New research, a “change of pace” for patients with diabetes

Millions of people with diabetes are at risk of developing foot ulcers, which often lead to amputations and other health complications. Now, scientists at the Center for Biomechanics and Rehabilitation Technologies (CRBT) have developed a new method to reliably detect this risk without the need for complex electronic sensors in shoes.

Dr Panagiotis Chatzistergos, an associate professor of orthopedic biomechanics, explained: “In the UK alone, 169 people have a finger, foot or limb amputated as a result of diabetes each week, but it is important to avoid up to 80% of ‘these amputations with proper management.

“Routine overloading of the sole of the foot during daily activities can lead to the appearance of foot ulcers, so it is very important to be able to identify which areas of the sole of the foot are most affected. “

A common method is to assess plantar pressure to prescribe special footwear or insoles, but many clinicians cannot use it because it is expensive and difficult to use. Dr. Chatzistergos and colleagues have developed a new concept to address this problem, using tunable structures printed in 3-D that will help clinicians better understand the cause of ulcer development and improve patient outcomes.

Dr Chatzistergos, who led the study, said: “Our work has demonstrated a method to reliably detect overload using a low-cost non-electronic technique. We used a thin-walled structure printed in 3-D. which changes its properties when loaded repeatedly above or below an adjustable threshold.We believe this is a step change current practice. “

Patients should wear sensor insoles in their footwear daily for a representative period of time, for example a day or a week, before re-analyzing them. During the analysis of the sensor template, the plantar areas that were routinely subjected to higher pressures should be identified, as opposed to the areas where the pressure was below this threshold.

The concepts behind the work, published in Royal Society Open Science, have been fully developed at Staffordshire University and intellectual property has been protected.

Professor Nachi Chockalingam, director of CRBT who co-authored the study, said: “Plantar pressure assessment is common among clinical practice and contributes to the recipe for insoles and footwear. However, current technologies are expensive and difficult to use in a daily clinic.

“Every year more than 26 million people develop worldwide diabetic foot ulcers and the incidence of lifelong foot ulcers in developing countries is over 20% among people with diabetes. Establishing low-cost methods to help prevent foot ulcers will reduce the global socioeconomic burden of diabetes and ultimately save lives. The concept presented in this paper, with further development, has the potential to transform the clinical management of foot ulcer risk to the whole world “.

Provided by Staffordshire University