Prevention of foot ulcers in persons with diabetes at risk of ulceration: A systematic review and meta‐analysis

van Netten, Jaap J.; Raspovic, Anita; Lavery, Lawrence A.; Monteiro‐Soares, Matilde; Paton, Joanne; Rasmussen, Anne; Sacco, Isabel C. N.; Bus, Sicco A.

doi:10.1002/dmrr.3652

Cited by 89Diabetic Foot Ulcer Assessment and ManagementSkin Diseases and DiabetesFoot and Ankle Surgery

Prevention of foot ulcers in persons with diabetes at risk of ulceration: A systematic review and meta‐analysis

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van Netten, Jaap J., Raspovic, Anita, Lavery, Lawrence A., Monteiro‐Soares, Matilde, Paton, Joanne, Rasmussen, Anne, Sacco, Isabel C. N., Bus, Sicco A.·2024·Diabetes/Metabolism Research and Reviews

DOI 10.1002/dmrr.3652

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Abstract

AIMS: Prevention of foot ulcers in persons with diabetes is important to help reduce the substantial burden on both individual and health resources. A comprehensive analysis of reported interventions is needed to better inform healthcare professionals about effective prevention. The aim of this systematic review and meta-analysis is to assess the effectiveness of interventions to prevent foot ulcers in persons with diabetes who are at risk thereof. MATERIALS AND METHODS: We searched the available scientific literature in PubMed, EMBASE, CINAHL, Cochrane databases and trial registries for original research studies on preventative interventions. Both controlled and non-controlled studies were eligible for selection. Two independent reviewers assessed risk of bias of controlled studies and extracted data. A meta-analysis (using Mantel-Haenszel's statistical method and random effect models) was done when >1 RCT was available that met our criteria. Evidence statements, including the certainty of evidence, were formulated according to GRADE. RESULTS: From the 19,349 records screened, 40 controlled studies (of which 33 were Randomised Controlled Trials [RCTs]) and 103 non-controlled studies were included. We found moderate certainty evidence that temperature monitoring (5 RCTs; risk ratio [RR]: 0.51; 95% CI: 0.31-0.84) and pressure-optimised therapeutic footwear or insoles (2 RCTs; RR: 0.62; 95% CI: 0.26-1.47) likely reduce the risk of plantar foot ulcer recurrence in people with diabetes at high risk. Further, we found low certainty evidence that structured education (5 RCTs; RR: 0.66; 95% CI: 0.37-1.19), therapeutic footwear (3 RCTs; RR: 0.53; 95% CI: 0.24-1.17), flexor tenotomy (1 RCT, 7 non-controlled studies, no meta-analysis), and integrated care (3 RCTs; RR: 0.78; 95% CI: 0.58-1.06) may reduce the risk of foot ulceration in people with diabetes at risk for foot ulceration. CONCLUSIONS: Various interventions for persons with diabetes at risk for foot ulceration with evidence of effectiveness are available, including temperature monitoring (pressure-optimised) therapeutic footwear, structured education, flexor tenotomy, and integrated foot care. With hardly any new intervention studies published in recent years, more effort to produce high-quality RCTs is urgently needed to further improve the evidence base. This is especially relevant for educational and psychological interventions, for integrated care approaches for persons at high risk of ulceration, and for interventions specifically targeting persons at low-to-moderate risk of ulceration.

