Effects of Special Therapeutic Footwear on the Prevention of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Open accessAbstract
Objective. To reduce diabetic foot ulcer (DFU) occurrence or recurrence, diabetic therapeutic footwear is widely recommended in clinical practice for at-risk patients. However, the effectiveness of therapeutic footwear is controversial. Thus, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine whether special therapeutic footwear could reduce the incidence of DFU. Method. We systematically searched multiple electronic databases (Medline, EMBASE, and EMB databases) to identify eligible studies published from inception to June 11, 2021. The database search, quality assessment, and data extraction were independently performed by two reviewers. Efficacy (i.e., incidence of DFU) was explored using the R’meta’ package (version 4.15-1). To obtain more robust results, the random-effects model and the Hartung-Knapp-Sidik-Jonkman method were selected to assess pooled data. Metaregression analysis and sensitivity analysis were performed to explore heterogeneity, and publication bias was assessed by a visual inspection of funnel plots and the AS-Thompson test. Results. Eight RCTs with a total of 1,587 participants were identified from the search strategy. Compared with conventional footwear, special therapeutic footwear significantly reduced the incidence of DFU (RR 0.49; 95% CI, 0.28-0.84), with no evidence of publication bias ( P = 0.69 ). Unexpectedly, the effectiveness of special therapeutic footwear had a reverse correlation with the intervention time ( coefficient = 0.085 , P < 0.05 ) in the metaregression analysis. Conclusion. Special therapeutic footwear with offloading properties is effective in reducing the incidence of DFU. However, the effect may decrease gradually over time. Despite undefined reasons, the optimal utility time and renewal frequency of special therapeutic footwear should be considered.
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Therapeutic footwear and foot temperature monitoring devices significantly reduce the incidence of diabetic foot ulcers.
“Regarding complication prevention, therapeutic footwear and foot temperature monitoring devices have been shown to significantly reduce the incidence of diabetic foot ulcers [40, 41]”
From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [40]
The Results (§3.4; page not supplied) report that special therapeutic footwear significantly reduced diabetic foot ulceration compared with conventional footwear. The cited paper does not establish the claim about foot temperature monitoring devices, so it supports only the footwear part of the sentence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTherapeutic offloading footwear significantly reduced foot ulcer risk.
“Two reviews [40, 41] demonstrated that therapeutic offloading footwear and home foot‐temperature monitoring significantly reduced foot ulcer risk, with evidence quality rated as low in both cases.”
From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [40]
Among high-risk populations for diabetic foot complications, therapeutic footwear and foot temperature monitoring devices reduce ulcer risk by 51% and 49%, respectively.
“Among high‐risk populations for diabetic foot complications, therapeutic footwear and foot temperature monitoring devices reduce ulcer risk by 51% and 49%, respectively [40, 41], warranting broader adoption.”
From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [40]
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Talaiti, M., Liao, X., Abulimiti, N., Zeng, M., & Wang, Y. (2026) · Journal of Diabetes Research · doi:10.1155/jdr/1464982
- Authors
- Luo, B., Cai, Y., Chen, D., Wang, C., Huang, H., Chen, L., Gao, Y., & Ran, X.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Gao, Yun
- Ran, Xingwu
- Venue
- Journal of Diabetes Research
- Publisher
- Wiley
- Published
- 2022-09-26
- Volume
- 2022
- Pages
- 1-10
- ISSN
- 2314-6745 (ISSN-L)
- 2314-6753
- PMC
- PMC9530919
- OpenAlex
- W4297103637
- Cited by
- 27
- References
- 48
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 4 · 2023: 4 · 2022: 1
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Diabetes Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Youth Science Fund Project of National Natural Science Foundation of China (81700087, 2017-CY02-00028-GX, 2020YFS0193, 2021JDKP0044, 2021YFS0014, 2022YFS0308, ZYGD18025)
- Science and Technology Bureau of Chengdu City (81700087, 2017-CY02-00028-GX, 2020YFS0193, 2021JDKP0044, 2021YFS0014, 2022YFS0308, ZYGD18025)
- Science and Technology Bureau of Sichuan Province (81700087, 2017-CY02-00028-GX, 2020YFS0193, 2021JDKP0044, 2021YFS0014, 2022YFS0308, ZYGD18025)
- West China Hospital, Sichuan University (81700087, 2017-CY02-00028-GX, 2020YFS0193, 2021JDKP0044, 2021YFS0014, 2022YFS0308, ZYGD18025)
- 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
- diabetic foot ulcer, therapeutic footwear, offloading, diabetic foot ulcer prevention, ulcer recurrence, intervention duration
- MeSH terms
- Diabetes Mellitus, Humans, Incidence, Randomized Controlled Trials as Topic, Diabetic Foot
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