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. 2025 Sep;53(7):1497-1503.
doi: 10.1002/jcu.24025. Epub 2025 Apr 29.

Early Prediction of Diabetes by Ultrasonographic Measuring of Heel Pad Thickness: A Case-Control Study

Syed Muhammad Yousaf Farooq  1 , Syed Amir Gilani  2 , Saleha Tahir  3 , Afeesa Abid  3 , Rimsha Khalid  3 , Hind Binjaffar  4 , Ahmed Alharthy  5 , Hatem Alabsi  5 , Fadi Toonsi  5 , Khaled Madani  6 , Reem L Mimish  5 , Samy A Abusikkien  7 , Sajid Hameed  8 , Basem Bahakeem  9
Affiliations

Early Prediction of Diabetes by Ultrasonographic Measuring of Heel Pad Thickness: A Case-Control Study

Syed Muhammad Yousaf Farooq et al. J Clin Ultrasound. 2025 Sep.

Abstract

Background: The heel pad is essential for cushioning and shock absorption during weight-bearing activities. Its thickness and integrity significantly impact foot health, particularly in diabetics at risk for ulcers due to neuropathy and vascular issues. This study examines heel pad thickness in diabetics and non-diabetics with normal BMI.

Materials and methods: It was a case-control study conducted in the University Ultrasound Clinic, Green Town, Lahore. The duration of the study was 7 months. A convenient sampling technique was used to collect the data. The study was conducted after the approval from the research ethical committee at the University of Lahore. The sample size was 132, of which 66 were diabetic and 66 were normal. Both males and females aged 16-80 years with normal BMI were included in this study. The study found that diabetic individuals had significantly thicker heel pads than non-diabetics.

Results: For the left foot, the diabetic group had a mean thickness of 15.7 mm without compression and 12.4 mm with compression, versus 10.7 and 8.9 mm in the non-diabetic group. For the right foot, the diabetic group had mean thicknesses of 14.8 mm without compression and 12.6 mm with compression, compared to 10.8 and 9.2 mm in the non-diabetic group. All differences were statistically significant, with p values of 0.000.

Conclusion: Individuals with diabetes had significantly thicker heel pads than non-diabetics, both with and without compression. Females consistently had thicker heel pads than males across all conditions. Identifying changes in heel pad thickness may contribute to the early detection of foot-related diabetic complications, even in individuals with a normal BMI.

Keywords: diabetes mellitus; diabetic foot; foot length; heel pad thickness; ultrasound imaging.

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References

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