Turkish Journal of Medical Sciences
Abstract
Background/aim: The primary aim of this study is to compare the thickness and stiffness of the PF and AT between healthy volunteers and patients with type 2 diabetes mellitus (T2DM). A secondary objective is to explore the correlations between the thickness and stiffness of the PF and AT with diabetes duration (in months) and hemoglobin A1c (HbA1c) levels in T2DM patients without peripheral neuropathy or foot ulcers, with peripheral neuropathy or with foot ulcers.Material and Methods: A total of 289 participants, including 117 healthy volunteers (Group A) and 172 T2DM patients (59.5%), matched for age, sex, and body mass index, were included. The T2DM cohort was stratified into three subgroups: Group B (without peripheral neuropathy or foot ulcers), Group C (with peripheral neuropathy), and Group D (with foot ulcers). Ultrasonography (USG) and shear wave elastography (SWE) were used to assess PF and AT properties, and correlations with diabetes duration and HbA1c levels were analyzed.
Results: T2DM patients exhibited significantly greater PF and AT thickness, and lower stiffness compared to healthy controls (p<0.001). Among subgroups, Group D had the greatest PF and AT thickness and the lowest stiffness, followed by Group C and then Group B (p<0.001 for all comparisons). Positive correlations were observed between diabetes duration, HbA1c levels, and tendon thickness, while negative correlations were identified with stiffness (p<0.001 for all).
Conclusion: USG and SWE revealed significant alterations in PF and AT properties in T2DM patients compared to healthy individuals, with these changes correlating with diabetes severity and duration.
Author ORCID Identifier
RIFAT BOZKUŞ: 0000-0003-1179-0653
İHSANİYE SÜER DOĞAN: 0000 0002 7586 0537
BERNA TURHAN: 0000 0003 2522 5719
SÜMEYYA DURAN KAYMAK: 0000-0003-0593-1202
MUSTAFA KURT: 0000-0002-7696-4629
RASİME KAVAK: 0000-0001-9782-0029
DOI
10.55730/1300-0144.6042
Keywords
Type 2 diabetes mellitus, plantar fascia, Achilles tendon, ultrasonography, shear wave elastography
First Page
893
Last Page
903
Publisher
The Scientific and Technological Research Council of Türkiye (TÜBİTAK)
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
BOZKUŞ, R, SÜER DOĞAN, İ, TURHAN, B, DURAN KAYMAK, S, KURT, M. H, & KAVAK, R. P (2025). Ultrasonographic and elastographic evaluation of plantar fascia and Achilles tendon alterations in type 2 diabetes mellitus. Turkish Journal of Medical Sciences 55 (4): 893-903. https://doi.org/10.55730/1300-0144.6042
