In patients with diabetic peripheral neuropathy (DPN), plantar pressure is a known risk factor for diabetic foot ulcer (DFU), but prior data have relied on single-time-point measurements. A prospective longitudinal study published in Diabetes Research and Clinical Practice examined sustained plantar pressure patterns in the months preceding DFU.

The analysis included 46 patients with DPN and prior DFU who wore an intelligent insole system for continuous plantar pressure monitoring during daily activities for up to 18 months or until ulceration.

During follow-up, 12 feet developed ulcers, all in the forefoot region. In the three months preceding ulceration, affected feet showed higher cumulative minutes of sustained plantar pressure (β 19; 95% CI 0.86-37; P=0.04) and more sustained-pressure bouts (β 0.64; 95% CI 0.024-1.3; P=0.042) compared with ulcer-free feet.

Overall, sustained forefoot plantar pressure was observed more frequently before ulcer occurrence.