Ultrasonographic evaluation of the achilles tendon in patients with Type 2 diabetes: A dual center study in Port Harcourt

Abstract

Background: Thickening of the Achilles tendon in the diabetic patient has been implicated in the development of diabetic foot ulcers which increases  morbidity and mortality. Ultrasonography is a non-invasive, non-ionizing, reproducible and affordable procedure that can be used to evaluate the Achilles tendonin the management of the disease.

Aim: To evaluate the Achilles tendon thickness (ATT) in type 2 diabetic patients comparing the findings to their age and sex-matched non-diabetic  counterparts. It also tried to establish a relationship, if any, of ATT with peripheral neuropathy, Body Mass Index (BMI) and duration of disease in the  study population.

Method: This was an analytical cross-sectional study involving 108 adult diabetic participants and 108 non-diabetic control participants. The ATT in both  groups were evaluated by ultrasonography. The ATT of the study group was correlated with their peripheral neuropathy score, BMI and duration of  disease. Data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 software

Results: The mean ATT was higher in diabetic subjects compared to the control subjects. The increased thickness of the AT was significantly more in the  presence of PN (p=0.0001). The optimal cut-off point of ATT for identifying the risk of PN in the feet of diabetics was determined to be > 5.75mm with an  accuracy of 83.3%

Conclusion: Patients with type 2 diabetes mellitus have significantly thicker AT than their age and sex-matched control subjects and the  presence of peripheral neuropathy further worsens the ATT. An ATT of > 5.75mm is the optimal cut-off for identifying the risk of PN in the feet of  diabetics