Offloading and adherence through technological advancements: Modern approaches for better foot care in diabetes

Abstract

ObjectiveThis manuscript aims to provide a review and synthesis of contemporary advancements in footwear, sensor technology for remote monitoring, and digital health, with a focus on improving offloading and measuring and enhancing adherence to offloading in diabetic foot care.MethodsA narrative literature review was conducted by sourcing peer‐reviewed articles, clinical studies, and technological innovations. This paper includes a review of various strategies, from specifically designed footwear, smart insoles and boots to using digital health interventions, which aim to offload plantar pressure and help prevent and manage wounds more effectively by improving the adherence to such offloading.ResultsIn‐house specially made footwear, sensor technologies remotely measuring pressure and weight‐bearing activity, exemplified for example, through applications like smart insoles and SmartBoot, and other digital health technologies, show promise in improving offloading and changing patient behaviour towards improving adherence to offloading and facilitating personalised care. This paper introduces the concept of gamification and emotive visual indicators as novel methods to enhance patient engagement. It further discusses the transformative role of digital health technologies in the modern era.ConclusionsThe integration of technology with footwear and offloading devices offers unparallelled opportunities for improving diabetic foot disease management not only through better offloading but also through improved adherence to offloading. These advancements allow healthcare providers to personalise treatment plans more effectively, thereby promising a major improvement in patient outcomes in diabetic foot ulcer healing and prevention.

The Stress of Measuring Plantar Tissue Stress in People with Diabetes-Related Foot Ulcers: Biomechanical and Feasibility Findings from Two Prospective Cohort Studies

“…The process to determine cumulative plantar tissue stress is very sensor-and technically driven at this point and hence complex. Despite widespread support for integrating sensors to measure and intervene to improve healing of diabetes-related foot ulcers [48][49][50], our research currently does not support this idea due to low feasibility. We do not recommend taking time-consuming measurements several times within 3 months in people with a diabetes-related foot ulcer.…”

The unique multidisciplinarity of diabetes‐related foot disease

“…1 In addition to these 21 publications that describe the presentday knowledge in diabetes-related foot disease, we also present 6 reviews from experts in the field in this special virtual issue. [23][24][25][26][27][28] These reviews aim to help guide the field forward, and discuss topics where the evidence may be thin, and where research and clinical practice can together advance the field and drive innovations.…”