In an important pilot study from Chennai, India, Prof. Vijay Viswanathan and his team at the M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre have shown that a low-cost, indigenously developed offloading sandal is just as effective as a far more expensive imported counterpart in healing diabetic foot ulcers (DFUs) .
The randomized clinical trial, published in the International Journal of Diabetes in Developing Countries, enrolled 42 individuals with uncomplicated Grade 1A plantar ulcers. Participants were assigned to one of two groups: one received a conventional imported offloading walker ($167 USD), while the other received a novel, locally manufactured ankle-height removable sandal ($36 USD) designed specifically for pressure redistribution over forefoot wounds .
Key Findings
- Healing Rates: Wound size reduction was significant in both groups (median size dropped from 5.9 to 1.2 cm² in the imported group and 3.9 to 1.0 cm² in the indigenous group), with no statistically significant difference between them.
- Time to Healing: Median healing time was 26.5 days for the imported device and 25 days for the indigenous sandal.
- User Comfort and Cost: Participants reported comfort and usability with the locally made device, which was also 4.6 times less expensive.
Engineering Simplicity and Efficacy
The indigenous sandal features a polyurethane outer sole with anti-skid tread, a rocker bottom for optimal metatarsal offloading, and a custom-molded insole (zero insole) that was cut and contoured to the individual wound site. On page 3of the study, helpful images illustrate the sandal’s construction, showing its high and wide toe box, Velcro fasteners, and layered sole for precise offloading.
This innovation underscores the potential of context-appropriate solutions: highly effective, tailored for tropical environments, and produced at a fraction of the cost—without compromising healing outcomes.
Why It Matters
With India now home to over 100 million people living with diabetes, innovations like this represent a potential public health game-changer—not by pushing the bleeding edge of technology, but by rooting solutions in affordability, accessibility, and evidence-based care.
Kudos to Prof. Viswanathan, Seena Rajsekar, Arutselvi Devarajan, Viswanathan Vishnu Vijay, Bamila Selvaraj, and Satyavani Kumpatla for this significant contribution to diabetic limb preservation science .
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