▁to ▁the ▁action ▁of ▁increased ▁mechanical ▁stress ; ▁ ▁effects ▁on ▁tend ons ▁and ▁lig aments : ▁protein ▁g ly cos yl ation ▁and ▁the ▁resulting ▁col lagen ▁ab normal ities ▁lead ▁to ▁greater ▁trans vers al ▁section ▁– ▁i . e . ▁thick ening ▁– ▁of ▁tend ons ▁and ▁lig aments ▁and ▁a ▁greater ▁coefficient ▁of ▁el astic ity . ▁Part icular ly ▁impact ed ▁by ▁this ▁process ▁are ▁Plant ar ▁F as cia ▁and ▁Ach illes ▁T end on . ▁Both ▁causes ▁lead ▁to ▁an ▁increased ▁st iff ness ▁of ▁those ▁structures ; ▁ ▁effects ▁on ▁cart il age : ▁similar ▁to ▁what ▁happens ▁to ▁tend ons ▁and ▁lig aments , ▁cart il age ▁changes ▁its ▁composition ▁mainly ▁due ▁to ▁the ▁modification ▁of ▁col lagen ▁fib ers . ▁This ▁increases ▁its ▁st iff ness ▁and ▁decre ases ▁the ▁range ▁of ▁motion ▁of ▁all ▁joint s ▁in ▁the ▁foot ▁and ▁an k le . ▁ ▁effects ▁on ▁mus cles : ▁Di ab etes ▁m ell it us ▁causes ▁severe ▁damage ▁to ▁n erve ▁condu ction , ▁thus ▁causing ▁a ▁w ors ening ▁in ▁the ▁management ▁of ▁the ▁related ▁mus cle ▁fib ers . ▁As ▁a ▁consequence , ▁both ▁intr insic ▁and ▁extr insic ▁mus cles ▁of ▁the ▁foot - ank le ▁complex ▁are ▁dam aged ▁in ▁structure ▁( redu ction ▁of ▁mus cle ▁volume ) ▁and ▁function ▁( redu ction ▁of ▁mus cle ▁strength ); ▁ ▁effects ▁on ▁peri pher al ▁sens ory ▁system : ▁imp a ired ▁n erve ▁condu ction