▁effect ▁of ▁in hib itory ▁regul atory ▁effect ▁on ▁M MP ▁gen es ▁and ▁thus ▁cause ▁M MP s ▁to ▁over ▁express . ▁ ▁Bi ome chan ics ▁Comp lications ▁in ▁the ▁di ab etic ▁foot ▁and ▁foot - ank le ▁complex ▁are ▁wider ▁and ▁more ▁destruct ive ▁than ▁expected , ▁and ▁may ▁comprom ise ▁structure ▁and ▁function ▁of ▁several ▁systems : ▁v asc ular , ▁nerv ous , ▁som atos ens ory , ▁mus cul os ke let al . ▁Thus , ▁a ▁deeper ▁compreh ension ▁of ▁the ▁alter ation ▁of ▁g ait ▁and ▁foot ▁bi ome chan ics ▁in ▁the ▁di ab etic ▁foot ▁is ▁of ▁great ▁interest , ▁and ▁may ▁play ▁a ▁role ▁in ▁the ▁design ▁and ▁on set ▁of ▁prevent ive ▁as ▁well ▁as ▁th era pe ut ic ▁actions . ▁ ▁Br ief ly , ▁the ▁effect ▁of ▁di ab etes ▁on ▁the ▁main ▁structures ▁of ▁the ▁foot - ank le ▁complex ▁can ▁be ▁summar ised ▁as : ▁ ▁effects ▁on ▁skin : ▁skin ▁– ▁and ▁the ▁soft ▁t issues ▁immediately ▁under ne ath ▁the ▁skin ▁– ▁under go ▁greater ▁compression ▁and ▁she ar ▁loading ▁than ▁usual , ▁thus ▁explaining ▁the ▁on set ▁of ▁t issue ▁damage ▁so ▁deeply ▁correl ated ▁to ▁tra um atic ▁ul cer ation ▁processes . ▁Besides ▁this , ▁skin ▁of ▁the ▁di ab etic ▁foot ▁suff ers ▁from ▁loss ▁of ▁autonom ic ▁nerv ous ▁control ▁and ▁consequ ently ▁reduced ▁hyd r ation , ▁making ▁it ▁less ▁el astic ▁and ▁thus ▁more ▁vulner able