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In patients with diabetes mellitus (DM), can affect multiple body systems. The aim of this cross-sectional study was to identify multisystem factors associated with metatarsophalangeal joint deformity in individuals with type 2 diabetes and peripheral neuropathy (n=60). Metatarsophalangeal joint deformity was quantified using computed tomography (CT) scans. Whole-body biomarkers included musculoskeletal “intrinsic muscle deterioration of the foot, tarsal/metatarsal bone density, ankle dorsiflexion, and metatarsophalangeal extension during standing tasks.” increase. Vasculature "ankle-humeral index". and the endocrine/immune system (sensitive C-reactive protein, endogenous fluorescence and hemoglobin A1C). Muscle wasting (r=0.27), bone mineral density (r=-0.35), metatarsophalangeal extension (r=0.50), maximal dorsiflexion (r=-0.31), and ankle-humeral index (r=0.33) was related. with metatarsophalangeal joint deformity (p<0.05). Regression models related to deformation preserved bone density and metatarsophalangeal extension (R2 = 0.34). All musculoskeletal biomarkers and the ankle-humeral index showed a weak to moderate association with metatarsophalangeal joint deformity. Tarsal/metatarsal bone mineral density and toe extension during standing movements were the two strongest factors associated with metatarsophalangeal deformity. Assessment and management of bone mineral density and toe extension movement patterns in the foot may reduce the risk of metatarsophalangeal joint deformity and skin injury and subsequent amputation.