Digital foot health technology and diabetic foot monitoring : a systematic review

Abstract

Diabetes Mellitus describes a metabolic disorder characterized by an increase in blood glucose levels secondary to imperfections of insulin secretion, action or both. Such defects lead to a detrimental effect on carbohydrate, fat and protein metabolism. It is estimated that approximately 20% of individuals living with diabetes mellitus develop a foot ulcer and, that around 400 patients experience an amputation secondary to diabetic foot ulcer related complications. Once a foot ulcer is developed, the risk of death increases two-fold for the patient affected compared to a patient who has never experienced a diabetic foot ulcer. Furthermore, if an ulcer becomes infected, the risk of foot amputation increases and so does the mortality rate post amputation which is estimated to increase up to 70%. Excessive plantar pressures induce a stress on the superficial layer of the skin leading to maceration and detachment of the skin itself. Sustained loading on the skin further damages the skin enough to form a superficial ulcer. Temperature, is also a strong predictor for foot ulceration. It is highly overlooked as it is a new concept. The proper technology has not yet been introduced as part of the clinical assessment of the diabetic high-risk foot.