Footwear for persons with diabetes at high risk for foot ulceration: Offloading, effectiveness, and costs

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People with diabetic foot disease are commonly prescribed with special footwear to help prevent a foot ulcer. The main mechanism here is the redistribution of mechanical pressure on the foot so to offload specific high-risk regions. Footwear to help prevent a (recurrent) foot ulcer is often to some extent custom-made and consists of pressure-relieving elements such as a rocker outsole, custom-made insert, metatarsal pad or bar, and cushioning insole top layer. Data-driven techniques such as in-shoe plantar pressure measurement prove to be a valuable tool to improve the offloading properties of preventative footwear, and when such pressure-improved footwear is adequately worn, risk for foot ulcer recurrence is reduced, in a cost-effective manner. Guidelines for what entails improved pressure relief and design protocols to achieve that have been developed, but methods to improve footwear adherence have not yet been established. Offloading through special footwear is one of the cornerstones of preventative treatment and should always be considered in people who are at high risk of foot ulcer development.
Original languageEnglish
Title of host publicationThe Science, Etiology and Mechanobiology of Diabetes and its Complications
ISBN (Electronic)9780128210703
Publication statusPublished - 1 Jan 2021

Publication series

NameThe Science, Etiology and Mechanobiology of Diabetes and its Complications

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