these problems and also reduce the risk of these complications. One of these methods is a rocker bottom shoe.  These are similar to the toning shoes that are promoted to ‘tone up’ when wearing them (they don’t actually do that!). They have, however, been shown to reduce plantar pressures so could be helpful in diabetes, however that needs to be in the context of balance issues that may occur due to the instability design of the toning or rockerbottom shoes.

A recent study in Gait and Posture from researchers at East Carolina University studied twenty non-diabetic healthy controls to investigate what the rocker sole shoes did to balance and postural stability. They concluded that:

In young healthy adults, shoes with rocker bottom soles had a destabilizing effect to perturbed stance, thereby increasing the potential for imbalance. These results raise concerns that footwear with rocker bottom sole modifications to accommodate an insensate foot may increase the risk of falls.

This does suggest that there are potential problems in using the toning or rocker shoes may have a negative impact on balance. If the person with diabetes has other risk factors for falls, then it may be advisable not to use them.

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Ultrasound diagnosis of peripheral neuropathy

by admin on November 26, 2012

The December issue of Diabetes Care has an intriguing paper on the use of diagnostic ultrasound of the tibial nerve in those with diabetes to detect diabetic peripheral neuropathy. Ultrasound is cheaper than nerve conduction studies. The cross sectionals study looked at those who had been diagnosed with diabetic neuropathy. They all had an enlarged nerve on ultrasound. This makes the potential for ultrasound to detect peripheral neuropathy.

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How common is plantar fasciitis in those with diabetes

March 28, 2010

Tweet It could actually be very common. Think about this: What are the main documented risk factors for plantar fasciitis? (see this). 1. High BMI 2. Tight calf muscles What do those with type 2 diabetes have: 1. High BMI 2. Tight calf muscles (from the glycation of the collagen) What is a common diagnostic […]

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Diabetes and barefeet

February 1, 2010

Tweet There has been a lot of publicity and debate recently over the benefits of running barefoot versus running in running shoes. Some of the debates have been interesting to follow with a lot of misinformation and misinterpretation of the the research. Barefoot runners have been widely touting some questionable research on barefoot running and […]

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Bone Mineral Density in Charcot’s Neuroarthropathy

January 26, 2010

Tweet A reduction in bone mineral density is know to be a problem in those with Charcot’s neuroarthropathy. A reccent study by Christensen et al (Bone mineral density in diabetes mellitus patients with and without a Charcot foot) investigated 49 people with diabetes, of which 24 had a charcot’s foot. They compared bone mineral desnity […]

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New genes linked to Type 2 diabetes identified

January 26, 2010

Tweet News from Diabetes UK: A new understanding and possible treatment for Type 2 diabetes could be on its way after one of the largest genetic studies to date discovered nine new genes linked to the condition. The genes and blood glucose levels of over 120,000 volunteers were studied by scientists from 174 research centres across […]

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FDA approves Victoza (liraglutide) for type 2 diabetes treatment

January 26, 2010

Tweet The FDA announced today that they have approved Victoza (liraglutide), a once-daily injection to treat type 2 diabetes in some adults. Here are some snippets from the press release: Victoza is in a class of medicines known as glucagon-like peptide-1 (GLP-1) receptor agonists that help the pancreas make more insulin after eating a meal. […]

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