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A multidisciplinary team approach (structured diabetic foot services) reduces diabetes-related lower extremity amputation.
“A multidisciplinary team approach (structured diabetic foot services) has been shown to reduce diabetes-related lower extremity amputation.85”
From Diabetic Foot Ulcers (2023) · cites this paper as [85]
The integrated-care discussion reports possible reductions in foot ulcers, not amputations. In §7.5 (Methodological considerations and limitations; page unavailable), the review says it did not consider amputation as a primary outcome and excluded population-based studies reporting only amputation prevention. The References list studies on multidisciplinary teams and amputations, but this review does not itself report the claimed effect. (LLM, conf=0.76)
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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Rayyan-a web and mobile app for systematic reviews.
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0384-4 · Cited by 26,092 · cited 1× · see citing works
“24 Cohen's Kappa was calculated for agreement between assessors.”
Background
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 2× · see citing works
“- 21 of 31 proposed threshold has not been published.”
Background
Diabetic foot ulcers and their recurrence
Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1615439 · Cited by 4,376 · cited 2× · see citing works
“4,6 In general, persons without any of these risk factors are considered not to be at risk for ulceration.”
Background
Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)
Schaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Hinchliffe, R. J., Lipsky, B. A., & IWGDF Editorial Board (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3266 · Cited by 970 · cited 3× · see citing works
“5 Even when an ulcer is successfully healed, risk of recurrence is high, with reported recurrence rates of 40% in the first year after healing, and 65% in the first 3 years.”
BackgroundMethodInfluential
GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines
Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Vandvik, P. O., Meerpohl, J., et al. (2016) · BMJ · doi:10.1136/bmj.i2089 · Cited by 814 · cited 2× · see citing works
“20,21 First, an extensive list of potential outcomes was rated on importance by the 16 external experts (including the representatives with lived experience), with a score of 1 (not important), 2 (of some importance) or 3 (very important).”
Background
Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016
Zhang, Y., Lazzarini, P. A., McPhail, S., van Netten, J. J., Armstrong, D. G., & Pacella, R. (2020) · Diabetes Care · doi:10.2337/dc19-1614 · Cited by 594 · see citing works
Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)
Bus, S. A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Raspovic, A., Sacco, I. D. C. N., van Netten, J. J., & on behalf of the International Working Group on the Diabetic Foot (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3269 · Cited by 519 · cited 1× · see citing works
“8 There are also emerging interventions, such as health behaviour strategies including motivational interviewing and cognitive behavioural therapy, which add psychological approaches to the arsenal of options for ulcer prevention, or foot ‐ ankle exercise programs targeting risk factors for…”
Background
Skin Temperature Monitoring Reduces the Risk for Diabetic Foot Ulceration in High-risk Patients
Armstrong, D. G., Holtz-Neiderer, K., Wendel, C. S., Mohler, M. J., Kimbriel, H. R., & Lavery, L. A. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2007.06.028 · Cited by 440 · see citing works
Preventing Diabetic Foot Ulcer Recurrence in High-Risk Patients
Lavery, L. A., Higgins, K. R., Lanctot, D. R., Constantinides, G. P., Zamorano, R. G., Athanasiou, K. A., Armstrong, D. G., & Agrawal, C. M. (2006) · Diabetes Care · doi:10.2337/dc06-1600 · Cited by 435 · cited 1× · see citing works
“We also found one non ‐ controlled study, a feasibility trial and qualitative evaluation of a group ‐ based cognitive behavioural therapy, 35 3).”
When and how to update systematic reviews: consensus and checklist
Garner, P., Hopewell, S., Chandler, J., MacLehose, H., Schünemann, H. J., Akl, E. A., Beyene, J., Chang, S., Churchill, R., Dearness, K., et al. (2016) · BMJ · doi:10.1136/bmj.i3507 · Cited by 426 · see citing works
Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review
van Netten, J. J., Price, P., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Jubiz, Y., Bus, S. A., & on behalf of the International Working Group on the Diabetic Foot (IWGDF) (2015) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2701 · Cited by 421 · cited 1× · see citing works
“This systematic review is an update and extension to our systematic reviews published in 2016 and 2020, 13,14 and published in parallel with our systematic review of clinical and biomechanical effectiveness of foot ‐ ankle exercise programs for people with diabetes ‐ related neuropathy.”
Background
Definitions and criteria for diabetic foot disease
van Netten, J. J., Bus, S. A., Apelqvist, J., Lipsky, B. A., Hinchliffe, R. J., Game, F. L., Rayman, G. A., Lazzarini, P. A., Forsythe, R. O., Peters, E. J. G., et al. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3268 · Cited by 386 · cited 1× · see citing works
“19 Furthermore, we did not consider amputation as a primary outcome in this systematic review because it depends largely on ulcer treatment, and is therefore not a specific outcome for prevention in the non ‐ ulcerated foot.”
Background
Home Monitoring of Foot Skin Temperatures to Prevent Ulceration
Lavery, L. A., Higgins, K. R., Lanctot, D. R., Constantinides, G. P., Zamorano, R. G., Armstrong, D. G., Athanasiou, K. A., & Agrawal, C. M. (2004) · Diabetes Care · doi:10.2337/diacare.27.11.2642 · Cited by 379 · see citing works
Reduction in Diabetic Amputations Over 11 Years in a Defined U.K. Population
Krishnan, S. T. M., Nash, F., Baker, N., Fowler, D., & Rayman, G. A. (2007) · Diabetes Care · doi:10.2337/dc07-1178 · Cited by 366 · see citing works
Manufactured Shoes in the Prevention of Diabetic Foot Ulcers
Uccioli, L., Faglia, E., Monticone, G., Favales, F., Durola, L., Aldeghi, A., Quarantiello, A., Calia, P., & Menzinger, G. (1995) · Diabetes Care · doi:10.2337/diacare.18.10.1376 · Cited by 350 · cited 1× · see citing works
“Summary of the literature : We found 3 RCTs that met the criteria for meta ‐ analysis, 48–50 and 3 cohort studies 51–53 (Table 4).”
Background
The impact of foot ulceration and amputation on mortality in diabetic patients. I: From ulceration to death, a systematic review
Jupiter, D. C., Thorud, J. C., Buckley, C. J., & Shibuya, N. (2015) · International Wound Journal · doi:10.1111/iwj.12404 · Cited by 344 · see citing works
Decreasing Incidence of Major Amputation in Diabetic Patients: a Consequence of a Multidisciplinary Foot Care Team Approach?
Larsson, J., Stenström, A., Apelqvist, J., & Agardh, C. (1995) · Diabetic Medicine · doi:10.1111/j.1464-5491.1995.tb02078.x · Cited by 340 · see citing works
Effect of Custom-Made Footwear on Foot Ulcer Recurrence in Diabetes
Bus, S. A., Waaijman, R., Arts, M. L. J., de Haart, M., Busch‐Westbroek, T. E., Baal, J. V., & Nollet, F. (2013) · Diabetes Care · doi:10.2337/dc13-0996 · Cited by 314 · cited 1× · see citing works
“Smart insoles that measure plantar pressure and provide a warning signal when pressure is too high are a new self ‐ management strategy targeting pressure reduction,andwefoundonepilotRCTonthistopic.”
Background
Prevention of amputation by diabetic education
MALONE, J. M., Snyder, M., Anderson, G. G., Bernhard, V. M., Holloway, G. A., & Bunt, T. J. (1989) · The American Journal of Surgery · doi:10.1016/0002-9610(89)90183-9 · Cited by 313 · see citing works
Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study
Gershater, M. A., Löndahl, M., Nyberg, P., Larsson, J., Thörne, J., Eneroth, M., & Apelqvist, J. (2008) · Diabetologia · doi:10.1007/s00125-008-1226-2 · Cited by 284 · cited 1× · see citing works
“Evidence statement (certainty of the evidence) : In people at high risk of foot ulceration, nail lacquer to improve self ‐ inspection may have no effect on ulcer recurrence (Certainty: Low; downgraded from moderate [1 RCT] to low because of imprecision).”
Background
Pressure relief and load redistribution by custom-made insoles in diabetic patients with neuropathy and foot deformity
Bus, S. A., Ulbrecht, J. S., & Cavanagh, P. R. (2004) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2004.02.010 · Cited by 281 · see citing works
The Effect of Callus Removal on Dynamic Plantar Foot Pressures in Diabetic Patients
Young, M. J., Cavanagh, P. R., Thomas, G., Johnson, M., Murray, H. J., & Boulton, A. J. M. (1992) · Diabetic Medicine · doi:10.1111/j.1464-5491.1992.tb01714.x · Cited by 265 · cited 2× · see citing works
“We therefore first grouped all studies on this topic based on both the intervention and the comparator conditions, resulting in seven different categories that were clearly distinct from each other.”
Background
Effect of Therapeutic Footwear on Foot Reulceration in Patients With Diabetes
Reiber, G. E., Smith, D. G., Wallace, C. M., Sullivan, K., Hayes, S. G., Vath, C., Maciejewski, M. L., Yu, O., Heagerty, P. J., & LeMaster, J. W. (2002) · JAMA · doi:10.1001/jama.287.19.2552 · Cited by 244 · see citing works
A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable
Bus, S. A., & van Netten, J. J. (2015) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2738 · Cited by 238 · see citing works
Diabetes education and care management significantly improve patient outcomes in the dialysis unit
McMurray, S. D., Johnson, G., Davis, S. N., & McDougall, K. A. (2002) · American Journal of Kidney Diseases · doi:10.1053/ajkd.2002.34915 · Cited by 235 · cited 1× · see citing works
“158,159 Even though foot ulcer risk is high in this population, 160–162 the lack of specific reporting of findings for the people at risk limits assessment of the effectiveness of an intervention for people at ‐ risk.”
Background
Benefits of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania: a prospective study.
Dargis, V., Pantelejeva, O., Jonushaite, A., Vileikytė, L., & Boulton, A. J. M. (1999) · Diabetes Care · doi:10.2337/diacare.22.9.1428 · Cited by 223 · cited 1× · see citing works
“134 For ulcer prevention, we found an RR of 0.78 (95% CI: 0.58–1.06) in the meta ‐ analysis, a statistically non ‐ significant difference favouring the intervention (Figure 6), with low heterogeneity ( I 2 : 0%).”
BackgroundInfluential
Reporting standards of studies and papers on the prevention and management of foot ulcers in diabetes: required details and markers of good quality
Jeffcoate, W. J., Bus, S. A., Game, F. L., Hinchliffe, R. J., Price, P., & Schaper, N. C. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30012-2 · Cited by 221 · cited 2× · see citing works
“…we strongly advocate for the reporting of results in intervention studies that are specific for the population at risk, with risk reported according to a validated stratification system (e.g. 8 ), and with each item of such a system reported separately for the population included as well (e.g.…”
Background
Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial
Lincoln, N. B., Radford, K., Game, F. L., & Jeffcoate, W. J. (2008) · Diabetologia · doi:10.1007/s00125-008-1110-0 · Cited by 191 · cited 2× · see citing works
“In people with diabetes at risk for foot ulceration, integrated foot care may reduce the risk of foot ulceration (Certainty: Low; downgraded from high [3 RCTs] to low because of imprecision and publication bias [1 unpub-lished study]).”
Background
A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS)
Crawford, F., Cezard, G. I., Chappell, F. M., Murray, G. D., Price, J. F., Sheikh, A., Simpson, C. R., Stansby, G. P., & Young, M. J. (2015) · Health Technology Assessment · doi:10.3310/hta19570 · Cited by 188 · cited 1× · see citing works
“4,6 In general, persons without any of these risk factors are considered not to be at risk for ulceration.”
Background
Prevention of Recurrent Foot Ulcers With Plantar Pressure–Based In-Shoe Orthoses: The CareFUL Prevention Multicenter Randomized Controlled Trial
Ulbrecht, J. S., Hurley, T., Mauger, D. T., & Cavanagh, P. R. (2014) · Diabetes Care · doi:10.2337/dc13-2956 · Cited by 183 · see citing works
Guidelines on offloading foot ulcers in persons with diabetes—IWGDF 2023 update.
Bus, S. A., Armstrong, D. G., Crews, R. T., Gooday, C., Jarl, G., Kirketerp‐Moller, K., Viswanathan, V., & Lazzarini, P. A. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3647 · Cited by 169 · see citing works
The Influence of Shoe Design on Plantar Pressures in Neuropathic Feet
Praet, S., & Louwerens, J. K. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.441 · Cited by 166 · see citing works
Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study
Abbott, C. A., Chatwin, K. E., Foden, P., Hasan, A. N., Sange, C., Rajbhandari, S. M., Reddy, P. N., Vileikytė, L., Bowling, F. L., Boulton, A. J. M., et al. (2019) · The Lancet Digital Health · doi:10.1016/s2589-7500(19)30128-1 · Cited by 164 · cited 2× · see citing works
“F I G U R E 3 Meta ‐ analysis on ulcer prevention with at ‐ home foot temperature monitoring in comparison with standard care. van NETTEN ET AL .”
BackgroundMethod
Feasibility and Efficacy of a Smart Mat Technology to Predict Development of Diabetic Plantar Ulcers
Frykberg, R. G., Gordon, I. L., Reyzelman, A. M., Cazzell, S. M., Fitzgerald, R. H., Rothenberg, G. M., Bloom, J. D., Petersen, B. J., Linders, D. R., Nouvong, A., et al. (2017) · Diabetes Care · doi:10.2337/dc16-2294 · Cited by 163 · cited 1× · see citing works
“This contradicts an earlier meta ‐ analysis where this study was not yet included, 10 but is similar to another meta ‐ analysis that included this new study.”
Result
Effectiveness of insoles on plantar pressure redistribution
Tsung, B. Y. S., Zhang, M., Mak, A. F. T., & Wong, M. W. N. (2004) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2003.09.0139 · Cited by 158 · see citing works
Reducing Plantar Pressure in the Neuropathic Foot: A comparison of footwear
Lavery, L. A., Vela, S. A., Fleischli, J. G., Armstrong, D. G., & Lavery, D. C. (1997) · Diabetes Care · doi:10.2337/diacare.20.11.1706 · Cited by 154 · see citing works
Custom Therapeutic Insoles Based on Both Foot Shape and Plantar Pressure Measurement Provide Enhanced Pressure Relief
