{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:55:06Z","timestamp":1792634106336,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"15","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2014,12,19]]},"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Musculotendinous overuse injuries are prevalent in people with type 2 diabetes. Non-enzymatic glycosylation of collagen resulting in tendon stiffening may play a role. In this case\u2013control study we determined whether patients with diabetes had poorer ultrasonographic structure in their Achilles tendons compared to age-matched controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>People with type 1 diabetes or type 2 diabetes, and age-matched controls, had computerised ultrasound tissue characterisation of both Achilles tendons. In contiguous ultrasonographic images of the tendon, echopatterns were quantified and categorised into four echo-types. Tendon abnormality was quantified as sum of echo-types III+IV. Furthermore, skin autofluorescence (AF) of the forearm (AF-value) was gathered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty four type 2 diabetes patients, 24 controls, 24 type 1 diabetes patients and 20 controls were included. AF-value was higher in type 1 diabetes (1.55\u00b10.17) than in their controls (1.39\u00b10.18, p&lt;0.001) and in type 2 diabetes (2.28\u00b10.38) compared to their controls (1.84\u00b10.32, p&lt;0.001) Achilles tendons of type 2 diabetes patients contained more echo-types III+IV (14.1\u00b17.9%) than matched controls (8.0\u00b15.4%, p&lt;0.001). There was a trend towards a difference in echo-types III+IV between type 1 diabetes patients (9.5\u00b15.3%) and their controls (6.5\u00b13.7%, p=0.055). In a stepwise linear regression analysis, body mass index (BMI) was moderately associated with tendon abnormality in patients with diabetes and controls (\u03b2=0.393, p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Type 2, and possibly type 1, diabetes patients showed poorer ultrasonographic Achilles tendon structure that may be a risk factor for tendinopathy. Although markers for accumulation of advanced glycation end products were elevated in both diabetes populations, only BMI was associated with these abnormalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NTR2209.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2014-093696","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T02:25:29Z","timestamp":1421202329000},"page":"995-999","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Achilles tendons in people with type 2 diabetes show mildly compromised structure: an ultrasound tissue characterisation study"],"prefix":"10.1136","volume":"49","author":[{"given":"Suzan","family":"de Jonge","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Rozenberg","sequence":"additional","affiliation":[{"name":"MOVEFIT-Sports Medicine, Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Vieyra","sequence":"additional","affiliation":[{"name":"MOVEFIT-Sports Medicine, Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk J","family":"Stam","sequence":"additional","affiliation":[{"name":"MOVEFIT-Sports Medicine, Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk-Jan","family":"Aanstoot","sequence":"additional","affiliation":[{"name":"Diabeter, Center for 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