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Control of lower extremity edema in patients with diabetes: Double blind randomized controlled trial assessing the efficacy of mild compression diabetic socks

  • Stephanie C. Wu
    Correspondence
    Corresponding author at: CLEAR, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL 60064, United States. Fax: +1 847 775 6570.
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Ryan T. Crews
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Melissa Skratsky
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Julia Overstreet
    Affiliations
    Madigan Army Medical Center, Tacoma, WA, United States
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  • Sai V. Yalla
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Michelle Winder
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Jacquelyn Ortiz
    Affiliations
    Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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  • Charles A. Andersen
    Affiliations
    Madigan Army Medical Center, Tacoma, WA, United States
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Published:February 26, 2017DOI:https://doi.org/10.1016/j.diabres.2017.02.025

      Highlights

      • Mild compression may be effectively and safely used in diabetes patients with LE edema.
      • Mild-compression diabetic socks significantly decreased calf and ankle circumferences.
      • Lower extremity circulation well maintained throughout the study.

      Abstract

      Aims

      Persons with diabetes frequently present with lower extremity (LE) edema; however, compression therapy is generally avoided for fear of compromising arterial circulation in a population with a high prevalence of peripheral arterial disease. This double blind randomized controlled trial (RCT) assessed whether diabetic socks with mild compression could reduce LE edema in patients with diabetes without negatively impacting vascularity.

      Methods

      Eighty subjects with LE edema and diabetes were randomized to receive either mild-compression knee high diabetic socks (18–25 mmHg) or non-compression knee high diabetic socks. Subjects were instructed to wear the socks during all waking hours. Follow-up visits occurred weekly for four consecutive weeks. Edema was quantified through midfoot, ankle, and calf circumferences and cutaneous fluid measurements. Vascular status was tracked via ankle brachial index (ABI), toe brachial index (TBI), and skin perfusion pressure (SPP).

      Results

      Seventy-seven subjects (39 controls and 38 mild-compression subjects) successfully completed the study. No statistical differences between the two groups in terms of age, body mass index, gender, and ethnicity.
      Repeated measures analysis of variance and Sidak corrections for multiple comparisons were used for data analyses. Subjects randomized to mild-compression diabetic socks demonstrated significant decreases in calf and ankle circumferences at the end of treatment as compared to baseline. LE circulation did not diminish throughout the study with no significant decreases in ABI, TBI or SPP for either group.

      Conclusions

      Results of this RCT suggest that mild compression diabetic socks may be effectively and safely used in patients with diabetes and LE edema.

      Keywords

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