Owings, T. M., Woerner, J. L., Frampton, J. D., Cavanagh, P. R., & Botek, G. G. (2008) · Diabetes Care · doi:10.2337/dc07-2288 · Cited by 151 · see citing works
The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—A comprehensive review
Chatwin, K. E., Abbott, C. A., Boulton, A. J. M., Bowling, F. L., & Reeves, N. D. (2019) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3258 · Cited by 138 · see citing works
Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet
Acerini, C. L., Ahmed, M. L., Ross, K. M., Sullivan, P. B., Bird, G., & Dunger, D. B. (1998) · Diabetic Medicine · doi:10.1002/(sici)1096-9136(199801)15:1 · Cited by 137 · see citing works
Risk stratification systems for diabetic foot ulcers: a systematic review
Monteiro‐Soares, M., Boyko, E. J., Ribeiro, J. L. D. C., Ribeiro, I., & Dinis-Ribeiro, M. J. (2011) · Diabetologia · doi:10.1007/s00125-010-2030-3 · Cited by 132 · cited 1× · see citing works
“7 Interventions to help prevent foot ulcers should therefore primarily target the populations with those risk factors mentioned.”
Background
Changing the Natural History of Diabetic Neuropathy: Incidence of Ulcer/Amputation in the Contralateral Limb of Patients With a Unilateral Nerve Decompression Procedure
Aszmann, O. C., Tassler, P. L., & Dellon, A. L. (2004) · Annals of Plastic Surgery · doi:10.1097/01.sap.0000143605.60384.4e · Cited by 125 · see citing works
The effects of insole configurations on forefoot plantar pressure and walking convenience in diabetic patients with neuropathic feet
Guldemond, N., Leffers, P., Schaper, N. C., Sanders, A. P., Nieman, F. H. M., Willems, P. J. B., & Walenkamp, G. H. I. M. (2006) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2006.08.004 · Cited by 123 · see citing works
Continuous Temperature-Monitoring Socks for Home Use in Patients With Diabetes: Observational Study
Reyzelman, A. M., Koelewyn, K., Murphy, M., Shen, X., Yu, E., Pillai, R., Fu, J., Scholten, H. J., & Ma, R. (2018) · Journal of Medical Internet Research · doi:10.2196/12460 · Cited by 121 · cited 3× · see citing works
“42 Adherence to either contacting a health professional or reducing activity when a hotspot was detected was reported in 3 RCTs.”
Background
Effectiveness of Different Types of Footwear Insoles for the Diabetic Neuropathic Foot
Viswanathan, V., Madhavan, S., Gnanasundaram, S., Gopalakrishna, G., Das, B. N., Rajasekar, S., & Ramachandran, A. (2004) · Diabetes Care · doi:10.2337/diacare.27.2.474 · Cited by 118 · see citing works
Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review
Ahmed, S. F., Barwick, A., Butterworth, P. A., & Nancarrow, S. (2020) · Journal of Foot and Ankle Research · doi:10.1186/s13047-020-00400-4 · Cited by 116 · cited 1× · see citing works
“For plantar pressure, numerous prospective studies have shown the risk of increased peak plantar pressure on ulcer incidence (e.g. 147,148 foranoverview),andfootwearisaproveneffectivestrategy to reduce plantar pressure and help prevent foot ulcers, as the current systematic review confirms (see…”
Background
Custom-Made Orthesis and Shoes in a Structured Follow-Up Program Reduces the Incidence of Neuropathic Ulcers in High-Risk Diabetic Foot Patients
Rizzo, L., Tedeschi, A., Fallani, E., Coppelli, A., Vallini, V., Iacopi, E., & Piaggesi, A. (2012) · The International Journal of Lower Extremity Wounds · doi:10.1177/1534734612438729 · Cited by 106 · cited 2× · see citing works
“Summary of the literature : We found 3 RCTs that met the criteria for meta ‐ analysis, 48–50 and 3 cohort studies 51–53 (Table 4).”
Background
Effectiveness of diabetic insoles to reduce foot pressures
Ashry, H. R., Lavery, L. A., Murdoch, D. P., Frolich, M., & Lavery, D. C. (1997) · The Journal of Foot & Ankle Surgery · doi:10.1016/s1067-2516(97)80071-3 · Cited by 106 · see citing works
Effectiveness of a new brand of stock ‘diabetic’ shoes to protect against diabetic foot ulcer relapse. A prospective cohort study
Busch, K., & Chantelau, E. A. (2003) · Diabetic Medicine · doi:10.1046/j.1464-5491.2003.01003.x · Cited by 105 · see citing works
How Effective is Cushioned Therapeutic Footwear in Protecting Diabetic Feet? A Clinical Study
Chantelau, E. A., Kushner, T., & Spraul, M. (1990) · Diabetic Medicine · doi:10.1111/j.1464-5491.1990.tb01404.x · Cited by 105 · cited 1× · see citing works
“However, in the control group, more people presented with multiple ulcers (4 out of 6 vs. 0 out of 4).”
Background
Validation of low-cost smartphone-based thermal camera for diabetic foot assessment
van Doremalen, R. F. M., van Netten, J. J., Baal, J. G., Vollenbroek-Hutten, M. M. R., & van der Heijden, F. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2019.01.032 · Cited by 99 · see citing works
The effect of regular callus removal on foot pressures
Pitei, D. L., Foster, A., & Edmonds, M. E. (1999) · The Journal of Foot & Ankle Surgery · doi:10.1016/s1067-2516(99)80066-0 · Cited by 97 · cited 3× · see citing works
“Regarding other outcomes, no differences were seen for adverse events (1 RCT), HRQoL (1 RCT), and adherence (2 RCTs) (Table 4).”
Background
Evaluation of the Impact of Chiropodist Care in the Secondary Prevention of Foot Ulcerations in Diabetic Subjects
Plank, J., Haas, W., Ivo Rakovac, A., Görzer, E., Sommer, R., Siebenhofer, A., & Pieber, T. R. (2003) · Diabetes Care · doi:10.2337/diacare.26.6.1691 · Cited by 96 · cited 1× · see citing works
“Summary of the evidence : We found 3 RCTs 131–133 that met the inclusion criteria for meta ‐ analysis, as they all investigated an intervention including at least a combination of education and footwear provision (2 also included podiatric/chiropodic treatment for pre ‐ ulcers), and 1 cohort study.”
Background
A comparison of customised and prefabricated insoles to reduce risk factors for neuropathic diabetic foot ulceration: a participant‐blinded randomised controlled trial
Paton, J. S., Stenhouse, E., Bruce, G., Zahra, D., & Jones, R. B. (2012) · Journal of Foot and Ankle Research · doi:10.1186/1757-1146-5-31 · Cited by 96 · see citing works
Plantar pressure relief in the diabetic foot using forefoot offloading shoes
Bus, S. A., Deursen, R. W. M. V., Kanade, R. V., Wissink, M., Manning, E., van Baal, J. G., & Harding, K. G. (2009) · Gait & Posture · doi:10.1016/j.gaitpost.2009.01.003 · Cited by 94 · see citing works
Outcomes of preventative care in a diabetic foot specialty clinic
Armstrong, D. G., & Harkless, L. B. (1998) · The Journal of Foot & Ankle Surgery · doi:10.1016/s1067-2516(98)80022-7 · Cited by 92 · cited 1× · see citing works
“…1–3) with abundant callus, thickened nails, or pre ‐ ulcerative sign on the apex or dorsal surface of a non ‐ rigid hammertoe, flexor tenotomy may reduce the risk of developing a toe ulcer (Certainty: Low; downgraded from moderate [1 RCT] to low because of the risk of bias [incomplete reporting]).”
Background
Amputation Prevention Initiative in South India
Viswanathan, V., Madhavan, S., Rajasekar, S., Snehalatha, C., & Ramachandran, A. (2005) · Diabetes Care · doi:10.2337/diacare.28.5.1019 · Cited by 90 · see citing works
Therapeutic Footwear for the Neuropathic Foot: An algorithm
Dahmen, R., Haspels, R., Koomen, B., & Hoeksma, A. F. (2001) · Diabetes Care · doi:10.2337/diacare.24.4.705 · Cited by 88 · see citing works
Effect of rocker shoe design features on forefoot plantar pressures in people with and without diabetes
Chapman, J., Preece, S. J., Braunstein, B., Höhne, A., Nester, C., Brueggemann, P., & Hutchins, S. W. (2013) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2013.05.005 · Cited by 86 · see citing works
1997 William J. Stickel Bronze Award. Comparison of strategies for reducing pressure at the site of neuropathic ulcers
Fleischli, J. G., Lavery, L., Vela, S., Ashry, H. A., & Lavery, D. C. (1997) · Journal of the American Podiatric Medical Association · doi:10.7547/87507315-87-10-466 · Cited by 86 · see citing works
Efficacy and Mechanism of Orthotic Devices to Unload Metatarsal Heads in People With Diabetes and a History of Plantar Ulcers
Mueller, M. J., Lott, D. J., Hastings, M. K., Commean, P. K., Smith, K. E., & Pilgram, T. K. (2006) · Physical Therapy · doi:10.1093/ptj/86.6.833 · Cited by 83 · see citing works
A pilot study testing the feasibility of skin temperature monitoring to reduce recurrent foot ulcers in patients with diabetes – a randomized controlled trial
Skafjeld, A., Iversen, M. M., Holme, I., Ribu, L., Hvaal, K. H., & Kilhovd, B. K. (2015) · BMC Endocrine Disorders · doi:10.1186/s12902-015-0054-x · Cited by 81 · see citing works
Pressure redistribution by molded inserts in diabetic footwear: a pilot study.
Lord, M., & Hosein, R. B. M. (1994) · PubMed · Cited by 81 · see citing works
The future for diabetic foot ulcer prevention: A paradigm shift from stratified healthcare towards personalized medicine
van Netten, J. J., Woodburn, J., & Bus, S. A. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3234 · Cited by 78 · see citing works
Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial
Tang, U. H., Zügner, R., Lisovskaja, V., Karlsson, J., Hagberg, K., & Tranberg, R. (2014) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2014.06.002 · Cited by 76 · see citing works
The reduction and redistribution of plantar pressures using foot orthoses in diabetic patients
Kato, H., Takada, T., Kawamura, T., Hotta, N., & Torii, S. (1996) · Diabetes Research and Clinical Practice · doi:10.1016/0168-8227(96)01214-4 · Cited by 76 · see citing works
Shear-Reducing Insoles to Prevent Foot Ulceration in High-Risk Diabetic Patients
Lavery, L. A., LaFontaine, J., Higgins, K. R., Lanctot, D. R., & Constantinides, G. P. (2012) · Advances in Skin & Wound Care · doi:10.1097/01.asw.0000422625.17407.93 · Cited by 76 · see citing works
The association of chronic kidney disease and dialysis treatment with foot ulceration and major amputation
Otte, J., van Netten, J. J., & Woittiez, A.-J. J. (2015) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2015.02.051 · Cited by 75 · cited 1× · see citing works
“158,159 Even though foot ulcer risk is high in this population, 160–162 the lack of specific reporting of findings for the people at risk limits assessment of the effectiveness of an intervention for people at ‐ risk.”
Background
An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration
Keukenkamp, R., Merkx, M. J. M., Busch‐Westbroek, T. E., & Bus, S. A. (2017) · Journal of the American Podiatric Medical Association · doi:10.7547/16-171 · Cited by 75 · cited 2× · see citing works
“In people with diabetes at risk for foot ulceration, integrated foot care may reduce the risk of foot ulceration (Certainty: Low; downgraded from high [3 RCTs] to low because of imprecision and publication bias [1 unpub-lished study]).”
Background
Effect of custom orthotics on plantar pressure distribution in the pronated diabetic foot.
Albert, S. F., & Rinoie, C. (1995) · PubMed · Cited by 73 · see citing works
Preventing foot ulceration in diabetes: systematic review and meta-analyses of RCT data
Crawford, F., Nicolson, D. J., Amanna, A. E., Martin, A., Gupta, S., Leese, G., Heggie, R., Chappell, F. M., & McIntosh, H. H. (2019) · Diabetologia · doi:10.1007/s00125-019-05020-7 · Cited by 73 · cited 3× · see citing works
“In people with diabetes at risk for foot ulceration, integrated foot care may reduce the risk of foot ulceration (Certainty: Low; downgraded from high [3 RCTs] to low because of imprecision and publication bias [1 unpub-lished study]).”
Background
Prevention of Ulceration, Amputation, and Reduction of Hospitalization: Outcomes of a Prospective Multicenter Trial of Tibial Neurolysis in Patients with Diabetic Neuropathy
Dellon, A. L., Muse, V., Nickerson, D. S., & al, E. (2012) · Journal of Reconstructive Microsurgery · doi:10.1055/s-0032-1306372 · Cited by 72 · see citing works
Pressure‐reduction and preservation in custom‐made footwear of patients with diabetes and a history of plantar ulceration
Waaijman, R., Arts, M. L. J., Haspels, R., Busch‐Westbroek, T. E., Nollet, F., & Bus, S. A. (2012) · Diabetic Medicine · doi:10.1111/j.1464-5491.2012.03700.x · Cited by 72 · see citing works
Clinical efficacy of therapeutic footwear with a rigid rocker sole in the prevention of recurrence in patients with diabetes mellitus and diabetic polineuropathy: A randomized clinical trial
López‐Moral, M., Lázaro‐Martínez, J. L., García‐Morales, E., García‐Álvarez, Y., Álvaro‐Afonso, F. J., & Molines-Barroso, R. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0219537 · Cited by 70 · see citing works
Custom-Molded Offloading Footwear Effectively Prevents Recurrence and Amputation, and Lowers Mortality Rates in High-Risk Diabetic Foot Patients: A Multicenter, Prospective Observational Study
Zhang, X., Wang, H., Du, C., Fan, X., Cui, L., Chen, H., Deng, F., Tong, Q., He, M., Yang, M., et al. (2022) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s341364 · Cited by 70 · cited 1× · see citing works
“74,98,108 Achieving higher adherence is a challenge, especially because attempts at finding factors associated with adherence consistently show only low explained variance.”
Background
The use of orthotic devices to correct plantar callus in people with diabetes
Colagiuri, S., Marsden, L., Naidu, V., & Taylor, L. R. (1995) · Diabetes Research and Clinical Practice · doi:10.1016/0168-8227(95)01050-n · Cited by 68 · see citing works
Losing a foot versus losing a dollar; a systematic review of cost studies in diabetic foot complications
Petrakis, I. E., Kyriopoulos, I., Ginis, A., & Athanasakis, K. (2017) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2017.1305891 · Cited by 68 · see citing works
Outpatient percutaneous flexor tenotomies for management of diabetic claw toe deformities with ulcers: a preliminary report.
Tamir, E., McLaren, A., Gadgil, A., & Daniels, T. R. (2008) · PubMed Central · Cited by 66 · see citing works
Effect of Metatarsal Pad Placement on Plantar Pressure in People with Diabetes Mellitus and Peripheral Neuropathy
Hastings, M. K., Mueller, M. J., Pilgram, T. K., Lott, D. J., Commean, P. K., & Johnson, J. E. (2007) · Foot & Ankle International · doi:10.3113/fai.2007.0015 · Cited by 66 · see citing works
The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe
van Netten, J. J., Bril, A., & van Baal, J. G. (2013) · Journal of Foot and Ankle Research · doi:10.1186/1757-1146-6-3 · Cited by 66 · see citing works
Effects of a Short Educational Program for the Prevention of Foot Ulcers in High-Risk Patients: A Randomized Controlled Trial
