Assessing the diabetic foot: plantar callus and pressure sensation

The purpose of this study was to explore the relationship between the loss of protective pressure sensation in the foot and the formation of plantar calluses, two well-known precursors of plantar ulceration, in adults with diabetes referred to an outpatient diabetes education program. Pressure sensation testing was performed using Semmes-Weinstein monofilaments. Foot inspection included the identification and measurement of plantar calluses. Using the Wilcoxon Rank Sum test, groups categorized as sensitive (n = 67) and insensitive (n = 35) were compared on callus formation. The groups had equivalent numbers, areas, and thickness of calluses. The high prevalence of calluses in both sensitive and insensitive groups suggests that additional factors such as age-related changes in the foot and routine footwear must be included in risk assessment of the diabetic foot and in consideration of preventive interventions.