Digital Health: 'Socksess' - Smart Sensing Socks For Monitoring Diabetic Feet And Preventing Ulceration

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Background: Diabetes damages nerves in the feet, known as 'neuropathy', affecting 1 in every 2 people with diabetes. This can cause people to lose all sensation and feeling in their feet and means that people with diabetes and neuropathy put high pressure on their feet without knowing. With nerves that are damaged, people do not have any natural way of knowing how much high pressure they put on their feet and can literally wear a hole in the bottom of their foot, known as a diabetic foot ulcer. Although it can start off as a small hole in the foot, a diabetic foot ulcer can become infected and someone may need to have part of their foot or leg removed (amputated) to stop the infection and save their life. In the UK, there are over 120 amputations every week because of a diabetic foot ulcer. Our Aim: The 'Socksess' project aims to create new technology to help make people with diabetes aware of how much pressure they put on their feet and prevent ulcers. We will develop and test a new 'smart-sensing sock' that will 'reconnect people with their feet' and help prevent ulcers and amputations. Our approach: We will do this through 'co-design' - working closely with people who have experience of living with diabetes, their families and healthcare professionals, to develop the technology, make design choices and publicise the work. We will also be supported by a panel of international experts in diabetic foot care and industry partners who will help guide long-term development, clinical evaluation and commercialisation.Planned Work: the project involves four main areas of work:1. Understanding the needs and preferences of people with diabetes, their carers and clinicians, to co-design a smart-sensing sock that will suit the lives of people with diabetes and help them to protect their feet.2. Developing and testing small sensors built into stretchable sock fabric for measuring foot loading in two ways: i) directly against the foot (pressure) and ii) side-to-side (shear stress).3. Testing prototypes of the smart-sensing socks in a group of people with diabetes who are at high-risk for getting an ulcer, and using this new technology to better understand how foot loading affects ulcer risk at specific points on the foot.4. Developing an easy to use feedback system: a way of letting people know when the loading on their feet might be too high and begin to cause a foot ulcer. This will be co-designed (as in 1 above) to make it as easy as possible for everyone to use.Working towards this goal, we will develop a number of advances:- new sensing technology for measuring pressure and shear stress (side-to-side foot loading)- integration of sensing into a 'smart-sock' measuring across the whole foot- new data from our clinical studies providing better understanding of foot loading in diabetes- Easy to use feedback system designed to 'reconnect people with their feet' and help them better monitor their foot healthImpact: This project will help address the global issue of diabetic foot ulcers and amputations that affect the lives of millions of people living with diabetes by developing a much-needed digital health monitoring solution. Through its ease of use, this technology will help to support a range of people with diabetes to better manage their foot health and 'reconnect with their feet', improving quality of life and preventing diabetic foot ulcers and amputations. The work will also bring benefits beyond use in diabetic foot health. It could also be used to assess and help manage conditions affecting mobility (e.g. arthritis) by monitoring and providing feedback on walking and balance. The technology could also help prevent bed sores on the feet and backs of the legs when people are lying in hospital beds for long periods of time. These smart-sensing socks could also help with better fitting of new footwear.