Monami, M., Zannoni, S., Gaias, M., Nreu, B., Marchionni, N., & Mannucci, E. (2015) · International Journal of Endocrinology · doi:10.1155/2015/615680 · Cited by 65 · see citing works
Beneficial effects of foot care nursing for people with diabetes mellitus: an uncontrolled before and after intervention study
Fujiwara, Y., Kishida, K., Terao, M., Takahara, M., Matsuhisa, M., Funahashi, T., Shimomura, I., & Shimizu, Y. (2011) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2011.05640.x · Cited by 65 · see citing works
Effectiveness of at-home skin temperature monitoring in reducing the incidence of foot ulcer recurrence in people with diabetes: a multicenter randomized controlled trial (DIATEMP)
Bus, S. A., de Stegge, W. B. A., van Baal, J. G., Busch‐Westbroek, T. E., Nollet, F., & van Netten, J. J. (2021) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2021-002392 · Cited by 65 · cited 3× · see citing works
“Results will be presented per intervention, and within intervention for different outcomes.”
Background
A preventative foot care programme for people with diabetes with different stages of neuropathy
Calle‐Pascual, A. L., Durán, A., Benedı́, A., Calvo, M. I., CHARRO, A. L., Diaz, J. A., Calle, J. R., Gil, E. C., Marañes, J. P., & Cabezas-Cerrato, J. (2002) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(02)00024-4 · Cited by 64 · cited 1× · see citing works
“…1–3) with abundant callus, thickened nails, or pre ‐ ulcerative sign on the apex or dorsal surface of a non ‐ rigid hammertoe, flexor tenotomy may reduce the risk of developing a toe ulcer (Certainty: Low; downgraded from moderate [1 RCT] to low because of the risk of bias [incomplete reporting]).”
Background
Optimised cushioning in diabetic footwear can significantly enhance their capacity to reduce plantar pressure
Chatzistergos, P., Gatt, A., Formosa, C., Farrugia, K., & Chockalingam, N. (2020) · Gait & Posture · doi:10.1016/j.gaitpost.2020.05.009 · Cited by 64 · see citing works
The ‘Step by Step’ Diabetic Foot Project in Tanzania: a model for improving patient outcomes in less-developed countries
Abbas, Z. G., Lutale, J. K., Bakker, K., Baker, N., & Archibald, L. K. (2011) · International Wound Journal · doi:10.1111/j.1742-481x.2010.00764.x · Cited by 63 · cited 1× · see citing works
“…people with diabetes at risk for ulceration (IWGDF 1–3) with abundant callus, thickened nails, or pre ‐ ulcerative sign on the apex or dorsal surface of a non ‐ rigid hammertoe, flexor tenotomy may reduce the risk of developing a toe ulcer (Certainty: Low; downgraded from moderate [1 RCT] to low…”
Background
Effect of customized insoles on vertical plantar pressures in sites of previous neuropathic ulceration in the diabetic foot
Raspovic, A., Newcombe, L., Lloyd, J., & Dalton, E. (2000) · The Foot · doi:10.1054/foot.2000.0604 · Cited by 62 · see citing works
Effectiveness and Safety of Using Podikon Digital Silicone Padding in the Primary Prevention of Neuropathic Lesions in the Forefoot of Diabetic Patients
Scirè, V., Leporati, E., Teobaldi, I., Laura, A. N., Rizzo, L., & Piaggesi, A. (2009) · Journal of the American Podiatric Medical Association · doi:10.7547/0980028 · Cited by 62 · see citing works
State of the art design protocol for custom made footwear for people with diabetes and peripheral neuropathy
Bus, S. A., Zwaferink, J. B. J., Dahmen, R., & Busch‐Westbroek, T. E. (2019) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3237 · Cited by 60 · cited 2× · see citing works
“Algorithms to facilitate this process have been designed, 149 as an update of an algorithm with proven effectiveness.”
BackgroundMethod
Efficacy of injected liquid silicone in the diabetic foot to reduce risk factors for ulceration: a randomized double-blind placebo-controlled trial.
van Schie, C. H. M., Whalley, A., Vileikytė, L., Wignall, T., Hollis, S., & Boulton, A. J. M. (2000) · Diabetes Care · doi:10.2337/diacare.23.5.634 · Cited by 59 · see citing works
Reduction in Foot Ulcer Incidence
Calle‐Pascual, A. L., Durán, A., Benedı́, A., Calvo, M. I., CHARRO, A. L., Diaz, J. A., Calle, J. R., Gil, E. C., Ibarra, J., Marañes, J. P., et al. (2001) · Diabetes Care · doi:10.2337/diacare.24.2.405 · Cited by 59 · see citing works
Effectiveness of offloading interventions for people with diabetes-related foot ulcers: a systematic review and meta analysis.
Lazzarini, P. A., Armstrong, D. G., Crews, R. T., Gooday, C., Jarl, G., Kirketerp‐Moller, K., Viswanathan, V., & Bus, S. A. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3650 · Cited by 57 · cited 1× · see citing works
“115 As a result, we included two surgical interventions for this systematic review: flexor tenotomy and nerve decompression.”
Method
Percutaneous flexor tenotomy for preventing and treating toe ulcers in people with diabetes mellitus
Rasmussen, A., Christensen, U. B., Almdal, T., & Holstein, P. (2013) · Journal of Tissue Viability · doi:10.1016/j.jtv.2013.04.001 · Cited by 56 · see citing works
Adherence to wearing therapeutic shoes among people with diabetes: a systematic review and reflections
Jarl, G. M., & Lundqvist, L. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s112275 · Cited by 56 · cited 1× · see citing works
“152,153 However, promising findings from two non ‐ controlled studies suggest that specific footwear for indoor use may improve adherence, 109,110 and this is currently being tested as part of an integrated approach (NCT05236660).”
Background
Meta‐analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes‐related foot ulcers
Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., & Golledge, J. (2020) · Diabetic Medicine · doi:10.1111/dme.14323 · Cited by 56 · cited 3× · see citing works
“10,11 A recent overview of systematic reviews in this field even found that more systematic reviews than RCTs exist on the topic of ulcer prevention.”
BackgroundResult
Chiropody May Prevent Amputations in Diabetic Patients on Peritoneal Dialysis
Lipscombe, J., Jassal, S. V., Bailey, S., Bargman, J. M., Vas, S. I., & Oreopoulos, D. G. (2003) · Peritoneal Dialysis International · doi:10.1177/089686080302300307 · Cited by 55 · see citing works
Two-Year Foot Care Program for Minority Patients with Type 2 Diabetes Mellitus of Zhuang Tribe in Guangxi, China
Liang, R., Dai, X., Zuojie, L., Zhou, A., & Meijuan, C. (2012) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2011.08.002 · Cited by 53 · see citing works
Optimizing footwear for the diabetic foot: Data-driven custom-made footwear concepts and their effect on pressure relief to prevent diabetic foot ulceration
Zwaferink, J. B. J., Custers, W., Paardekooper, I., Berendsen, H. A., & Bus, S. A. (2020) · PLoS ONE · doi:10.1371/journal.pone.0224010 · Cited by 53 · see citing works
Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review
van Netten, J. J., Raspovic, A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Sacco, I. C. N., & Bus, S. A. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3270 · Cited by 52 · see citing works
The effect of silicone injections in the diabetic foot on peak plantar pressure and plantar tissue thickness: A 2-year follow-up
van Schie, C. H. M., Whalley, A., Armstrong, D. G., Vileikytė, L., & Boulton, A. J. M. (2002) · Archives of Physical Medicine and Rehabilitation · doi:10.1053/apmr.2002.33058 · Cited by 51 · see citing works
Evaluation of orthotic insoles for people with diabetes who are at‐risk of first ulceration
Martínez-Santos, A., Preece, S. J., & Nester, C. (2019) · Journal of Foot and Ankle Research · doi:10.1186/s13047-019-0344-z · Cited by 49 · see citing works
The Role of Foot-Loading Factors and Their Associations with Ulcer Development and Ulcer Healing in People with Diabetes: A Systematic Review
Hulshof, C. M., van Netten, J. J., Pijnappels, M. A. G. M., & Bus, S. A. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9113591 · Cited by 49 · cited 2× · see citing works
“…the smart insoles developed and tested in this study is that they do not measure peak plantar pressure (for which evidence of its association with ulceration exists 147,148 ), but a threshold of continuous low pressure that is not validated as predictive for diabetes ‐ related foot ulceration.”
Background
Prevalence of risk factors for foot ulceration in patients with end‐stage renal disease on haemodialysis
Kaminski, M. R., Frescos, N., & Tucker, S. (2011) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2011.02605.x · Cited by 48 · see citing works
The insole materials influence the plantar pressure distributions in diabetic foot with neuropathy during different walking activities
Nouman, M., Dissaneewate, T., Leelasamran, W., & Chatpun, S. (2019) · Gait & Posture · doi:10.1016/j.gaitpost.2019.08.023 · Cited by 47 · see citing works
Patient education for the prevention of diabetic foot ulcers
Gershater, M. A., Pilhammar, E., Apelqvist, J., & Alm‐Roijer, C. (2011) · European Diabetes Nursing · doi:10.1002/edn.189 · Cited by 46 · cited 1× · see citing works
“The 2 RCTs that did not show any effect included a single educational session only, 29,30 whereas the new RCT with a large effect included quarterly follow ‐ up.”
Background
Recurrence and Prevention of Diabetic Foot Ulcers after Total Contact Casting
Frigg, A., Pagenstert, G., Schäfer, D. J., Valderrábano, V., & Hintermann, B. (2007) · Foot & Ankle International · doi:10.3113/fai.2007.0012 · Cited by 43 · see citing works
Low Long-Term Risk of Foot Ulcer Recurrence After Nerve Decompression in a Diabetes Neuropathy Cohort
Nickerson, D. S., & Rader, A. J. (2013) · Journal of the American Podiatric Medical Association · doi:10.7547/1030380 · Cited by 42 · see citing works
Evaluation of a multidisciplinary consultation of diabetic foot
Hamonet, J., Verdié-Kessler, C., Daviet, J., Denes, É., Hoang, C. L. N., Salle, J.-Y., & Munoz, M. (2010) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2010.04.001 · Cited by 39 · cited 1× · see citing works
“We found 5 non ‐ controlled studies all reporting lower ulcer incidence during periods when integrated preventive care was available compared to periods when such care was not available, 135–137 or in participants adherent to integrated care compared to participants non ‐ adherent.”
Background
Risk assessments and structured care interventions for prevention of foot ulceration in diabetes: development and validation of a prognostic model
Crawford, F., Chappell, F. M., Lewsey, J., Riley, R. D., Hawkins, N., Nicolson, D., Heggie, R., Smith, M. C., Horne, M., Amanna, A. E., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24620 · Cited by 39 · cited 1× · see citing works
“Despite the importance of this topic, with various publications contributing to this debate, 164,165 ulcer risk classification is only considered an intervention when a classification is linked directly to a strategy based on the referral of people for treatment.”
Background
Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review
Chen, P., Campillo-Vilorio, N., Dhatariya, K., Jeffcoate, W. J., Lobmann, R., McIntosh, C. D., Piaggesi, A., Steinberg, J. S., VAS, P. R., Viswanathan, V., et al. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3786 · Cited by 37 · see citing works
Nerve Decompression After Diabetic Foot Ulceration May Protect Against Recurrence
Nickerson, D. S., & Rader, A. J. (2014) · Journal of the American Podiatric Medical Association · doi:10.7547/0003-0538-104.1.66 · Cited by 36 · see citing works
The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy
Lin, T., Sheen, H., Chung, C., Yang, S., Lin, S., Luo, H., Chen, C., Chan, I., Shih, H. S., & Sheu, W. H. (2013) · Journal of Foot and Ankle Research · doi:10.1186/1757-1146-6-29 · Cited by 36 · see citing works
Reduction of peak plantar pressure in people with diabetes‐related peripheral neuropathy: an evaluation of the DH Pressure Relief Shoe™
Raspovic, A., Landorf, K. B., Gazarek, J., & Stark, M. (2012) · Journal of Foot and Ankle Research · doi:10.1186/1757-1146-5-25 · Cited by 35 · see citing works
Predictors of adherence to wearing therapeutic footwear among people with diabetes
Jarl, G. M., Tranberg, R., Johansson, U., Alnemo, J., & Lundqvist, L. (2020) · Journal of Foot and Ankle Research · doi:10.1186/s13047-020-00413-z · Cited by 35 · cited 1× · see citing works
“45 Thedrawbackof the smart insoles developed and tested in this study is that they do not measure peak plantar pressure (for which evidence of its association with ulceration exists 147,148 ), but a threshold of continuous low pressure that is not validated as predictive for diabetes ‐ related foot…”
Background
Clinical and biomechanical effectiveness of foot‐ankle exercise programs and weight‐bearing activity in people with diabetes and neuropathy: A systematic review and meta‐analysis
van Netten, J. J., Sacco, I. D. C. N., Lavery, L. A., Monteiro‐Soares, M., Paton, J. S., Rasmussen, A., Raspovic, A., & Bus, S. A. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3649 · Cited by 35 · see citing works
Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear
Kavros, S. J., Straaten, M. G. V., Wood, K. A. C., & Kaufman, K. R. (2011) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2011.03.009 · Cited by 34 · see citing works
Development and preliminary evaluation of a psychosocial intervention for modifying psychosocial risk factors associated with foot re-ulceration in diabetes
Vedhara, K., Beattie, A., Metcalfe, C. D., Roche, S., Weinman, J. A., Cullum, N. A., Price, P., Dayan, C. M., Cooper, A. R., Campbell, R. M., et al. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.02.013 · Cited by 34 · see citing works
Avaliação de um programa para prevenção de úlceras neuropáticas em portadores de diabetes
Cisneros, L. D. L. (2010) · Brazilian Journal of Physical Therapy · doi:10.1590/s1413-35552010000100006 · Cited by 32 · see citing works
Low Recurrence Rate of Diabetic Foot Ulcer After Nerve Decompression
Nickerson, D. S. (2010) · Journal of the American Podiatric Medical Association · doi:10.7547/1000111 · Cited by 31 · see citing works
High Plantar Pressure and Callus in Diabetic Adolescents
Duffin, A. C., Kidd, R., Chan, A. K. F., & Donaghue, K. C. (2003) · Journal of the American Podiatric Medical Association · doi:10.7547/87507315-93-3-214 · Cited by 31 · see citing works
Custom-made footwear designed for indoor use increases short-term and long-term adherence in people with diabetes at high ulcer risk
Keukenkamp, R., van Netten, J. J., Busch‐Westbroek, T. E., & Bus, S. A. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2021-002593 · Cited by 31 · cited 1× · see citing works
