How much pressure causes a diabetic foot ulcer? An 18-month prospective study investigating plantar pressure characteristics in the lead up to ulceration
Authors' conclusion
Plantar pressures during daily activities were continuously measured in the three months preceding DFU using an intelligent insole system, with a greater number of minutes and bouts of sustained plantar pressure preceding DFU development.
Study context
- Population
- Patients with diabetic peripheral neuropathy and diabetic foot ulcer (DFU) history
- Participants
- 46 patients
- Exposure
- Feet that developed DFU vs ulcer-free feet
- DFU feetn = 12
- Outcome
- Sustained plantar pressure parameters preceding DFU
- Follow-up
- 3 months preceding DFU
Methodological details18-month continuous plantar pressure monitoring with intelligent insole system, multilevel binary logistic regression
- 18-month continuous plantar pressure monitoring with intelligent insole system
- Multilevel binary logistic regression
Main finding
As reported in the abstract
Sustained plantar pressure at forefoot
Minutes of sustained plantar pressure
19
95% CI 0.86–37P = 0.04
DFU feet
Bouts of sustained pressure
0.64
95% CI 0.024–1.3P = 0.042
DFU feet
Observational data: associations, not effects.
Original publication
How much pressure causes a diabetic foot ulcer? An 18-month prospective study investigating plantar pressure characteristics in the lead up to ulceration. Diabetes Res Clin Pract. Published 3 May 2026. doi:10.
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