Offloading and Adherence Through Technological Advancements: Modern Approaches for Better Foot Care in Diabetes

Authors

Sicco A Bus
Neil D Reeves
David G Armstrong
Bijan Najafi

Publication Date

2-1-2024

Journal

Diabetes/Metabolism Research and Reviews

DOI

10.1002/dmrr.3769

PMID

38536196

PMCID

PMC11464855

PubMedCentral® Posted Date

10-10-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Diabetic Foot, Digital Health, Disease Management, Health Personnel, Shoes, Diabetes Mellitus, adherence, diabetic foot, digital health, footwear, offloading, sensor technology

Abstract

Objective: This 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.

Methods: A 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.

Results: In-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.

Conclusions: The 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.