Evidence map›Paper›PMID 42400935›Full record

ArticleJournal of foot and ankle research2026

Relation Between Calcaneal Fat Pad Thickness and Plantar Foot Ulceration in Patients With Type 2 Diabetes Mellitus.

Sem J van den Nieuwenhof, Margot H M Heijmans, Jeroen J van der Reijden, Chantal D Bakker, Roel H D Vaes

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Article in Journal of foot and ankle research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Sem J van den NieuwenhofDepartment of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.
Margot H M HeijmansDepartment of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.ORCID https://orcid.org/0000-0002-1628-6336
Jeroen J van der ReijdenDepartment of Radiology, Máxima Medical Center, Veldhoven, the Netherlands.
Chantal D BakkerDepartment of Rehabilitation Medicine, Máxima Medical Center, Veldhoven, the Netherlands.
Roel H D VaesDepartment of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.ORCID https://orcid.org/0009-0006-8626-8180

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThinning of fat pads may elevate the risk of developing plantar foot ulcers potentially resulting in lower-extremity amputations. Evaluating whether fat pad thickness is associated with plantar foot ulceration could aid in early risk detection. This study therefore aims to compare fat pad thickness between type 2 diabetes mellitus (T2DM) patients with and without plantar foot ulcers using MRI.

methodsThis retrospective cross-sectional study included patients diagnosed with T2DM of whom a nonweight bearing MRI of the ankle or foot was available. The thickness of the calcaneal fat pad was measured in the sagittal plane, measuring perpendicularly from the lowest cortex of the calcaneal bone to and including the skin. Calcaneal fat pad thickness was compared between T2DM patients with and without plantar foot ulceration.

resultsIn total, 42 patients were included of which 16 in the T2DM group with plantar foot ulceration. The calcaneal fat pad was significantly thinner in T2DM patients with plantar foot ulceration compared to those without plantar foot ulceration (15.7 ± 3.2 mm vs. 18.6 ± 2.8 mm, p = 0.004).

conclusionThis study established an initial association between fat pad thickness and plantar foot ulceration in T2DM patients. Our findings suggest that a reduction in calcaneal fat pad thickness may decrease the shock-absorbing ability of the plantar fat pads, making the underlying tissue more vulnerable to injury, increasing the risk of developing plantar foot ulcers. The initial association between fat pad thickness and foot ulceration should be further explored to discover its potential in clinical practice.

Indexed as

Adipose TissueCalcaneusDiabetes Mellitus, Type 2Diabetic FootAgedCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective Studiesdiabetic foot ulcerfat padMRItype 2 diabetes mellitus

Identifiers

PMID42400935
PMCPMC13332807

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.