Mild-compression diabetic socks safely reduce lower extremity edema in patients with diabetes

Study aim & design

The aim of this study was to assess whether diabetic socks with mild compression (18-25 mmHg) could reduce lower extremity (LE) edema in diabetic patients without negatively impacting vascularity (1).

To this end, 80 patients with diabetes and LE edema were randomized to receive either mild-compression knee-high diabetic socks („DCS“) or non-compression knee-high diabetic socks („CON“). Subjects were instructed to wear the socks during waking hours. Primary outcomes were assessment of LE edema and LE vascularity.

Participants

38 patients with DCS and 39 patients with CON completed the study.

Abbreviations

• ABI: Ankle brachial index
• CON: Control socks
• DCS: Diabetic compression socks
• LE: Lower extremity
• SPP: Skin perfusion pressure
• TBI: Toe brachial index

Patient randomization

Group 1: DCS = 18-25 mmHg knee-high diabetic socks

• Eligible: n = 40
• Dropout: n = 2 (did not return to visits)
• Final evaluation: n = 38

Group 2: CON = Non-compression knee-high diabetic socks

• Eligible: n = 40
• Dropout: n = 1 (due to family issues)
• Final evaluation: n = 39 

Both groups wore their socks for 4 weeks. The following measurements were taken at the baseline and at the weekly follow-up visits:

• Edema = midfoot, ankle & calf circumferences
• Vascularity = ABI, TBI, SPP

Results

With diabetic compression socks, LE edema was significantly reduced, while LE vascularity remained unaffected.

A high compliance rate was observed as 96% of the patients wore the DCS during more than 75% of the waking hours.

Moreover, the comfort of DCS was rated as high and it increased over wearing time:

Conclusion

This study demonstrates that mild-compression diabetic socks effectively reduce LE edema in diabetic patients, without negatively impacting LE vascularity. This clearly indicates that diabetes is not necessarily a contraindication for mild to moderate compression.

In addition, the increase in comfort rating over time suggests that the wearing of compression is subject to a learning process during which the patient’s  appreciation towards compression rises.