Shoe insert protects against diabetic foot

New „intelligent insole“ should prevent the formation of ulcers

09/16/2014

A new shoe sole promises help with diabetes. As the University Hospital Magdeburg is currently reporting, the Department of Kidney and Hypertension Diseases, Diabetology and Endocrinology have a joint venture with ifak System and OrthoFit Schuhtechnik GmbH in Magdeburg „intelligent insole“ developed. With the help of this diabetes patients will be protected in the future from poorly healing wounds and amputations in the area of ​​the feet.

Nerve damage from high blood sugar
Anyone with diabetes mellitus for years runs the risk of developing diabetic foot syndrome (DFS). The reason: High blood sugar damages the peripheral nerve tracts, which lead to the small tiptoe and ensure that people react sensitively to touch and pressure. As a result, it comes to massive feelings, because „This means that pressure and temperature signals can no longer be transmitted from the skin to the brain and back“, explains Prof. Dr. med. Peter Mertens, Director of the Magdeburg University Hospital for Kidney and Hypertension Diseases, Diabetology and Endocrinology. A not rare development, because „after about a decade, about half of diabetics suffer from such peripheral nerve damage“, Prof. Mertens continues.

Wound healing sometimes requires months
In healthy people, for example, the peripheral nerve tracts ensure that the weight is quite high when standing for long periods at the same place „automatically“ is shifted from one foot to the other after a certain time. Diabetics, on the other hand, often do not realize at all that their toes, heel or other part of their foot are being overburdened by the damage to their nerves. Therefore, the foot is often not relieved, which pressure ulcers may arise, but also are not noticed. This can have far-reaching consequences: even a small uneven spot or a tiny little stone in the shoe can lead to open wounds or severe destruction of the tissue. In addition, a so-called diabetic foot causes the wounds to heal badly and thus quickly ignite: „It sometimes takes many months of intensive care and hospital stays until an ulcer has healed. And not always succeed“, said the diabetologist and senior physician at the University Hospital, Dr. med. Silke Klose.

Temperature measurements indicate possible sites of ulcer formation
The treatment of diabetes patients was carried out according to the University of Magdeburg so far with a so-called „diabetes-adapted footbed“. It is a custom-made deposit bed with a special foam pad, which by default „in transition“ measured. „The goal is an individually custom-made, pressure-balancing footbed“, explains orthopedic master shoemaker Volker Herbst of the Magdeburg-based company OrthoFit. However, according to the experts, even such a bed can offer patients 100% protection against ulcers. Accordingly, work continued on the development of adjuvants - guided by studies from the US, which had already come to the beginning of the 21st century to interesting results: According to regular temperature measurements on the feet of diabetic patients could point to possible sites of ulcer, because already one week before the outbreak of such an average temperature of 4 ° C. gone up. If the foot was then relieved immediately, so the formation of the ulcer could be prevented.

„Smart insole“ proves to be reliable in 95% of cases
These insights have now flowed into a novel technical approach, developed by ifak System and OrthoFit, together with physicians from the University Hospital of the University of Bonn for kidney and hypertension diseases, diabetology and endocrinology: „In addition to pressure sensors, eight additional temperature sensors were integrated into endangered areas of the foot sole in this newly designed intelligent insole“, explains Dipl.-Ing. Fred Samland from the ifak. However, according to the University of Magdeburg, for the technology to work, the patient needs a smartphone because the measurements analyzed by computer chips in the insole would be transmitted via a wireless app. „The display is kept simple to avoid interpretation errors“, explains Dipl.-Ing. Thorsten Szczepanski, Managing Director of ifak GmbH. The „warning system“ for those affected remind of a traffic light, because while at „green“ everything is alright, show „yellow“ already suggest that sufferers should relieve the foot. However, this is already in the „red area“, this is clearly indicated by a beep or vibration. At the latest then, according to Prof. Mertens, the foot load should be changed to promote the circulation of the tissue, „when the foot temperature rises, the foot should be completely relieved and examined for an incipient ulcer by the patient. An introduction to the supervising doctor would be the next step.“ As the university continues to report, the „intelligent insole“ so far, it has been tested on twenty patients standing, with 95% of cases „Reliable“ have shown. Now, a more comprehensive study should follow in the coming months.

Daily and proper foot care particularly important
Failure to treat a diabetic foot can be bad luck. In this country alone, according to the university, around 45,000 amputations per year would have to be due to late-recognized episodes of the so-called „diabetes“ be amputated. Nevertheless, some tips can help reduce the risk. This includes above all the daily and proper foot care, by washing the feet thoroughly with a mild soap every day and carefully checking for pressure points, cornea or injuries. Warm foot baths, on the other hand, should only be carried out briefly, since otherwise there is a danger of germs getting into the softened tissue. Also important is the creaming of the dry skin to avoid cracks. If wounds occur, they must be treated promptly. First aid here forms disinfectant and a sterile compress, but then immediately a doctor should be consulted, in order to avoid any consequential damage. (No)