Leveraging smart technologies to improve the management of diabetic foot ulcers and extend ulcer‐free days in remission

• Published in: Diabetes/metabolism research and reviews Vol. 36; no. S1; pp. e3239 - n/a
• Main Authors: Najafi, Bijan, Reeves, Neil D., Armstrong, David G.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2020
• Subjects: Complex patients; Complications; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - complications; Diabetic Foot - etiology; Diabetic Foot - prevention & control; Diabetic Foot - rehabilitation; diabetic foot ulcers; digital health; Disease Management; Feet; Foot diseases; Humans; Leg ulcers; Patients; personalized care; plantar tissue stress; Quality of Life; Remission; Remission (Medicine); Remission Induction; Shoes - standards; Telemedicine - statistics & numerical data; thermography; Ulcers; wearable; Wound healing; personalized care; diabetic foot ulcers; wearable; digital health; thermography; plantar tissue stress
• DOI: 10.1002/dmrr.3239
• ISSN: 1520-7552

The prevalent and long neglected diabetic foot ulcer (DFU) and its related complications rank among the most debilitating and costly sequelae of diabetes. Management of the DFU is multifaceted and requires constant monitoring from patients, caregivers, and healthcare providers. The alarmingly high rates of recurrence of ulcerations in the diabetic foot requires a change in our approach to care and to the vernacular in the medical literature. Our efforts should be directed not only on healing of open wounds, but also on maximizing ulcer‐free days for the patient in diabetic foot remission. The increasing development and use of technology within every aspect of our lives represents an opportunity for creative solutions to prevent or better manage this devastating condition. In particular, recent advances in wearable and mobile health technologies appear to show promise in measuring and modulating dangerous foot pressure and inflammation to extend remission and improve the quality of life for these most complex patients. This review article discusses how harnessing wearables and digital technologies may improve the management and optimize prevention of DFUs by identifying high‐risk patients for triage and timely intervention, personalizing prescription of offloading, and improving adherence to protective footwear. While still in their infancy, we envisage a future network of skin‐worn, jewellery‐worn, and implantable sensors that, if allowed to effectively communicate with one another and the patient, could dramatically impact measuring, personalizing, and managing how we and the patients we serve move through our collective world.