“…the smart insoles developed and tested in this study is that they do not measure peak plantar pressure (for which evidence of its association with ulceration exists 147,148 ), but a threshold of continuous low pressure that is not validated as predictive for diabetes ‐ related foot ulceration.”
Background
Prevalence of risk factors for foot ulceration in a general haemodialysis population
Jones, N. J., Chess, J. A., Cawley, S., Phillips, A. O., & Riley, S. (2012) · International Wound Journal · doi:10.1111/j.1742-481x.2012.01044.x · Cited by 30 · cited 1× · see citing works
“Contrary to flexor tenotomy, studies on nerve decompression still suffer from having inadequate standard care comparators and descriptors.”
Background
Flexor tendon tenotomy treatment of the diabetic foot: a multicenter randomized controlled trial.
Askø Andersen, J., Rasmussen, A., Engberg, S., Bencke, J., Frimodt-Møller, M., Kirketerp-Møller, K., & Rossing, P. (2022) · Diabetes Care · doi:10.2337/dc22-0085 · Cited by 29 · cited 2× · see citing works
“PICO : In people with diabetes at risk for foot ulceration, can surgical interventions, in comparison to no surgery, help improve selected outcomes (Table 1)?”
BackgroundResult
Intensified insulin treatment is associated with improvement in skin microcirculation and ischaemic foot ulcer in patients with type 1 diabetes mellitus: a long-term follow-up study
Rathsman, B., Jensen‐Urstad, K., & Nyström, T. (2014) · Diabetologia · doi:10.1007/s00125-014-3248-2 · Cited by 27 · cited 1× · see citing works
“As a result, there is no evidence to suggest that there are benefits of nerve decompression in ulcer b S h a d e d a r e a m e a n s t h i s ou t c o m e w a s i n c l u d e d i n t h e s t u d y , w i t h g r ee n m e a n i n g i n t e r v e n t i on s t a t i s t i c a ll y s i g n i fi c a n t l…”
Background
Stratification of foot risk predicts the incidence of new foot disease, but do we yet know that the adoption of routine screening reduces it?
Jeffcoate, W. J. (2011) · Diabetologia · doi:10.1007/s00125-011-2075-y · Cited by 27 · cited 1× · see citing works
“However, this still provides evidence of the preventative effect of these programs, further supported by seven non ‐ controlled studies that consistently showed beneficial effects of integrated care programs.”
Result
Can the use of a topical antifungal nail lacquer reduce risk for diabetic foot ulceration? Results from a randomised controlled pilot study
Armstrong, D. G., Holtz, K., & Wu, S. (2005) · International Wound Journal · doi:10.1111/j.1742-4801.2005.00097.x · Cited by 25 · cited 1× · see citing works
“Summary of the literature : We found 1 RCT, 43 investigating if mobile ‐ health to prompt the use of a liquid crystal ‐ based foot thermometer (text messages and voice reminders) improved adherence to temperature measurements, compared to participants provided with the same thermometer without…”
Background
Users’ needs and expectations and the design of a new custom-made indoor footwear solution for people with diabetes at risk of foot ulceration
Keukenkamp, R., van Netten, J. J., Busch‐Westbroek, T. E., Nollet, F., & Bus, S. A. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.2003878 · Cited by 25 · cited 1× · see citing works
“152,153 However, promising findings from two non ‐ controlled studies suggest that specific footwear for indoor use may improve adherence, 109,110 and this is currently being tested as part of an integrated approach (NCT05236660).”
Background
How Effective Is Orthotic Treatment in Patients with Recurrent Diabetic Foot Ulcers?
Fernández, M. L. G., Lozano, R. M., Diaz, M. I. G.-Q., Jurado, M. A. G., Hernández, D. M., & Montesinos, J. V. B. (2013) · Journal of the American Podiatric Medical Association · doi:10.7547/1030281 · Cited by 23 · see citing works
Lower resource utilization for patients with healed diabetic foot ulcers during participation in a prevention program with foot temperature monitoring
Isaac, A. L., Swartz, T. D., Miller, M. L., Short, D. J., Wilson, E. A., Chaffo, J. L., Watson, E. S., Hu, H., Petersen, B. J., Bloom, J. D., et al. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001440 · Cited by 22 · cited 5× · see citing works
“One non ‐ controlled study found no difference in ulcer recurrence between a period with and without temperature monitoring (0.84 vs. 0.87 per participant ‐ year respectively 41 ).”
BackgroundInfluential
Importance of Footwear Outsole Rigidity in Improving Spatiotemporal Parameters in Patients with Diabetes and Previous Forefoot Ulcerations
López‐Moral, M., Molines-Barroso, R. J., Álvaro‐Afonso, F. J., Uccioli, L., Senneville, É., & Lázaro‐Martínez, J. L. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9040907 · Cited by 21 · see citing works
Adherence to at-Home Monitoring of Foot Temperatures in People with Diabetes at High Risk of Ulceration
Rovers, F. J., van Netten, J. J., Busch‐Westbroek, T. E., de Stegge, W. B. A., & Bus, S. A. (2022) · The International Journal of Lower Extremity Wounds · doi:10.1177/15347346221114565 · Cited by 21 · cited 1× · see citing works
“…subset analysis that the skin does not always heat up before it breaks down, 142 adherence to measuring temperature on a daily basis is challenging, 143 as is activity ‐ changing behaviour when a hotspot is found, and the necessity to do such measurements on a daily basis may even reduce the…”
Background
A randomised controlled trial and cost‐consequence analysis of traditional and digital foot orthoses supply chains in a National Health Service setting: application to feet at risk of diabetic plantar ulceration
Parker, D., Nuttall, G. H., Bray, N., Hugill, T., Martínez-Santos, A., Edwards, R. T., & Nester, C. (2019) · Journal of Foot and Ankle Research · doi:10.1186/s13047-018-0311-0 · Cited by 20 · see citing works
Effect of a carbon reinforcement for maximizing shoe outsole bending stiffness on plantar pressure and walking comfort in people with diabetes at high risk of foot ulceration
Zwaferink, J. B. J., Custers, W., Paardekooper, I., Berendsen, H. A., & Bus, S. A. (2021) · Gait & Posture · doi:10.1016/j.gaitpost.2021.04.010 · Cited by 18 · see citing works
Konfektionierte Spezialschuhe zur Ulkusrezidivprophylaxe beim diabetischen Fußsyndrom
Striesow, F. (1998) · Medizinische Klinik - Intensivmedizin und Notfallmedizin · doi:10.1007/bf03044805 · Cited by 18 · see citing works
Foot thermometry with mHeath-based supplementation to prevent diabetic foot ulcers: A randomized controlled trial
Lazo‐Porras, M., Bernabé‐Ortiz, A., Taype-Rondán, Á., Gilman, R. H., Málaga, G., Manrique, H. A., Neyra, L., Calderon, J., Pinto, M. E., Armstrong, D. G., et al. (2020) · Wellcome Open Research · doi:10.12688/wellcomeopenres.15531.1 · Cited by 17 · see citing works
Preventive treatment of foot deformities in Type 1 diabetic patients aged 15–50 years – an epidemiological and prospective study
Borssén, B., Bergenheim, T. A., & Lithner, F. (1996) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.1996.37866000.x · Cited by 16 · see citing works
The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study
Andersen, J. A., Rasmussen, A., Frimodt‐Møller, M., Rossing, P. R., Kirketerp‐Møller, K., & Engberg, S. (2019) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2019.100208 · Cited by 16 · see citing works
The Effect of Percutaneous Flexor Tenotomy on Healing and Prevention of Foot Ulcers in Patients With Claw Deformity of the Toe
Schmitz, P. P., Scheffer, R., Gier, S. D., Krol, R. M., van der Veen, D., & Smeets, L. (2019) · The Journal of Foot & Ankle Surgery · doi:10.1053/j.jfas.2019.03.004 · Cited by 16 · see citing works
Does the skin heat up before it breaks down in diabetic foot ulceration?
de Stegge, W. B. A., van Netten, J. J., & Bus, S. A. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3621 · Cited by 15 · see citing works
(Cost-)effectiveness of lower extremity nerve decompression surgery in subjects with diabetes: the DeCompression (DECO) trial—study protocol for a randomised controlled trial
Rinkel, W. D., Fakkel, T. M., Cabezas, M. C., Birnie, E., & Coert, J. H. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-035644 · Cited by 14 · see citing works
Reliability of the evidence to guide decision-making in foot ulcer prevention in diabetes: an overview of systematic reviews
Crawford, F., Nicolson, D. J., Amanna, A. E., & Smith, M. C. (2022) · BMC Medical Research Methodology · doi:10.1186/s12874-022-01738-y · Cited by 14 · cited 1× · see citing works
“12 However, the usefulness of these systematic reviews in informing best practice is limited, because of (a combination of) three key shortcomings: (i) focusing on one intervention only, thereby not providing a comprehensive and balanced analysis of all therapeutic options for ulcer prevention;…”
Background
A Longitudinal Investigation into the Functional and Physical Durability of Insoles Used for the Preventive Management of Neuropathic Diabetic Feet
Paton, J. S., Stenhouse, E., Bruce, G., & Jones, R. B. (2014) · Journal of the American Podiatric Medical Association · doi:10.7547/0003-0538-104.1.50 · Cited by 13 · see citing works
Análisis de las reulceraciones en una unidad multidisciplinar de pie diabético tras la implementación de un programa de cuidado integrado del pie
Jiménez, S., Rubio, J. A., Álvarez, J., & Lázaro‐Martínez, J. L. (2018) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2018.03.012 · Cited by 13 · see citing works
Biomechanical and musculoskeletal changes after flexor tenotomy to reduce the risk of diabetic neuropathic toe ulcer recurrence
Mens, M. A., van Netten, J. J., Busch‐Westbroek, T. E., Bus, S. A., Streekstra, G. J., Wellenberg, R. H. H., Maas, M. M., Nieuwdorp, M., & Stufkens, S. A. S. (2021) · Diabetic Medicine · doi:10.1111/dme.14761 · Cited by 12 · see citing works
Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy
Agarwal, P., Sharma, B., & Sharma, D. (2019) · Journal of Clinical Orthopaedics and Trauma · doi:10.1016/j.jcot.2019.08.014 · Cited by 11 · see citing works
Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes
Hellstrand, S., Sundberg, L., Karlsson, J., Zügner, R., Tranberg, R., & Tang, U. H. (2020) · Environment Development and Sustainability · doi:10.1007/s10668-020-00901-z · Cited by 11 · see citing works
The effect of transitional care on the prevention of diabetic foot ulcers in patients at high risk for diabetic foot
Jian-ping, L., Chen, T., Wang, S., & Liu, H. (2019) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-019-00736-z · Cited by 10 · cited 2× · see citing works
“In people with diabetes at risk for foot ulceration, integrated foot care may reduce the risk of foot ulceration (Certainty: Low; downgraded from high [3 RCTs] to low because of imprecision and publication bias [1 unpub-lished study]).”
Background
Our experience of reinnervation of sole in diabetic sensorimotor polyneuropathy: A chance to change the natural history of disease
Agarwal, P., & Sharma, D. (2021) · Journal of Clinical Orthopaedics and Trauma · doi:10.1016/j.jcot.2021.01.007 · Cited by 10 · see citing works
Prévention des plaies du pied chez les diabétiques à haut risque par une méthode innovante d’appareillage par podo-orthèses sur mesure. Étude prospective
Tazi, O., & Debure, C. (2008) · Journal des Maladies Vasculaires · doi:10.1016/j.jmv.2008.09.003 · Cited by 9 · see citing works
Insoles to ease plantar pressure in people with diabetes and peripheral neuropathy: a feasibility randomised controlled trial with an embedded qualitative study
Collings, R., Freeman, J. A., Latour, J. M., Hosking, J., & Paton, J. S. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01252-y · Cited by 9 · see citing works
Polyurethane foam sheets for relieving pressure from diabetic neuropathic plantar ulcers: a pilot study
A Piaggesi, M. R. (2000) · Journal of Dermatological Treatment · doi:10.1080/09546630050517667 · Cited by 8 · see citing works
Orthopädische Maßschuhversorgung bei Diabetikern
Illgner, U., Wühr, J., Rümmler, M., Drerup, B., & Wetz, H. H. (2009) · Der Orthopäde · doi:10.1007/s00132-009-1507-6 · Cited by 8 · see citing works
A new application of the Rotterdam Diabetic Foot Study Test Battery: grading pedal sensory loss to predict the risk of foot ulceration
Rinkel, W. D., Cabezas, M. C., & Coert, J. H. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108836 · Cited by 6 · cited 1× · see citing works
“Despite the importance of this topic, with various publications contributing to this debate, 164,165 ulcer risk classification is only considered an intervention when a classification is linked directly to a strategy based on the referral of people for treatment.”
Background
Clinical Efficacy of a 3D Foot Scanner app for the Fitting of Therapeutic Footwear in Persons with Diabetes in Remission: A Randomized and Controlled Clinical Trial
López‐Moral, M., Molines-Barroso, R. J., García‐Álvarez, Y., Álvaro‐Afonso, F. J., García‐Madrid, M., & Lázaro‐Martínez, J. L. (2022) · The International Journal of Lower Extremity Wounds · doi:10.1177/15347346221124645 · Cited by 5 · see citing works
Plantar pressure: Comparing two Poron insoles
Cumming, A. W., & Bayliff, T. (2011) · Cited by 4 · see citing works
The Evaluation of Foot Rockers on the Kinematic Parameters of Individuals With Diabetes
Karimi, M. T. (2017) · Foot & Ankle Specialist · doi:10.1177/1938640017729500 · Cited by 3 · cited 1× · see citing works
“Plantar pressure was lower in therapeutic insoles/footwear (1 cohort, 53 18 non ‐ controlled studies 54–72 ) compared to individuals' own footwear or standard conditions tested in cross ‐ sectional studies.”
Result
268-OR: Cost-Effectiveness and Cost Utility of At-Home Foot Skin Temperature Monitoring for Ulcer Prevention in People with Diabetes: A Multicenter Randomized Controlled Trial (diatemp)
van Netten, J. J., de Stegge, W. B. A., Dijkgraaf, M. G. W., & Bus, S. A. (2021) · Diabetes · doi:10.2337/db21-268-or · Cited by 3 · cited 1× · see citing works
“With the emergence of a new RCT in a mixed group of people with moderate to high risk of ulceration, 33 our meta ‐ analysis resulted in a relative risk ratio of 0.66, suggesting education can help prevent ulceration.”
BackgroundInfluential
[Percutaneous needle flexor tendon tenotomy to prevent diabetic foot ulcers].
Busch‐Westbroek, T. E., Mens, M. A., van Netten, J. J., Bus, S. A., Nieuwdorp, M., & Stufkens, S. A. S. (2021) · PubMed · Cited by 2 · see citing works

