An integrative review of therapeutic footwear for neuropathic foot due to diabetes mellitus

Novel 3D-printed foot orthoses with variable hardness: A comfort comparison to traditional orthoses

Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D printed orthosis and fabrication method that utilizes custom architectures to produce variable-hardness regions. These novel orthoses are compared to traditionally fabricated orthoses during a 2-week user comfort study. Twenty (n = 20) male volunteers underwent orthotic fitting for both traditional and 3D-printed foot orthoses prior to engaging in treadmill walking trials and 2 weeks of wear. Each participant undertook a regional comfort, acceptance, and comparison analysis of the orthoses at three time points throughout the study (0, 1, and 2 weeks). Both the 3D-printed and the traditionally fabricated foot orthoses demonstrated statistically significant increases in comfort when compared to the factory fabricated shoe insert. Additionally, the two orthosis groups were not significantly different from each other in comfort rankings both regionally and overall at any time point. The similar comfort achieved by the 3D-printed orthosis to the traditionally fabricated orthosis after 7 days and 14 days emphasizes the potential of the future use of the more reproducible and adaptable 3D-printed orthosis manufacturing methodology.

Dietary approach for management of Type-2 diabetes: An overview of glycemic indices of commonly consumed foods in Nigeria

BACKGROUND AND AIMS

The global prevalence of diabetes mellitus is on the increase, and Africa, particularly Nigeria is not left out. The management of the disease using a diabetes drug is often a hard choice to make for many. Information on the right food is inevitably important, as eating some type of food and avoiding or limiting some could help manage diabetes. Therefore, this study investigated glycemic indices of commonly consumed staples in Nigeria.

METHODS

Databases like PubMed, ScienceDirect, Google scholars, African journal online and Nigerian journal online was used to search for relevant information. Keywords like: nutritional management, diabetes in Nigeria, quality of life, prevalence, glycemic index, foods and diabetes, macronutrients and diabetes, were used separately or combined to obtain the relevant information.

RESULTS

Findings from literature search revealed that the glycemic indices of many staples such as Rice dough (Tuwo shinkafa), maize dough (tuwo masara), millet dough (tuwo gero), yam/cassava flour (amala), pounded fermented cassava (fufu, akpu), garri (eba), african salad (abacha), pounded yam (ema, iyan), rice (shinkafa, isesi), beans (wake, ewa, Agwa), and plantain (Ojoko, Ogbagba, Ogede) that are consumed in different parts of Nigeria are high (75.0%-97.0%). However, available information revealed that less commonly consumed foods like, Maize pudding (igbangwu), dried beef floss (dambu), Fonio (acha), bean pudding (moi-moi) and Tom Brownvita (Turnbrown) exhibit lower glycemic indices (14.1%-52.9%).

CONCLUSIONS

This study revealed the few among several local foods in Nigeria that are low in glycemic indices that could be useful in the management of Type-2 diabetes. However, these foods may require further certification by appropriate authorities and agencies to enable persons with diabetes, particularly in Nigeria make informed choices on the right food to consume.

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

To evaluate the ability of high-risk patients with diabetes in remission to select proper therapeutic footwear (TF) and validate a novel 3D foot scanner app for selecting the proper fitting TF. We conducted a randomized and controlled clinical trial enrolling 30 patients with a previously healed diabetic foot ulcer carried out in a specialized diabetic foot unit between November 2021 and June 2022. All patients were recommended to TF with extra depth volume and rocker sole. The control group could acquire the TF size and model according to aesthetic preferences, while the experimental group had to acquire a specific size and model according to the result of a novel mobile app 3D feet scan. TF was recommended to change when the ill-fitting reasons were found, excessive length or tightness or compromise with toes. The primary outcome measure was the requirement of TF change after prescription because of ill-fitting. A total of seven patients required TF change, one of them (6.7%) in the experimental group and six patients (40%) in the control group (p = .031, 95% CI [0.011-1.04]). Reasons for ill-fitting were as follows: four patients due to excessive length and three patients due to toe compromise. The relative risk reduction for the need to change the TF via the foot scan compared to the control group was 83%, and the number needed to treat was 20. High-risk patients with diabetes tend to select TF with inadequate fitting (length or capacity), and they should be guided hand to hand to acquire proper TF.

Fit for purpose? Footwear for patients with and without diabetic peripheral neuropathy: A cross-sectional study

AIM

This paper determines whether patients with and without Diabetic Peripheral Neuropathy use suitable footwear, taking into account that these persons are subject to a significant loss of sensitivity in the feet.

METHODS

Cross-sectional observational study was conducted of 108 participants with diabetes mellitus. Inclusion criteria were at least five years' progression of diabetes, the ability to walk unaided and no distal amputation of the foot. The presence of DPN was evaluated according to the criteria of the International Working Group on the Diabetic Foot. Foot length was measured using a Brannock® device and internal shoe length was determined using a CEGI® pedometer.

RESULTS

In relation to adjustment, 21.6% of the shoes examined had no type of closure. The most common form of closure was laces, which were used in 32.4% of the shoes. 92.5% of footwear had internal seams. No significant relationship was found between the presence or otherwise of DPN and the use of appropriate shoe closure (p = 0.304), recommended heel height (p = 0.18), leather material (p = 0.77) and absence of internal seams (p = 0.759).

CONCLUSIONS

The majority of our participants living with DPN do not wear fitting shoes. Therefore, it is advisable to evaluate their use of footwear, both in primary health care and in podiatry clinics, to forestall potential complications.

The Frequency and Risk Factors of Diabetic Foot Ulcer Recurrence Among Jordanian Patients with Diabetes

BACKGROUND

Diabetic foot is a major public health problem and their complications are an imperative cause of morbidity and mortality in diabetes.

OBJECTIVE

To evaluate the rate of recurrence of foot ulcers post two years of follow-up, including the associated risk factors in the patients attending the diabetic foot clinic at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG), Amman, Jordan.

METHODS

A historical cohort design was adopted for the patients who presented for the first time to the diabetic foot clinic at the NCDEG. Every patient who came to the clinic was reviewed by using his or her medical files with respect to diabetic foot-related complaints. Patients were classified under four categories: (1) Recurrent foot ulcers (2) chronic foot ulcer (3) free of recurrence, and (4) no foot ulcers. Among the four groups, group 1 (recurrent foot ulcers, n=76) and group 3 (free of recurrence, n=54) were included for the analysis.

RESULTS

Among the 141 patients who presented to the diabetic foot clinic during the two-year study period, 76 (53.9%) of them experienced ulcer recurrences, 54 (38.3%) were recurrence-free, and 11 (7.8%) had chronic ulceration. The two-year recurrence rate was 58.5%. The presence of deformity and osteomyelitis were the statistically significant independent risk factors for recurrent foot ulceration.

CONCLUSION

This study of recurrences was clearly related to the type and complications of the ulcers rather than to the other variables. Recurrent foot ulceration is linked to the presence of osteomyelitis and/or deformities.