On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
New in Diabetes Care: dropout from diabetic foot ulcer offloading trials is not random. Slower walking and depressive symptoms predict who leaves (AUC 0.81) — and a lower-burden smart boot kept people engaged. Attrition is signal, not noise.
Ninety percent of clinicians know about the Medicare Therapeutic Shoe Benefit and nearly all recommend shoes, yet fewer than one in five eligible patients ever gets them. A new study from Ryan Crews and Carol Kurth shows the bottleneck isn't awareness. It's friction.
A new protocol paper in Sensors describes a chatbot that doses walking like a drug for patients in diabetic foot remission.
A cost-effectiveness analysis of the DIAFOS trial shows that in-shoe plantar pressure-guided custom footwear saves over €8,000 per ulcer prevented — and adherent patients push the probability of cost-effectiveness to 94%. The economic case for prevention just got stronger.
A new bibliometric analysis from Wei and colleagues at Capital Medical University in Beijing maps 25 years (2000–2024) of global research on plantar pressure and diabetic foot ulcers — over 2,100 publications indexed in the Web of Science Core Collection. The findings tell a story that will feel familiar to many of us who have... Continue Reading →
Honored to deliver the keynote at the inaugural meeting of ADFA in Paris.
Chronic wounds are biological computers stuck in a boot loop. Sharp debridement is Control-Alt-Delete — the histological reboot that converts a chronic wound back into an acute one. Only then can you run the apps.
A new systematic review finds that roughly one in three adults in remission after a healed diabetic foot ulcer develop a recurrent ulcer within 12 months — a risk comparable to several common cancers. Healing is the beginning of the next chapter, not the end of the story.
Our new paper is out today in Diabetology, and I'm really proud of this one. It's a narrative review—co-authored with Bijan Najafi and Shervanthi Homer-Vanniasinkam—that traces the entire arc of offloading from the 1930s to right now. We called it "From Plaster to Pixels" because that's genuinely what's happened. From plaster-of-Paris casts in leprosy clinics... Continue Reading →
There's a moment in most engineering disciplines when you have to confront an uncomfortable truth: the "best" solution on paper isn't always the best solution in the field. NASA learned this with the Space Shuttle — a magnificent machine that required 25,000 people and six months to turn around between flights. The Saturn V, by... Continue Reading →