Flagged first, then by citations

Research works printed but not linked: 7

Jeffcoate WJ, Bus SA, Game FL, et al. Reporting standards of studies and papers on the prevention and management of foot ulcers in diabetes: required details and markers of good quality. Lancet Diabetes Endocrinol. 2016;4(9):781-788. https://doi.org/10. 1016/s2213-8587(16)30012-2 · DOI
van NETTEN ET AL. -27 of 31 15207560, 0, · DOI
Reike H, Bruning A, Rischbieter E, Vogler F, Angelkort B. Recur- rence of foot lesions in patients with diabetic foot syndrome: in- fluence of custom-molded orthotic device. Diabetes Stoffwechs. 1997(6):107-113.
Baumann R. Efficacy of industrially produced protective footwear for the 'diabetic foot': an observational study. Diabetes Stoffwechs. 1996;5:107-112 (German).
Albert SF, Christensen LC. Rigid foot orthoses in the treatment of the neuropathic diabetic foot. Low Extrem. 1996;3:97-105.
Piaggesi A, Romanelli M, Fallani E, Baccetti F, Navalesi R. Poly- urethane foam sheets for relieving pressure from diabetic neuro- pathic plantar ulcers. J Dermatol Treat. 2000;11(1):39-42.
Rogers K, Otter SJ, Birch I. The effect of PORON and plastazote insoles on forefoot plantar pressures. Br J Podiatry. 2006;9(4): 111-114.

