A Scoping Review of Footwear Worn by People With Diabetes in Low- and Middle-Income Countries: Implications for Ulcer Prevention Programs

Abstract

Few people with diabetes in low-and middleincome countries wear footwear recommended by international guidelines for ulcer prevention.n Poverty, culture, climate, health literacy, and the nature of health care in low-and middle-income countries are barriers to implementation of international ulcer prevention guidelines.

A Resource-Efficient Plantar Pressure Evaluation System for Diabetic Foot Risk Assessment

“…First, several design requirements for a plantar pressure measurement system to be effective for DFU risk screening in LMICs were defined in order to direct the design process. Medical, economic, and anthropological literature regarding healthcare and diabetes care in LMICs [9,10,[13][14][15][30][31][32][33] and communications with healthcare providers in India, Kenya, Tanzania, and South Africa informed the following set of requirements:…”

“…The recommended risk assessment consists of a series of careful procedures, including at least six different clinical measurements intended to be performed by a specialist [8]. The demanding nature of these methods is incompatible with the resource constraints of many settings [9,10], an issue that has received little attention from the international community. As one example of the scale that podiatry resource constraints reach in some regions, it is estimated that there are fewer than five podiatrists in the entire country of Kenya, which has a population of over 53 million [11].…”