Foot care can be the Achilles’ heel of people with diabetes, says Dr. David Armstrong, a professor of surgery at the University of Arizona.

People with diabetes “over time will lose the gift of pain – they will develop neuropathy – and they can wear a hole in their foot just like you or I could wear a hole in a shoe or a sock,” says Dr. Armstrong.

The statistics on diabetes and foot issues are sobering. Up to 25% of people with diabetes will develop a foot ulcer in their lifetimes, and more than half of all foot ulcers will become infected. 20% of those infections result in amputation. Health officials badly want to reduce these numbers.

“Every 20 seconds a limb is lost due to diabetes, but all of these amputations could be prevented,” says Dr. Bijan Najafi, associate professor of surgery at the University of Arizona and director of the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP). “We need to find a smart way to predict the risk of diabetic foot ulcer and help patients to take care of their own health.”

Traditionally, the best ways for people with diabetes to manage these problems has been to check their feet every day for wounds or sores, maintain a rigorous regimen of foot care, visit the podiatrist regularly, and wear specialized socks and shoes. Diabetic socks are generally designed to be form-fitting and seamless to eliminate any potential sources of irritation. They may have fibers with some antifungal or anti-microbial properties, but for the most part, their main purpose is to not make diabetic foot problems any worse.

But what if you could prevent these foot problems before they occur? Today there are new products available and others soon coming to market that have the potential to alter the landscape for people with diabetes who are working to take good care of their feet. Dr. Armstrong and Dr. Najafi work together at iCAMP, a subsidiary of the Southern Arizona Limb Salvage Alliance (SALSA), which has recently received several large grants to study smart sock technology and its potential to be useful to people with diabetes. The socks they are studying are made with fiber-optics which can sense changes in temperature, pressure, and joint angle, and then communicate that information via bluetooth or wi-fi to a user’s phone or to a medical caregiver’s computer. These 3 parameters (temperature, pressure, and joint angle) are indicators of the potential development of ulcers, and the socks are providing a new opportunity to provide more in-depth, real-time data about what is happening around the foot than has ever been available before. If successful, it’s likely to save millions in health care costs, since once an ulcer develops it can be very costly and difficult to manage.

“If we can find a change of temperature in the plantar area, we can alert patients and doctors to do preventive care before the breakdown of skin or ulcer is happening,” says Dr. Najafi.

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