Sorted by citations

Diabetic Foot Ulcers
Armstrong, D. G., Tan, T.-W., Boulton, A. J. M., & Bus, S. A. (2023) · JAMA · doi:10.1001/jama.2023.10578 · Cited by 1,658 · see citing works
Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update).
Schaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F., Monteiro‐Soares, M., Senneville, E., & the IWGDF Editorial Board (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3657 · Cited by 583 · see citing works
Self-citation
Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)
Bus, S. A., Sacco, I. D. C. N., Monteiro‐Soares, M., Raspovic, A., Paton, J. S., Rasmussen, A., Lavery, L. A., & van Netten, J. J. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3651 · Cited by 298 · see citing works
“…(IWGDF risk 3), prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking, to help prevent a recurrent plantar foot ulcer; furthermore, encourage the person to consistently wear this prescribed footwear, both indoors and outdoors (Strong; Moderate) 9.”
Influential
A new declaration for feet's sake: Halving the global diabetic foot disease burden from 2% to 1% with next generation care
Lazzarini, P. A., Raspovic, K. M., Meloni, M., & van Netten, J. J. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3747 · Cited by 70 · see citing works
Clinical and biomechanical effectiveness of foot‐ankle exercise programs and weight‐bearing activity in people with diabetes and neuropathy: A systematic review and meta‐analysis
van Netten, J. J., Sacco, I. D. C. N., Lavery, L. A., Monteiro‐Soares, M., Paton, J. S., Rasmussen, A., Raspovic, A., & Bus, S. A. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3649 · Cited by 35 · see citing works
Offloading and adherence through technological advancements: Modern approaches for better foot care in diabetes
Bus, S., Reeves, N. D., Armstrong, D. G., & Najafi, B. (2024) · Diabetes/Metabolism Research Reviews · doi:10.1002/dmrr.3769 · Cited by 22 · see citing works
“58 This study recruited 90 participants with diabetic neuropathy and previous DFU, with participants randomly assigned to control (smart insole and watch but no pressure feed-back) and intervention (smart insole, smart watch and high ‐ pressure feedback) groups.”
Background
The effectiveness of a thermography-driven preventive foot care protocol on the recurrence of diabetic foot ulcers in low-medical resource settings: An open-labeled randomized controlled trial
Qin, Q., Oe, M., Nakagami, G., Kashiwabara, K., Sugama, J., Sanada, H., & Jais, S. (2023) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2023.104571 · Cited by 19 · see citing works
Podcast on the IWGDF 2023 Guidelines on the Prevention of Foot Ulcers in Persons with Diabetes
Bus, S. A., & van Netten, J. J. (2024) · Diabetes Therapy · doi:10.1007/s13300-024-01578-7 · Cited by 18 · see citing works
Oxidative stress and programmed cell death in diabetic wounds: A comprehensive review
Hong, L., Li, M., & Fan, Y. (2025) · Science Progress · doi:10.1177/00368504251370676 · Cited by 21 · see citing works
The International Working Group on the Diabetic Foot: Stories and Numbers Behind Three Decades of Evidence-Based Guidelines for the Management of Diabetes-Related Foot Disease
van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F. L., Monteiro‐Soares, M., Senneville, É., & Schaper, N. C. (2023) · Diabetes Therapy · doi:10.1007/s13300-023-01510-5 · Cited by 21 · see citing works
The quest for wellness: How to optimise self‐care strategies for diabetic foot management?
Pouwer, F., Perrin, B., Lavender, A., Najafi, B., Ismail, K., & Vileikytė, L. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3751 · Cited by 14 · see citing works
Prevention of foot ulcers recurrence in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials for the development of the italian guidelines for the treatment of diabetic foot syndrome
ROS, R. D., Volpe, A., Bordieri, C., Tramonta, R., Bernetti, A., Scatena, A., Monge, L., Ragghianti, B., Silverii, G. A., Uccioli, L., et al. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02353-7 · Cited by 13 · see citing works
Footwear fit as a causal factor in diabetes‐related foot ulceration: A systematic review
Jones, P. J., Armstrong, D. G., Frykberg, R. G., Davies, M. J., & Rowlands, A. V. (2024) · Diabetic Medicine · doi:10.1111/dme.15407 · Cited by 12 · see citing works
Foot care behaviours and associated factors among patients with type 2 diabetes: A cross-sectional study
Ang, C., Goh, K. F. I., Lodh, N., Qin, V. M., Liew, H., Sidhu, H. R. S., Ng, J. J., Subramaniam, T., Tan, E., Koh, G. C., et al. (2024) · Journal of Global Health · doi:10.7189/jogh.14.04145 · Cited by 16 · see citing works
“Evidence-based diabetic FC behaviours have proven to be a cost-effective and essential primary preventive measure for DFUs and related complications [17,18].”
Background
Update on the impact of lipid and glucose control on diabetic wound healing
Rui, S., Xu, Y., Ji, Z., Li, X., Tao, Z., Luo, W., Yao, Y., Chen, L., & Ma, G. (2025) · Metabolism Open · doi:10.1016/j.metop.2025.100408 · Cited by 12 · see citing works
Unlocking the multidimensionality of plantar pressure measurements for the evaluation of footwear in people with diabetes
Vossen, L. E., Bus, S. A., & van Netten, J. J. (2025) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2025.112502 · Cited by 10 · see citing works
Adherence to wearing prescribed footwear in people at risk of diabetes‐related foot ulcers
Jarl, G. M., Hulshof, C. M., Tijhuis, K. A., Busch‐Westbroek, T. E., Bus, S. A., & van Netten, J. J. (2024) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70002 · Cited by 10 · see citing works
“This adherence level is concerning, as it has been associated with higher risk of foot ulceration [2, 26].”
Background
The unique multidisciplinarity of diabetes‐related foot disease
van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F. L., Monteiro‐Soares, M., Senneville, É., & Schaper, N. C. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3804 · Cited by 10 · see citing works
An integrated personalized assistive devices approach to reduce the risk of foot ulcer recurrence in diabetes (DIASSIST): study protocol for a multicenter randomized controlled trial
Vossen, L. E., van Netten, J. J., Bakker, C. D., Berendsen, H. A., Busch‐Westbroek, T. E., Peters, E. J. G., Sabelis, L. W. E., Dijkgraaf, M. G. W., & Bus, S. A. (2023) · Trials · doi:10.1186/s13063-023-07635-z · Cited by 9 · see citing works
‘Nutrition has everything to do with wound healing’—health professionals' perceptions of assessment and management of nutrition in individuals with diabetes‐related foot ulceration
Donnelly, H. R., Clarke, E. D., Collins, C. E., & Tehan, P. E. (2024) · International Wound Journal · doi:10.1111/iwj.14898 · Cited by 9 · see citing works
The effect of calcaneus and metatarsal head offloading insoles on healthy subjects’ gait kinematics, kinetics, asymmetry, and the implications for plantar pressure management: A pilot study
Shuang, J., Haron, A. H., Massey, G. J., Mansoubi, M., Dawes, H., Bowling, F. L., Reeves, N. D., Weightman, A., & Cooper, G. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303826 · Cited by 8 · see citing works
Residual diabetic foot osteomyelitis after surgery leads to poor clinical outcomes: A systematic review and meta‐analysis
Reyes, M. C., Suludere, M. A., Tarricone, A. N., Sajjad, T., Coye, T. L., Sideman, M. J., & Lavery, L. A. (2024) · Wound Repair and Regeneration · doi:10.1111/wrr.13215 · Cited by 8 · see citing works
Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear
Mondal, S., Lodh, M., Sahoo, S., Paul, K., Biswas, D., Krishna, C. S. M., Parida, A. K., Ganguly, A., & Dasgupta, R. (2025) · Scientific Reports · doi:10.1038/s41598-025-86013-y · Cited by 7 · see citing works
“The role of therapeutic footwear was more important for prevention of DFU recurrence than prevention of DFU in those with high risk foot 10 .”
Evaluating and mapping the evidence that screening for diabetic foot disease meets the criteria for population-wide screening: a scoping review
Pallin, J. A., Connell, L., McIntosh, C. D., Kavanagh, P., Dinneen, S. F., Kearney, P. M., & Buckley, C. M. (2024) · BMJ Public Health · doi:10.1136/bmjph-2023-000561 · Cited by 7 · see citing works
The predictive value of cumulative plantar tissue stress on future plantar foot ulceration in people with diabetes—A 12‐month prospective observational study
Hulshof, C. M., van Netten, J. J., Busch‐Westbroek, T. E., Sabelis, L. W. E., Peters, E. J. G., Pijnappels, M. A. G. M., & Bus, S. A. (2025) · Diabetic Medicine · doi:10.1111/dme.70099 · Cited by 7 · see citing works
Short-Term Efficacy of a Multi-Modal Intervention Program to Improve Custom-Made Footwear Use in People at High Risk of Diabetes-Related Foot Ulceration
van Netten, J. J., Vossen, L. E., Driebergen, F. M., Wolthuis, D., Merkx, M. J. M., & Bus, S. A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14113635 · Cited by 5 · see citing works
Comparison of 4, 8, and 12 week screening and foot care frequencies in persons in remission: The DIATIME comparative efficacy study – A randomized clinical trial
López‐Moral, M., García‐Madrid, M., García‐Morales, E., García‐Álvarez, Y., Álvaro‐Afonso, F. J., & Lázaro‐Martínez, J. L. (2025) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2025.112962 · Cited by 5 · see citing works
Recurrence rates after healing in patients with neuroischemic diabetic foot ulcers healed with and without sucrose octasulfate‐impregnated dressings: A 1‐year comparative prospective study
Lázaro‐Martínez, J. L., García‐Madrid, M., Bohbot, S., López‐Moral, M., Molines-Barroso, R. J., & García‐Álvarez, Y. (2024) · International Wound Journal · doi:10.1111/iwj.70028 · Cited by 5 · see citing works
“22 These strategies are commonly used and recommended in routine clinical practice once the patient has healed.”
Lower extremity limb salvage in diabetic patients: the impossible is possible
Galstyan, G. R., Artemova, E. V., Bardiugov, P. S., Bondarenko, O. N., Нусредовна, Д. З., Doronina, L. P., Egorova, D. N., Zaitseva, E. L., Mitish, V. A., Sergeeva, S. V., et al. (2025) · Diabetes Mellitus · doi:10.14341/dm13245 · Cited by 5 · see citing works
Design and biomechanical function of indoor-specific versus regular custom-made footwear for people with diabetes at high risk of foot ulceration
Vossen, L. E., van Netten, J. J., Busch‐Westbroek, T. E., & Bus, S. A. (2025) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2025.106605 · Cited by 4 · see citing works
Interpretable machine learning model for predicting recurrence in patients with diabetic foot ulcers
Mou, W., Shan, W., Yu, S., Rui, S., Du, C., Huo, Z., Gu, H., Armstrong, D. G., Tang, D., Wang, Y., et al. (2025) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2025-005242 · Cited by 4 · see citing works
Implementation of evidence-based foot screening in people with diabetes: A scoping review
HOUGHTON, J., Hynes, M. C., Roberts, N. W., van der Westhuizen, H., Dave, J. A., & Farmer, A. A. (2025) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2025.108972 · Cited by 4 · see citing works
In-Shoe Pressure Measurements in Diabetic Footwear Practice: Success Rate and Facilitators of and Barriers to Implementation
Zwaferink, J. B. J., Nollet, F., & Bus, S. A. (2024) · Sensors · doi:10.3390/s24061795 · Cited by 4 · see citing works
“Apart from this history of ulceration, the important ulcer risk factors include peripheral neuropathy, peripheral artery disease, foot deformity, amputation, and end-stage renal disease [2–5].”
Background
Novel Vibrating Foot Orthoses for Improving Tactile Sensation in Type 2 Diabetes With Peripheral Neuropathy
Thimabut, W., Thimabut, N., Peng, L., & Hou, Z. (2024) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2024.3435469 · Cited by 4 · see citing works
“As stated in a prior analysis of a clinical result [68], diabetics who are at risk of developing foot ulcers may presume that the VFO could help prevent foot ulcers and their recurrence.”
Background
Research progress on risk prediction models for the diabetic foot
Qi, H., Zhang, T., Hou, L., Li, Q., Huang, R., & Ma, L. (2025) · Acta Diabetologica · doi:10.1007/s00592-025-02505-3 · Cited by 5 · see citing works
Hotspots: Adherence in home foot temperature monitoring interventions for at‐risk feet with diabetes—A narrative review
Jones, P. J., Lavery, L. A., Davies, M. J., Webb, D. R., & Rowlands, A. V. (2023) · Diabetic Medicine · doi:10.1111/dme.15189 · Cited by 4 · see citing works
Evidence Mapping of Clinical Practice Guideline Recommendations for Self-Management Strategies of Diabetic Foot Ulcers
Shi, S., Yang, P., Liu, X., Li, Y., & Yang, C. H. (2025) · Advances in Wound Care · doi:10.1089/wound.2024.0276 · Cited by 3 · see citing works
Correcting the cause: Surgical offloading for healing and recurrence prevention in neuro-mechanical diabetic foot ulcers
Agarwal, P., Nema, M., Kukrele, R., & Sharma, D. (2026) · Tropical Doctor · doi:10.1177/00494755251414933 · Cited by 3 · see citing works
Development and validation of a new questionnaire for the assessment of patients with diabetic foot disease: The Diabetic Foot Questionnaire (DiaFootQ)
Ruiz‐Muñoz, M., Fernández-Torres, R., Formosa, C., Gatt, A., Pérez-Panero, A. J., Belloso, A. J. P., Martinez-Barrios, F.-J., & González‐Sánchez, M. (2024) · Primary care diabetes · doi:10.1016/j.pcd.2024.07.002 · Cited by 3 · see citing works
Decompressive Nerve Surgery Associated with Low Diabetic Foot Ulcer Rate and High-Risk Bias: A Systematic Review and Meta-Analysis
Louca, M., Meares, C., & Dusseldorp, J. R. (2024) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000011700 · Cited by 3 · see citing works
“28 In this systematic review and meta-analysis, we evaluated primarily the available clinical DNS studies that clearly report the new and recurrent DFU incidence following DNS for DSPN.”
Best practice offloading treatments for diabetic foot ulcer healing, remission, and better plans for the healing-remission transition
Lazzarini, P. A., & van Netten, J. J. (2025) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2025.01.012 · Cited by 3 · see citing works
Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population
Rojas-Torres, F., Infanzón-Talango, H., García-Ulloa, A. C., Hernández-Jiménez, S. C., & Rodríguez‐Reyes, G. (2024) · Endocrinología Diabetes y Nutrición (English ed ) · doi:10.1016/j.endien.2024.09.007 · Cited by 3 · see citing works
Impact of Podiatric Surveillance on Amputation Rates in Patients with Diabetes and Chronic Kidney Disease
Behme, S., Girgis, C., & Schmidt, B. M. (2025) · The International Journal of Lower Extremity Wounds · doi:10.1177/15347346251337862 · Cited by 2 · see citing works
Gait Profile Score and its correlation with clinical outcomes in individuals with diabetic neuropathy: A cross-sectional study with 102 patients
Ferreira, J. S. S. P., Cruvinel-Júnior, R. H., Duarte, M., & Sacco, I. D. C. N. (2025) · Gait & Posture · doi:10.1016/j.gaitpost.2025.07.328 · Cited by 2 · see citing works
Prevalence, Screening Practices and Risk Stratification for Diabetic Foot Complications in Primary Healthcare Clinics: A Cross-Sectional Study in Gauteng Province, South Africa
Ntuli, S. M. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22121794 · Cited by 2 · see citing works
Predictive effects of diabetes-related risk factors for falls in community-dwelling people with diabetic peripheral neuropathy based on a logistic regression model
Suda, E. Y., Sartor, C. D., Pássaro, A. D. C., Watari, R., Docko, E. Y., & Sacco, I. D. C. N. (2026) · PLoS ONE · doi:10.1371/journal.pone.0340262 · Cited by 2 · see citing works
Sub-calcaneal plantar fat pad assessment using dual-energy computed tomography: First experience in the diabetic foot
Mens, M. A., Fassaert, T. F., Homan, J. H., Busch‐Westbroek, T. E., Stufkens, S. A. S., Wellenberg, R. H. H., Streekstra, G. J., Bus, S. A., Nieuwdorp, M., & Maas, M. M. (2023) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2023.106126 · Cited by 2 · see citing works
The effects of the use of customized silicone digital orthoses on pre-ulcerative lesions and plantar pressure during walking in people with diabetic neuropathy: A study protocol for a randomized controlled trial
Lucoveis, M. D. L. S., Gamba, M. A., Silva, É. Q., Pinto, L. A. S., & Sacco, I. D. C. N. (2023) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2023.101247 · Cited by 2 · see citing works
“However, studies demonstrating the efficacy of silicone digital orthoses for preventing hyperkeratosis are still very limited and of low scientific quality [32,34].”
Background
Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population
Rojas-Torres, F., Infanzón-Talango, H., García-Ulloa, A. C., Hernández-Jiménez, S. C., & Rodríguez‐Reyes, G. (2024) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2024.05.008 · Cited by 2 · see citing works
Diabetes-related foot interventions to improve outcomes for Indigenous peoples in high-income countries: A scoping review
Garrett, M., Ihaka, B., Murphy, R., & Kenealy, T. W. (2024) · First Nations Health and Wellbeing - The Lowitja Journal · doi:10.1016/j.fnhli.2024.100031 · Cited by 1 · see citing works
New-Design Orthotic Footwear for Tactile Stimulation: A Pilot Study on Two Distinct Stimuli
Thimabut, W., Thimabut, N., Peng, L., & Hou, Z. (2024) · International Joint Conference on Neural Networks (IJCNN) · doi:10.1109/ijcnn60899.2024.10650953 · Cited by 1 · see citing works
Can artificial intelligence and wearable technologies transform diabetes foot health?
Kong, W. M., & Saif, F. (2025) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000942 · Cited by 2 · see citing works
The impact of obesity-related anthropometric indices on diabetic foot ulcer and mortality: analysis of a nationally representative sample
Zhang, Z., Zhou, L., Xu, Y., Yao, L., Ma, T., & Pan, X. (2025) · HORMONES · doi:10.1007/s42000-025-00745-0 · Cited by 1 · see citing works
Nanotherapeutics for Diabetic Foot Ulcer and Wound Healing with Metal Nanobiomaterials
Mathew, S. S., Joshy, V. A., & Sharan, L. (2026) · Nanotechnology in the life sciences · doi:10.1007/978-3-032-08576-4_12 · Cited by 1 · see citing works
Device-dependent variability of plantar pressure thresholds: Consequences for clinical decision-making in diabetic foot care
Chockalingam, N., Giacomozzi, C., Healy, A., Monteiro, R. L., Ferreira, J. S. S. P., & Sacco, I. D. C. N. (2026) · Gait & Posture · doi:10.1016/j.gaitpost.2026.110128 · Cited by 1 · see citing works
From pathophysiology to therapy: molecular mechanisms of stem cell and extracellular vesicle-mediated repair in diabetic peripheral neuropathy
Zhou, J., Yu, Y., Song, L., Qian, P., Zhao, M., Ding, F. W. X., Lian, X., & Yu, M. (2026) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2026.1854350 · Cited by 1 · see citing works
Science or Tradition? Strength of Evidence for Footwear Fit Guidelines From Peer‐Reviewed Studies of People With Diabetes—A Foot in Diabetes UK Systematic Review
Jones, P. J., Vlachopoulos, C., Branthwaite, H. R., Gohil, K., Cassidy, R., Morriss-Roberts, C., Pankhurst, C., & Hill, A. D. (2026) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70189 · Cited by 1 · see citing works
Exploring diabetic foot screening programs with integrated consolidated framework for implementation: Rapid review protocol
Blanchette, V., Fakhfakh, M., Andoulsi, Y., Brousseau‐Foley, M., Pallin, J. A., Buckley, C. M., Drudi, L. M., de Mestral, C., Kuhnke, J. L., & McIntosh, C. D. (2025) · HRB Open Research · doi:10.12688/hrbopenres.14119.1
“…the individual level, its population-based implementation is more complex at the organizational and societal levels, considering various factors, such as the rising number of individuals with diabetes, local contexts, resource availability, intervention, and organizational heterogeneity 2,24,25 .”
Influential
Meta-analyses: how can we ensure that the hole is not greater than the sum of the parts?
Kieran, K. (2023) · Pediatric Nephrology · doi:10.1007/s00467-023-06118-2
“It is by no means unusual that systematic reviews and meta-analyses report on relatively few manuscripts: a review of recent publications in PubMed finds 103 studies included in one systematic review [6], 25 in another [7], and 19 in a third [8].”
Pemeriksaan Kaki Diabetes di Wisma Caring Sejahtera Depok Jawa Barat
Bahri, K., Hidayat, R., Fadli, M., Anggara, H., Ardi, R. Q., Nurmalasari, E., Wulandari, M. F., Susanto, E., Putri, M. M., & Hidayat, R. (2023) · JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) · doi:10.33024/jkpm.v6i9.11294
Diabetic foot: Footwear in a management programme
Paavana, T., Crooks, S. A., & Hariharan, K. (2023) · International Journal of Orthopaedic Surgery · doi:10.4103/ijors.ijors_23_23
Lower limb gait joint coordination variability in people with diabetes-related foot ulcers
Crowther, R. G., Robertson, A., Fernando, M. E., Lazzarini, P. A., Sangla, K. S., & Golledge, J. (2024) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2024.106382
Antiendotoxin immunity and neutrophil activity in purulent-necrotic inflammation of the feet against the background of diabetes
Валерьевич, П. А., Мидхатович, З. А., Dener, E. H., Abdirakhmanova, E. I., & Basarkina, D. M. (2025) · Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) · doi:10.21518/akh2025-034
After the Foot has Healed
Mendeszoon, M. J., Mendeszoon, E. R., & Iosue, H. (2025) · Clinics in Podiatric Medicine and Surgery · doi:10.1016/j.cpm.2025.06.010
Long-Term Effect of a Structured Educational Program on Diabetic Foot on Major Adverse Limb and Cardiovascular Events in People with Type 1 Diabetes
Alonso-Carril, N., Valverde, M., Barceló, J. A., Pascual, L. G., Barahona, M. J., Rodriguez-Rodríguez, S., Berrocal, B., Quirós, C., Simó-Servat, A., Puig-Jové, C., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14228149
“19) in favor of structured education, although the results did not reach statistical significance [19].”
Influential
What Footwear Do People with Diabetes Mellitus Use? A Narrative Review
Carral-Sota, R., Reina‐Bueno, M., Vázquez-Bautista, M. D. C., Benhamú-Benhamú, S., & Palomo-Toucedo, I. C. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14238529
Exploring Experiences and Perspectives of Prescribed Foot Orthoses in People With Diabetes
Sedighi, N., Hendry, G., Pallari, J., & Barn, R. (2026) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70130
Exploring the societal cost of major lower limb amputations in patients with type 2 diabetes – A nation-wide and matched register study using difference in difference analysis
Fredslund, E. K., Londero, L. S., & Buhl, C. S. (2026) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2026.109310
Effects of non-pharmacological interventions on ulcer healing in patients with diabetic foot: a network meta-analysis of randomized controlled trials
Zheng, J., Xie, D., Wu, M., Xu, H., Lin, S., & Dong, L. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1811595
Analysis on AI-Powered Smart Footwear for Early Foot Ulcer Detection and Prevention
Thanikachalam, Y., Malayappan, B., Arulmozhi, P., Dhanasri, K., Kayalvizhi, S., & Mithra, S. (2026) · International Conference on Visual Analytics and Data Visualization (ICVADV) · doi:10.1109/icvadv67766.2026.11469798
Einlagen: Therapieelement nach Verletzungen und bei Erkrankungen
Laube, W. (2026) · Springer eBooks · doi:10.1007/978-3-662-72826-0_16
Preventive strategies for diabetic foot ulcer recurrence: a systematic review and meta-analysis of randomized controlled trials
Miranda, C., & ROS, R. D. (2026) · Gazzetta Medica Italiana Archivio per le Scienze Mediche · doi:10.23736/s0393-3660.26.06444-2
Healthcare Provider Knowledge and Utilization of the Medicare Therapeutic Shoe Benefit
Kurth, C. S., & Crews, R. T. (2026) · Journal of the American Podiatric Medical Association · doi:10.3390/japma116030032
Offloading orthotic insoles on healing of diabetic foot ulcers: a protocol for systematic review and meta-analysis
Jamil, A., & Javaid, H. B. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-113984
An Integrated Personalized Multimodal Intervention Improves Adherence to Wearing Custom-Made Footwear in People With Diabetes at High Foot Ulcer Risk: A Multicenter Randomized Controlled Trial (DIASSIST)
Vossen, L. E., van Netten, J. J., Hulshof, C. M., Jelsma, N., Slootman, A., Merkx, M. J. M., & Bus, S. A. (2026) · Diabetes Care · doi:10.2337/dc25-3113
Treating an unresponsive diabetic foot ulcer with cold atmospheric plasma, maggot therapy and alginate dressing: a case report
Faraji, N., Goli, R., Parizad, N., Ghoushchi, R. A., Hassanpour, A., & Mohammadpour, Y. (2026) · Journal of Wound Care · doi:10.12968/jowc.2023.0238
Safety and Efficacy of Flexor Tenotomy for Treatment of Digital Ulcerations and Pre-Ulcerative Lesions
Skolnik, J., Speis, D. B., Sciotti, N. R., Hossain, M., Mukhtar, Z., Sharma, A., Kigner, S., Rose-Sauld, S., & Landsman, A. S. (2026) · Foot & Ankle Specialist · doi:10.1177/19386400261456904
Multifactorial strategies for the prevention of the risks of ulceration in patients affected by diabetic foot: a no-profit, multicentre, clinical trial protocol
Leardini, A., Pagotto, U., Paola, L. D., Leopardi, M. P., Belvedere, C., Ortolani, M., Platano, D., Caravaggi, P., Rogati, G., Sacchetti, G., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-112163
FATORES ASSOCIADOS ÀS PRÁTICAS DE AUTOCUIDADO COM OS PÉS EM PESSOAS COM DIABETES MELLITUS: ESTUDO TRANSVERSAL
Medeiros, L. L. D. M., ARAÚJO, D. L., Félix, L. G., de Lima, M. P. D., & Araújo, K. M. D. F. A. (2026) · Enfermagem em Foco · doi:10.21675/2357-707x.2026.v17.e-2026034
Therapeutic footwear in patients with diabetes: a position statement from the Italian diabetic foot study group
Giurato, L., Scatena, A., Giglio, R. D., Murdolo, G., Mastinu, M., Gicchino, M., Gabriele, D., Vermigli, C., Panunzi, A., Uccioli, L., et al. (2026) · Acta Diabetologica · doi:10.1007/s00592-026-02722-4
FACTORES ASOCIADOS A LAS PRÁCTICAS DE AUTOCUIDADO DE LOS PIES EN PERSONAS CON DIABETES MELLITUS: ESTUDIO TRANSVERSAL
Medeiros, L. L. D. M., ARAÚJO, D. L., Félix, L. G., de Lima, M. P. D., & Araújo, K. M. D. F. A. (2026) · Enfermagem em Foco · doi:10.21675/2357-707x.2026.v17.e-2026034e
FACTORS ASSOCIATED WITH ADHERENCE TO FOOT SELF-CARE IN PEOPLE WITH DIABETES MELLITUS: A CROSS-SECTIONAL STUDY
Medeiros, L. L. D. M., ARAÚJO, D. L., Félix, L. G., de Lima, M. P. D., & Araújo, K. M. D. F. A. (2026) · Enfermagem em Foco · doi:10.21675/2357-707x.2026.v17.e-2026034i
Discomfort Avoidance and Desire for Normality Are Decision‐Making Drivers of Footwear Choice in Underserved Communities at Risk of Diabetic Foot Ulcer
Anil, K., Sharma, N., Patel, S., Bailey, J., Smith, C., Abey, S., Allcock, K., Collings, R., & Paton, J. S. (2026) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70186 · Cited by 1 · see citing works
Comparing the Effectiveness of Different Types of Orthoses in Preventing Diabetic Foot Ulcer Recurrence: A Systematic Review of Randomized Clinical Trials
Amini, B., Salehi‐Pourmehr, H., & Rad, S. G. (2026) · Journal of Foot and Ankle Research · doi:10.1002/jfa2.70192
Feet Health of Diabetic Hemodialysis Patients and Type 2 DM Patients: A Cross-Sectional and Comparative Study
ERAYDIN, Ş. (2026) · Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi · doi:10.38108/ouhcd.1570503
Stakeholder Perspectives on Barriers and Facilitators to Implementing Nurse‐Led Diabetic Plantar Pressure Assessment and Management: A Multicentre Group Concept Mapping Study
Luo, J., Chen, S., Qi, X., Peng, K., & Zhang, X. (2026) · Journal of Clinical Nursing · doi:10.1111/jocn.70567
From ulcer to remission: podiatric and technological strategies to prevent ulceration and amputation in the diabetic foot
Moya, M. O. C., Cabrera, L. H., Ramírez, L. M., González, M. A. G., Pazos, A. A., Feitó, L. B. F., & Pernas, G. G. (2026) · SAP Podiatry · doi:10.62486/pod2026160
Intensive Integrated Prevention Protocol Reduces the Risk of Ulcer Recurrence in Patients with Previous Diabetic Foot Ulcer
Bonanni, F. R., Giurato, L., Uccioli, L., Luca, M. D., Lorusso, G., Adriani, E., Proietti, L., Bergesi, L., Zimbile, A., Bellia, A., et al. (2026) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2026.105036
Research Progress in Traditional Chinese Medicine Interventions for the Pre-Ulcerative Stage of Diabetes-Related Foot Disease Based on the Theory of Blood Stasis Obstructing the Vessels
何, 婉. (2026) · Journal of Clinical Personalized Medicine · doi:10.12677/jcpm.2026.55384

