Background: Diabetic peripheral neuropathy (DPN) is one of the major risks to diabetic foot diseases (DFD). Currently, there are few quantitative methods to assess progression of DFD if no obvious ulcerations, microtraumas, and other skin lesions are presented. We investigated the differences of sole images (SI) on hard and soft floors in patients with or without diabetes and evaluated the availability to predict DPN and severity of DFD.

Material and Methods: We prospectively recruited 104 patients from December 2017 to December 2018. Both SI on hard and soft floors were taken by the specific device with a camera underneath and were analyzed according to total area, shape, distal and proximal variations and bilateral differences. Severity of DFD was defined and calculated according to classical neurological and hemodynamic assessments.

Results: SI variations were significantly increased in diabetic patients with DPN compared with those without DPN (p<0.01). A weak but positive correlation was presented significantly between diabetes duration and SI variations (r=0.247, p<0.05). Moreover, SI variations also showed positive correlation with severity of DFD (r=0.462, p<0.001). The area under the ROC (receiver operating characteristic) curve of SI variations for diagnosing probable DPN was 0.722 with the optimal cut-off value of 0.591. The sensitivity, specificity was 67.9% and 72.9%, respectively. Logistic regression analysis showed that SI variation was a significant factor to predict DPN.

Conclusion: Variations of SI on hard and soft floors increase along with diabetes duration and have significantly positive correlation with severity of DFD. Because of good sensitivity and specificity for screening of DPN, this approach may be effective and useful in daily practice to diabetic patients.


S. Chou: None. M. Haraguchi: None. H. Komori: None. K. Watanabe: None. S. Tsuichihara: None. S. Nakamura: None. H. Takemura: None.

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