Sedentary behavior increases risk of foot ulcer in diabetic
This study aimed to prospectively explore the association between sedentary time (SED-time) and the development of diabetic foot ulcer (DFU) in people with diabetic peripheral neuropathy (DPN).

175 DPN individuals who attended the annual evaluation for the SAMBA Study (2012–2019) were included. Main outcome measure was the first diagnosis of DFU. SED-time was measured by the PAS 2.1 questionnaire. Nerve function was evaluated by nerve conduction studies. Vascular function was assessed by Ankle-brachial index (ABI) and pedal pulses. Foot deformity and skin dryness were examined by visual inspection.

-- 62 participants (35.5%) developed a DFU during the study. SED-time was significantly higher in people who developed DFUs (12.8 ± 3.0 vs 9.4 ± 3.1 h/day).

-- Logistic regression showed that among several nervous (motor amplitude, OR 0.33; sensory amplitude, 0.85) and vascular parameters (ABI, 0.23, 0.1–0.61; pedal pulses, 2.81, 0.12–0.63) and foot characteristics (deformity, 2.63, 1.30–5.32; skin dryness, 2.04, 0.95–4.37), SED-time was one of the strongest variables contributing to the development of DFUs.

Conclusively, SED-time is an independent predictor of the risk of DFU in people with DPN. The monitoring of SED-time with strategies aimed at reducing it should be included in the standard care of diabetic patients.