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review
van Netten, J. J., Price, P., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Jubiz, Y., Bus, S. A., & on behalf of the International Working Group on the Diabetic Foot (IWGDF) (2015) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2701 · Cited by 421 · see citing works
Preventing foot ulceration in diabetes: systematic review and meta-analyses of RCT data
Crawford, F., Nicolson, D. J., Amanna, A. E., Martin, A., Gupta, S., Leese, G., Heggie, R., Chappell, F. M., & McIntosh, H. H. (2019) · Diabetologia · doi:10.1007/s00125-019-05020-7 · Cited by 73 · see citing works
Prevention of foot ulcers recurrence in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials for the development of the italian guidelines for the treatment of diabetic foot syndrome
ROS, R. D., Volpe, A., Bordieri, C., Tramonta, R., Bernetti, A., Scatena, A., Monge, L., Ragghianti, B., Silverii, G. A., Uccioli, L., et al. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02353-7 · Cited by 13 · see citing works
Effectiveness of foot temperature monitoring for preventing ulcers in individuals with diabetes: an umbrella review.
de Araújo, A. L., Garcês, T. S., Negreiros, F. D. D. S., Florêncio, R. S., Cestari, V. R. F., Mattos, S. M., Araújo, W. C. O., Freire, K. A., Fabricio, S. E. D. P., Damasceno, L. L. V., et al. (2026) · PubMed · doi:10.11124/jbies-25-00538
From ulcer to remission: podiatric and technological strategies to prevent ulceration and amputation in the diabetic foot
Moya, M. O. C., Cabrera, L. H., Ramírez, L. M., González, M. A. G., Pazos, A. A., Feitó, L. B. F., & Pernas, G. G. (2026) · SAP Podiatry · doi:10.62486/pod2026160

Authors: van Netten, J. J., Raspovic, A., Lavery, L. A., Monteiro‐Soares, M., Paton, J., Rasmussen, A., Sacco, I. C. N., & Bus, S. A.
Affiliations: Department of Rehabilitation Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
La Trobe University (AU)
The University of Texas Southwestern Medical Center (US)
Universidade do Porto (PT)
University of Plymouth (GB)
Steno Diabetes Center Copenhagen (DK)
Physical Therapy Speech and Occupational Therapy Department School of Medicine University of São Paulo São Paulo Brazil
Amsterdam UMC Location University of Amsterdam (NL)
ORCID: van Netten, Jaap J.
Raspovic, Anita
Lavery, Lawrence A.
Monteiro‐Soares, Matilde
Paton, Joanne
Bus, Sicco A.
Venue: Diabetes/Metabolism Research and Reviews
Publisher: Wiley
Published: 2023-05-27
Volume: 40
Issue: 3
Pages: e3652-e3652
ISSN: 1520-7552 (ISSN-L)
1520-7560
DOI: 10.1002/dmrr.3652
OpenAlex: W4378567045
Cited by: 89
References: 158
Citations by year: 2026: 29 · 2025: 24 · 2024: 21 · 2023: 15
FWCI: 3.20
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Diabetes/Metabolism Research and Reviews (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion, other-oa)
PEARL (University of Plymouth) (submittedVersion, cc-by-nc-nd)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
Figshare (submittedVersion, cc-by-nc-nd)
PEARL (University of Plymouth) (submittedVersion)
La Trobe University
Funders: Amsterdam University Medical Centers
Novo Nordisk Fonden (NNF16SA0024126-3)
Fundação para a Ciência e a Tecnologia
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
Keywords: foot ulcer prevention, diabetes mellitus, diabetic foot, temperature monitoring, insoles, quality of evidence, cost-effectiveness, quality of life, health care utilization, patient-reported outcomes
MeSH terms: Humans, Risk Factors, Diabetic Foot

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Prevention of foot ulcers in persons with diabetes at risk of ulceration: A systematic review and meta‐analysis

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